Quality of life of men with AIDS and the model of social determinants of health

Abstract

OBJECTIVE: to analyze the quality of life (QoL) of men with AIDS from the perspective of the model of social determinants of health (MSDH). METHOD: cross-sectional study conducted in an outpatient infectious diseases clinic from a Brazilian university hospital over the course of one year with a sample of 138 patients. A form based on the MSDH was used to collect sociodemographic data addressing individual, proximal, intermediate determinants and the influence of social networks together with an instrument used to assess the QoL of people with HIV/AIDS. The project was approved by the Institutional Review Board (Protocol No. 040.06.12). RESULTS: according to MSDH, most men with AIDS were between 30 and 49 years old (68.1%), mixed race (59.4%), heterosexual (46.4%), single (64.5%), Catholic (68.8%), had a bachelor's degree (39.2%), had no children (61.6%), and had a formal job (71.0%). The perception of QoL in the physical, level of independence, environment, and spirituality domains was intermediate, while QoL was perceived to be superior in the domains of psychological and social relationship. A perception of lower QoL was presented by homosexual (p=0.037) and married men (p=0.077), and those with income below one times the minimum wage (p=0.042). A perception of greater QoL was presented by those without a religion (p=0.005), living with a partner (p=0.049), and those who had a formal job (p=0.045). CONCLUSION: social determinants influence the QoL of men with AIDS.

Factors related to the perceived stigmatization of people living with HIV

“…We found that most had a religion, similar to other studies of people with HIV (14,(22)(23) and other studies with people living in similar situations such as cancer patients (24) and chronic renal disease patients (25) , so that clinical evolution and the course of serious illnesses lead to the rediscovery of the importance of spirituality, strengthening hope in enduring physical and emotional distress related to the disease and treatment (24)(25) . Although most participants in this study were heterosexual, which can be justified by the stimulus to early sexuality and the possibility of paid sex (26) , homosexuals are the ones who are strongly stigmatized and linked to large manifestations of exclusion and blamed for HIV infection (22,27) ; this is similar to what happens with drug users, being labelled and socially excluded (6,18,22,27) .…”

“…Although most participants in this study were heterosexual, which can be justified by the stimulus to early sexuality and the possibility of paid sex (26) , homosexuals are the ones who are strongly stigmatized and linked to large manifestations of exclusion and blamed for HIV infection (22,27) ; this is similar to what happens with drug users, being labelled and socially excluded (6,18,22,27) . We found that interruption of ART was not predominant in this study.…”

Quality of life of elderly people living with HIV/AIDS in outpatient follow-up

“…Regarding the children, although the diagnosis of the infection brings the fear of interrupting family projects negatively affecting the QoL of fathers and mothers, in Africa many individuals who have children adhere to the treatment and face the disease, in an attempt to maintain the projects of paternity and motherhood, thus maintaining the role of public life (14) . However, the presence of children can generate many future concerns related to concerns about health, which, coupled with the fear of not being able to maintain employment and income, has negatively impacted the QoL of many parents living with HIV/AIDS (15) . As for the variable "occupation" with the category "concerns about secrecy", it is observed that the condition of being away or retired, can give people psychological well-being, because they no longer have to return to work or are taken to seek new employment because of stress and confrontations related to disclosure of their HIV status to their employers and colleagues (15) ; and also the receipt of monthly salary in addition to providing the purchasing power of necessary goods, contributes to family expenses and provides more autonomy (6) .…”

AIDS and jail: social representations of women in freedom deprivation situations

“…In accordance with the reified knowledge about managing the disease, the information was spread by the press through images of weak people, and associated with the idea of death and the behaviors of risk groups (15) . This association opened up a space for the development of preconceptions against minorities, in addition to moral and social stigma that strengthened feelings of guilt (16)(17) . This attitude stresses that the initial limitation of medical information, proceeding from scientific research that demanded time, favored the social qualification of the disease.…”