ANTIRETROVIRAL DRUGS IN THE SUS: A LITERATURE REVIEW ON ADHERENCE TO HIV TREATMENT

Abstract

hiv infection continues to be a global public health challenge, affecting millions since the 1980s. Advances in antiretroviral therapies have transformed hiv from a fatal condition into a manageable chronic disease. In 2023, approximately 39.9 million people were living with the virus, and 1.3 million new infections were reported. In brazil, the unified health system (sistema único de saúde - sus) guarantees free access to treatment, but patient adherence remains a critical challenge. Objective: this study aims to investigate the factors influencing adherence to antiretroviral treatment, which are essential for improving quality of life and preventing serious complications. Methodology: this is a narrative literature review study on adherence to antiretroviral treatment (tarv) in the context of the unified health system (sus) in brazil. Scientific databases such as pubmed, scielo, and lilacs were researched using descriptors and boolean operators to identify relevant studies. Inclusion criteria encompassed articles published between 2014 and 2024, in portuguese, english, and spanish, focusing on free full-text articles. The selection process ensured the relevance and quality of the analyzed articles. The bibliographic search resulted in the identification of 177 studies across the pubmed, scielo, and lilacs databases. Among these, 31 articles were selected for in-depth analysis of adherence to antiretroviral treatment in the context of the unified health system (sus). Results: after screening, 18 studies were chosen for detailed reading, organized into two thematic categories: “access and availability of medications in the sus” and “adverse reactions to medications.” The first category highlights the fundamental role of the sus in the distribution and monitoring of antiretrovirals, which is essential to ensuring patient adherence and the quality of life of people living with hiv. The second category examines how the side effects of medications negatively impact the continuity of treatment. The findings demonstrate the effectiveness of sus’s universal access policies to tarv, which have significantly contributed to improving the quality of life for patients, despite challenges related to adverse reactions and the necessary support. Conclusion: this study analyzed the complexity of adherence to antiretroviral treatment, identifying factors that influence the continuity of medication use. The centralization of antiretroviral distribution by sus was a positive aspect, ensuring access and regularity in dispensing. However, challenges such as side effects, cultural and socioeconomic barriers negatively affect adherence. Treatment interruptions are often linked to negative perceptions of adverse effects.