[Evolution of psychosocial factors in a cohort of HIV-infected patients adherent to therapy].

At the present time, one of the main problems encountered by patients living with HIV is related to the notion of therapy adherence. In this context, quality of life appears to be an essential variable, because it seems correlated to adherent behavior. Mannheimer et al (2005) have indeed shown in a longitudinal study that adherent patients maintained a high level of quality of life over time. However, the long-term evolution of psychosocial variables related to quality of life in adherent patients at the time of their inclusion is not known. This study therefore aims, through longitudinal follow-up of a cohort of adherent patients, at describing the evolution over time of psychosocial factors related to their quality of life. The sample was constituted from the HIV-infected population consulting in the respective wards of six cities in the Midi-Pyrénées region (France). Inclusion criteria were set according to objective and subjective criteria of adherence as recommended by literature. The sample size was 133 individuals at T0 and 110 individuals at T1, which is compatible with chosen statistical requirements (two-tailed alpha risk 5%, study power 80%, SD 20). The results show a significant decrease over time of mental health and health perceptions in adherent patients. Moreover, at 6 months, results reveal, in patients who are no longer adherent, higher scores across several dimensions of stress and a decrease of their mental health level in comparison to adherent patients. It seems living with the HIV for patients having an adherent behavior has repercussions over time, thus inducing a degree of frailty on the mental health level. Also, in adherent patients becoming non-adherent over time, the stress variable appears as essential.