Lucy D. Lazóriga-Sandoval’s research while affiliated with National Institute of Health of Peru and other places

Background Indigenous communities in Peru has been historically affected by high mortality rates attributable to HIV-AIDS infection, associated with a low access to health services, and socio-cultural barriers. In this context, the study aimed to describe factors associated with antiretroviral treatment adherence in people from Awajun and Wampis indigenous communities, living with HIV-AIDS in a Peruvian Amazonian region. Methods A cross-sectional study was completed with a consecutive sample of people from indigenous communities (Awajun or Wampis) living with HIV, who were receiving antiretroviral treatment for at least the last three months. Participants were recruited between October 1 and December 30, 2021, from four districts of Bagua and Condorcanqui provinces in the Amazonian region. An ad-hoc questionnaire was used to collect information about demographic, economic, and socio-cultural factors and access to health services. The Simplified Medication Adherence Questionnaire (SMAQ) was used to evaluate adherence to antiretroviral therapy. Multivariate logistic regression analysis with backward stepwise was performed to explore factors that might influence adherence. Results Of the 208 participants, 28.8% reported complete adherence to antiretroviral treatment. The multivariate logistic regression showed that occupation (aPR: 1.86; 95%CI 1.15–3.02), economic income (aPR: 0.64; 95%CI 0.41–0.99), and adverse reactions to antiretroviral therapy (aPR: 0.36; 95%CI 0.18–0.70) were related to complete adherence to medication. Conclusion Only a third of participants reported complete adherence to antiretroviral therapy. Factors associated with adherence to antiretroviral medication were related to socioeconomic conditions and adverse reactions to the therapeutic scheme. Interventions to improve adherence in indigenous people living with HIV should consider these factors in order to develop effective implementation strategies.

Background: Indigenous communities in Peru has been historically affected by high mortality rates attributable to HIV-AIDS infection, associated with a low access to health services, and socio-cultural barriers. In this context, the study aimed to describe factors associated with antiretroviral treatment adherence in people from awajun and wampis indigenous communities, living with HIV-AIDS in a peruvian amazonian region. Methods. A cross-sectional study, which was completed in a consecutive sample of people from indigenous communities (awajun or wampis) living with HIV, who are received antiretroviral treatment at least on the last three months. Participants were recruited between October 1 and December 30, 2021, from four districts of Bagua and Condorcanqui provinces – Amazonian region. An ad-hoc questionnaire was applied to collect information about demographical, economical, and socio-cultural factors and access to health services; and the Simplified Medication Adherence Questionnaire (SMAQ) was performed to evaluate the adherence to antiretroviral therapy. Multivariate logistic regression analysis with backward stepwise were performed to explore factors that might influence adherence. Results: Of the 208 participants, 28.8% reported complete adherence to antiretroviral treatment. The multivariate logistic regression showed that occupation (aPR: 1.86; 95%CI 1.15-3.02), economic income (aPR: 0.64; 95%CI 0.41-0.99), and adverse reactions to antiretroviral therapy (aPR: 0.36; 95%CI 0.18-0.70) were related with complete adherence to medication. Conclusions: Only a third of participants reported a complete adherence to antiretroviral therapy. Factors associated with adherence to antiretroviral medication were related to socioeconomic conditions and adverse reactions to therapeutic scheme. Interventions related to improve adherence in indigenous people living with HIV should have to consider these factors in order to develop effective implementation strategies.

Objetivo: Conocer las barreras en la gestión de los establecimientos de salud que atienden a población indígena y afrodescendiente del Perú. Material y métodos: Se diseñó una encuesta virtual en gestión sanitaria al personal del primer nivel de atención de 89 establecimientos de salud (EESS) de 27 provincias, durante los meses de octubre y noviembre del 2021. Resultados:En el 73 % de EESS, el personal refiere no conocer el plan contra la tercera ola pandémica, 14,8% de EESS el personal refiere no está capacitado en manejo de la COVID-19, en el 22,7% de EESS se reunieron para coordinar cómo enfrentar la tercera ola pandémica, en el 83% de EESSel personal refiere no contar con presupuesto para su plan contra la COVID-19. Conclusiones:Hay barreras en la visión, gestión y presupuesto en EESS que atienden poblaciones indígenas yafroperuano, lo que afectaría la ejecución eficaz de estrategias para el control de la pandemiapor la COVID-19. Palabras Clave: Servicios de Salud; Pueblos Indígenas; pueblos originarios; COVID-19; Administración Sanitaria; Perú. (Fuente: DeCS-BIREME).