What question did this study set out to answer?

This study aims to identify factors associated with the interruption of antiretroviral therapy (ART) among hospitalized individuals living with HIV.

March 17, 2026Open Access

Factors Associated with the Interruption of Antiretroviral Therapy in Hospitalized People Living with HIV: A Multivariate Analysis

Key Points

This study aims to identify factors associated with the interruption of antiretroviral therapy (ART) among hospitalized individuals living with HIV.
Cross-sectional design conducted with hospitalized individuals living with HIV.
Used multivariate analysis employing Poisson regression.
Analyzed sociodemographic, behavioral, clinical, and healthcare access characteristics.
Sample included individuals from a reference service in Southern Brazil.
Male gender associated with a 58% higher probability of ART interruption.
Alcohol use linked to a 46% higher risk of treatment discontinuation.
Homeless individuals had a 38% greater risk of interruption.
Finding transportation to medication dispensing over 31 minutes increased discontinuation risk by 67%.
Individuals diagnosed through symptoms had a 30% increased chance of ART discontinuation.

Abstract

Continuous adherence to Antiretroviral Therapy (ART) is essential for controlling HIV infection and improving quality of life. However, treatment interruption remains a major challenge for healthcare services, especially among vulnerable populations. This study aimed to identify factors associated with ART interruption among hospitalized people living with HIV, providing evidence for strategies to retain these populations in care. This was a cross-sectional study with multivariate analysis using Poisson regression, including people living with HIV hospitalized at a reference service in the Central region of Rio Grande do Sul (CEP approval no. 5.828.312). The outcome variable was ART interruption, defined as the absence of medication dispensing for a period exceeding that recommended by clinical protocols. Explanatory variables included sociodemographic, behavioral, clinical, and healthcare access characteristics. The analysis estimated prevalence ratios (PR) and 95% confidence intervals (CI95%). Male gender was associated with a 58% higher probability of ART interruption compared to females (PR = 1.58; CI95%: 1.42–1.71). Alcohol use (PR = 1.46; CI95%: 1.10–1.97) and the use of other psychoactive substances (PR = 1.98; CI95%: 1.36–2.54) were also strongly associated with treatment discontinuation. Homeless individuals had a 38% higher risk of interruption (PR = 1.38; CI95%: 1.12–1.78). Regarding access, people who took more than 31 minutes to reach the medication dispensing site had a 67% higher prevalence of discontinuation (PR = 1.67; CI95%: 1.13–1.89). Furthermore, a history of previous interruptions was associated with a 52% higher probability of a new interruption (PR = 1.52; CI95%: 1.27–1.91). Seeking HIV diagnosis due to clinical symptoms increased the chance of ART discontinuation by 30% compared with those diagnosed through rapid testing (PR = 1.30; CI95%: 1.09–1.67). The results show the influence of individual, social, and structural factors on ART interruption. Strengthening access, reducing geographic and social barriers, and ensuring comprehensive care are fundamental to promoting treatment retention among people living with HIV.

Factors Associated with the Interruption of Antiretroviral Therapy in Hospitalized People Living with HIV: A Multivariate Analysis

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Abstract

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