O perfil da mulher portadora de HIV/AIDS e sua adesão à terapêutica antirretroviral

Abstract

RESUmoEsse trabalho teve como objetivos caracterizar o perfil sociodemográfico e clínico, os comportamentos em saúde, crenças e atitudes sobre a doença e o tratamento de mulheres com HIV/AIDS atendidas no serviço ambulatorial de um hospital universitário do interior de São Paulo, bem como identificar fatores que interferem na adesão à terapêutica antirretroviral. Os sujeitos do estudo foram 60 mulheres acompanhadas no serviço. Os dados foram colhidos por meio de entrevista semiestruturada. As mulheres tinham idade média de 39,8 (desvio padrão 9,1) anos, baixa escolaridade, condições socioeconômicas insatisfatórias e mantinham relacionamento estável. A relação heterossexual foi a forma mais frequente de infecção; 55% das mulheres já abandonaram o tratamento e alegavam como principais motivos os esquemas terapêuticos impostos, os efeitos colaterais dos antirretrovirais, o enfrentamento psicológico da doença e o pesar iminente da morte; 35% delas não atingiram critérios de adesão considerando-se o uso de 95% da terapêutica antirretroviral prescrita. DeScrIToreS Original article AbSTrAcTThe objectives of this study were to characterize the sociodemographic and clinical profiles, health behaviors, beliefs and attitudes towards the disease and treatment of women with HIV/AIDS, outpatients of a university hospital located in the interior of São Paulo state, and to identify the factors that affect their adherence to antiretroviral therapy. The participants were 60 female outpatients of the referred service. The data were collected through semi-structured interviews. The women's mean age was 39.8 (standard deviation of 9.1) years; most of the women had a low education level, lived in deprived socioeconomic conditions, and were in a stable relationship. The most frequent form of infection was through a heterosexual relationship; 55% of the women had abandoned treatment, and their main reasons were the imposed therapeutic schemes, the side effects of antiretroviral drugs, coping with the disease, and the perspective of imminent death; 35% did not meet the adherence criteria, considered as taking 95% of the prescribed antiretroviral therapy. DeScrIpTorSHIV Acquired Immunodeficiency Syndrome Women Antiretroviral therapy, highly active Nursing care RESUmEnTrabajo que objetivó caracterizar el perfil sociodemográfico y clínico, el comportamiento en salud, creencias y actitudes sobre la enfermedad y el tratamiento de mujeres con HIV/SIDA atendidas en servicio ambulatorio de hospital universitario del interior de São Paulo, así como identificar factores que interfieren en la adhesión a la terapéu-tica antirretroviral. Los sujetos del estudio fueron 60 mujeres atendidas en el servicio. Datos recolectados mediante entrevista semiestructurada. Las mujeres tenían un promedio etario de 39,8 (desvío estándar 9,1), baja escolaridad, condiciones socioeconó-micas insatisfactorias, y mantenían relación estable. La relación heterosexual fue la forma más frecuente de infección; 55% de las mujeres ya abandonaron el tratamiento, alegando como...

HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country

“…The rate of HIV infection is increasing progressively in women compared to men, highlighting the feminization of the epidemic process. Of the 592,914 diagnoses from 1980 to June 2010, 385,818 were for males and 207,080 were for females, with a similar pattern between groups (Felix and Ceolim, 2012). The increasing HIV-positive cases in the female population are associated with socio-economic factors and unprotected sexual intercourse.…”

Perfil clínico-epidemiológico de adultos hiv-positivo atendidos em um hospital de Natal/RN Clinical-epidemiological profile of hiv-positive adults attended in a hospital from Natal/RN

“…In Brazil, when the epidemic of HIV/AIDS emerged it was restricted to metropolitan areas in the southeast and south of the country, and its most prevalent transmission was among men who have sex with men, through blood transfusion and intravenous drug use 2 . Currently, the profile of HIV/AIDS has changed, since studies have shown an increase in the number of cases among women 3 , heterosexuals 4 , people between 15 and 24 years old, adults over 50 years old, individuals with low level of education, i.e., pauperization, with the education 5 as a socioeconomic indicator, and an increased number of cases in the less urbanized regions 6 . Today, Antiretroviral Treatment (HAART) is a reality and by 2013, in countries of medium and low income, 11.7 million people received it, and according to current trends, the number will increase to 15 million in 2015 7 .…”

“…From approximately 718,000 Brazilians living with HIV/AIDS by 2012, 313,000 (44%) were on HAART, in 2002 less than half of this number -125,000 -was in treatment 5 . Increasing adherence to HAART has brought positive results in combating the disease and improving the quality of life 3 and survival of the HIV-positive 8 individual, and may also be associated with reduced mortality rates related to AIDS. In 2009, 2 million people died in the world of AIDSrelated causes; in 2013, that number dropped to 1.5 million 7 .…”

“…This suggests problems of adaptation to the treatment or instability in the clinical frame because it is expected that the CD4 cell count and immune recovery happen in the first year of HAART and stability in the second year 25 . This hypothesis is strengthened by the fact that most of the CD4 counts (85%) were between 200 and 500 cells/ mm 3 and only 10% exceeded 500 cells/mm 3 . However, only 15% had modified the initial regimen of treatment and, therefore, it is assumed that the majority is still in the process of adaptation to the treatment, because 60% of them started treatment for less than five years.…”

“…At the time of data collection of the research, these numbers changed, the percentage drop to 5% of cases with CD4 under 200 cells/ mm 3 and viral load became undetectable in 97% of cases. This change can be explained by the fact that survey participants were on HAART, and the treatment increases the amount of cells affected by HIV and reduce viral load within the first three months 25 .…”