Paradox of the success of antiretroviral therapy (HAART): experiences of treatment interruption for HIV/AIDS in Porto Alegre, Rio de Janeiro, and Manaus - Brazil.

The purpose of this article is to analyze factors contributing to treatment discontinuation among people living with HIV (PLHIV). The study draws on qualitative data from 30 in-depth interviews conducted in three Brazilian cities: Porto Alegre (9), Rio de Janeiro (10), and Manaus (11). In Manaus, respondents emphasized inadequate healthcare experiences and changes in primary providers as key triggers for discontinuity. In Rio de Janeiro, organizational dynamics within health services-such as failure to honor scheduled appointments-were identified as significant, often compelling individuals to miss work or arrive late, creating tensions between health and livelihood. In Porto Alegre, life-course disruptions were particularly salient, as they sever ties with providers and require effort to reestablish care. A paradox emerges wherein improved health and quality of life from antiretroviral therapy (ART) leads individuals to suspend treatment when they feel well. Despite these challenges, participants acknowledged the benefits of ART and expressed willingness to resume treatment, framing the interview process as an opportunity for reflection on adherence.