HIV/AIDS patients adherence to antiretroviral therapy and the impact of the use of psychoactive substances

Objective: Describe the profile of the HIV/AIDS patients who use psychoactive substances; relate the use of psychoactive substances and Antiretroviral Therapy (ART) to non-adherence; and identify the main barriers for non-adherence. Methods: A cross-sectional study in a population of HIV/AIDS patients under ART prescription. Non-adherence to ART was considered when the patients presented a viral load higher than 40 copies per mL. The use of psychoactive substances was evaluated by Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Results: From 320 HIV/AIDS patients analyzed, 18.8% were not adhering to ART, 25.8% used alcohol, 21.7% smoked and 29.7% used some illicit psychoactive substance. The barriers were: high number of pills to be taken; fear that other people may know they are sick; difficulty of taking so many pills (if they do not feel sick); and they do not believe in the efficacy of the treatment (would rather try alternative treatments). Conclusion: Patients under higher risk are not white and young, from lower social classes, and use psychoactive substances. Strategies should focus on the promotion of adherence considering the barriers reported.