OBJETIVO: O "Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral" é um instrumento auto-aplicável para a identificação do grau de adesão ao tratamento anti-retroviral em pacientes com infecção pelo HIV. O objetivo do estudo foi de traduzir, adaptar e validar o questionário para seu uso no Brasil. MÉTODOS: O questionário foi traduzido do original em espanhol ao português, utilizando o processo de tradução-retradução (espanhol/português/espanhol), seguido de avaliação verbal da compreensão com um pequeno grupo de pacientes. Foram estudadas as propriedades psicométricas do instrumento em uma amostra de 59 pacientes com infecção pelo HIV em tratamento anti-retroviral. Os pacientes foram avaliados em centro especializado no atendimento de pacientes infectados pelo HIV ou com Aids, em Porto Alegre, Rio Grande do Sul, entre os meses de junho a novembro de 2005. Para o processo de validação do instrumento foram analisados os indicadores de consistência interna, validez relacionada a um critério externo, sensibilidade e especificidade. RESULTADOS: A análise dos resultados permitiu identificar uma adequada confiabilidade do questionário (alfa=0,64) e validade relacionada a um critério externo (carga viral; r=-0,48; p<0,001). Também observou-se adequada sensibilidade (79,2%) e especificidade (57,1%) do questionário para a detecção entre indivíduos com carga viral indetectável e detectável. CONCLUSÕES: A versão em português do Questionário para Avaliação da Adesão ao Tratamento Anti-retroviral mostrou ser útil, confiável e válida para a avaliação do grau de adesão ao tratamento anti-retroviral em pacientes com infecção pelo HIV.
Objective To determine the rate and factors associated with perinatal transmission among women infected with HIV‐1.
Design Cohort study.
Setting Centro Municipal de Atendimento em DST/AIDS is a major reference centre for HIV treatment in Porto Alegre city, southern Brazil.
Population Pregnant and puerperal women infected with HIV‐1.
Methods Women were enrolled during pregnancy and seen monthly at the antenatal care centre. Those detected at delivery that presented at the centre within the first 10 days of postpartum were included. Maternal, obstetric and infant‐related characteristics were ascertained and testing for CD4 cell count, HIV PCR/RNA assay, anti‐HCV, HBSAg and syphilis were performed. Antiretrovirals and formula were provided free of charge following Brazilian guidelines.
Main outcome measure HIV‐1 infection status in the infant.
Results Perinatal transmission was assessed in 343 children (95% of the whole sample). Overall, the transmission rate was 3.2% (95% CI: 1.7–5.8%). Perinatal transmission rates increased with maternal viral load (≥10,000 copies/mL; RR: 11.27; 95% CI: 1.38–92.23). In multivariate analyses, the only independent risk factor for perinatal transmission was the maternal viral load at baseline (OR = 2.72 per log increase in the number of copies; 95% CI: 1.17–6.50).
Conclusion Perinatal transmission rate was low among HIV‐1 infected women in clinical care and on antiretroviral therapy despite poor socio‐economic conditions. Viral load level was the only independent predictor of perinatal transmission. It is possible to prevent HIV‐1 perinatal transmission in a developing country if we provide antiretrovirals and formula.
In this article, the authors report an experience developed in the Specialized Care Sevice on STD/AIDS from Porto Alegre, where one of them works. It approaches adult women, emphasizing sexuality, reproduction and vulnerability concerning STDs, mainly HIV infection. The methodology used is a data survey starting from the return to the service in order to receive female condoms within one year. Subjects are HIV-positive women linked to the service. Results show that the use of this method is incipient and that its adoption demands a change in behaviour from women already in an early stage of their development, prior to adult age, and that there is a huge importance of raising awareness among professionals, either in Education or Health fields.
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