Care for the Person Who Lives With Hiv/Aids in Primary Health Care

Abstract

Objective: to understand the process of caring for the person with HIV/AIDS in the Primary Health Care of a capital in southern Brazil. Method: qualitative, exploratory and descriptive research, carried out in the Health Centers of this city, from March to August 2015. Sixteen nurses participated through semi-structured interviews, which were organized and codified with the help of the software QSR Nvivo®, version 10. Afterwards, the data were analyzed through comparative analysis. Results: results were described in two categories: “The inter-subjective encounter given the vulnerability to HIV/AIDS”, and, “Accepting needs and formulating actions given the reality”. Potentialities and weaknesses were evidenced through these categories, such as: reception, long-term care, active search, home visits, and, in return, lacking a formal flow of care for people living with HIV/ AIDS, lack of HIV/AIDS line of care and medical/centered care. Conclusion: the need to implement HIV/AIDS management in primary care was verified, as well as to overcome the fragilities in this care with the aid of implementing a formal care flow, establishing managerial processes and permanent education for the professionals. Then, expanding and qualifying care in HIV/AIDS, with important contributions of the nurse in the perspective of integral care in the process of living with HIV/AIDS.

Performance of the nursing team in the rapid HIV tes

“…It was pointed out, in recent evidence, that nurses who work in Health Centers feel unprepared to approach People Living with HIV / AIDS (PLWHA) and their life and health issues, especially concerning the disclosure of the diagnosis. 21 STI user access to the PHC service is still marked by a reduced demand related mainly to stigma and discrimination. 22 The demand for the service is reduced due to fear of looking for services close to their places of residence or even the fear of being identified and meeting people they know, 22 and the restriction of hours can cause even more reduction in the search for assistance.…”

Linha de cuidado para crianças e adolescentes vivendo com HIV: pesquisa participante com profissionais e gestores

“…22 This is often due to the demand for resources, such as a team of professionals with experience and structure in the service, as well as technology for clinical and laboratory monitoring. 23 There is also a lack of definition of the LC and of transfer flows between the services, 24 which indicates the need for articulation between the HCN points. Transfers are considered unsatisfactory/ insufficient, especially regarding the lack of definition on which points are indicated for referring the results of the appointments between the teams.…”

“…30 The difficulty of affiliation to PHC for people living with HIV is justified by the lack of professional preparation to develop assistance to this population and by the stigma. 4,24,31 There is a need for awareness, monitoring and qualification. These recurring situations demand a permanent education as an inducer of changes in the work processes, in order to involve the components of the various points of the HCN 15 in the responsibilities and to achieve sharing, instead of purely transferring responsibilities in the decentralization process.…”

Associação entre casos de AIDS em menores de cinco anos e cobertura da atenção básica

“…No Brasil, desde os anos de 1990, nota-se uma cobertura crescente da assistência pré-natal no âmbito da APS, alcançando valores superiores a 90% em todas as regiões do país e em mulheres com diferentes características demográficas, sociais e reprodutivas. Sabe-se que o cuidado pré-natal é fundamental para o bem-estar materno e fetal, e pode contribuir para a prevenção da transmissão vertical pelo HIV (6)(7) .…”

“…A literatura aponta que uma redução de casos de HIV/AIDS pode ser alcançada com a promoção de ações educativas, disponibilização de testes rápidos de forma regular e oferta de serviços que garantam o tratamento das pessoas infectadas, sendo que, essas ações podem ser alcançadas, por meio de maior acesso à APS (7) . Na última década, maior acesso à APS contribuiu, de algum modo, para um avanço, na saúde das pessoas infectadas pelo HIV (5)(6)(7) . O acesso às ações e serviços da APS pode ser mensurado por meio da cobertura populacional pelas equipes de Atenção Básica que considera a centralidade da APS como ordenadora do cuidado, consolidandose num indicador fundamental, o qual também foi pactuado (4) .…”