RESUMEN
BACKGROUND: Highly active antiretroviral therapy has brought about a substantial improvement in the prognosis of HIV/AIDS. In this context, therapy-related body changes (lipodystrophy) gain in importance, in light of the psychological distress they cause and of their association with adherence to treatment. This study analyses patients' self-perception of central fat gain (CFG) and peripheral fat loss (PFL). METHODS: A total of 457 patients were interviewed in a university outpatient facility for the treatment of adults and adolescents with HIV/AIDS in the city of São Paulo, Brazil, between September and December 2001. RESULTS: Two-thirds of subjects (64.3%) perceived body changes. The self-perception of CFG and PFL was associated with greater schooling. The self-perception of CFG was more frequent among women and in patients who used protease inhibitors for longer periods. The self-perception of PFL was more frequent among older patients, patients who used stavudine for longer periods, and patients who reported a lack of adherence to antiretroviral agents. The quality of affective/social relationships with friends and family was inversely associated with the self-perception of PFL. CONCLUSION: The evaluation of self-perceived body changes and their determinants in individuals living with HIV/AIDS may help improve provided care. Listening to what patients have to say concerning antiretroviral therapy-related body changes and how they perceive them, as well as including the patient in therapeutic decisions in this regard will contribute towards greater adherence to proposed interventions and towards an improvement in the quality of life.