DETERMINANT FACTORS OF THE LACK OF ADHERENCE TO ANTIRETROVIRAL TREATMENT IN WOMEN CARRIERS OF THE HUMAN IMMUNODEFICIENCY VIRUS, ATTENDED AT THE HOSPITAL OF INFECTOLOGY “DR. JOSÉ DANIEL RODRÍGUEZ MARIDUEÑA” IN THE CITY OF GUAYAQUI

Abstract

INTRODUCTION: Few studies examine the conditioning factors of non-adherence to antiretroviral (ARV) treatment in the context of vulnerability in women carriers of the human immunodeficiency virus (HIV), many of which enhance gender inequality and have repercussions on the clinical, emotional, and socioeconomic evolution of this group. OBJECTIVE: To identify conditioning factors for the lack of therapeutic adherence to ARVs in women with HIV at the Hospital of Infectology José Daniel Rodríguez Maridueña (HIDJDRM) in the city of Guayaquil-Ecuador. METHOD: A descriptive, cross-sectional study with a qualitative approach was conducted from October 2021 to March 2022, in 85 HIV carrier women on ARV treatment between 20 and 50 years of age enrolled in the HIJDRM. A questionnaire was designed and applied with socio-economic-educational-cultural-quality of life information and demographic data related to the CD4 lymphocyte curve and HIV viral load; patients were classified into two groups: Group 1 “Adherent” and Group 2 “Non-adherent”. RESULTS: 45% (n=38) of the women studied belonged to the “non-adherent” category, factors such as mood disorders, polypharmacy, family burden, poverty, discrimination, and social exclusion were present in 100% (n= 38) of the “Non-adherent” cases, while low cognitive development, economic dependence, physical abuse, and problematic substance use were identified in 34% (n=13) of them. CONCLUSIONS: Gender inequity recognized through various forms of discrimination such as the feminization of poverty, traditional practices of abuse of women and girls, lack of access to education and health promotion, and overload of family responsibilities, among others, are related to the lack of adherence to ARV treatment in the female HIV-positive population attended at HIJDRM.