Provision of health care actions and services for the management of HIV/AIDS from the users’ perspective

Abstract

RESUMENObjetivo: Analizar la oferta de acciones en los servicios de salud que prestan asistencia a las personas que viven con SIDA en el seguimiento de los servicios especializados del municipio de Ribeirão Preto-SP. Método: Estudo descriptivo, exploratorio, del tipo encuesta. Se llevaron a cabo entrevistas con cuestionario estructurado y análisis de datos por medio de estadísticas descriptivas. Resultados: La oferta de acciones y servicios de salud se la ve como regular. Para los 301 sujetos, la atención de rutina por el equipo de referencia; exáme-nes de laboratorio y facilitación de antirretrovirales, vacunas y preservativos obtuvieron evaluación satisfactoria. Evaluadas como regular la oferta de exámenes para la prevención y el diagnóstico de comorbilidades, e insatisfactoria la oferta de atención especializada por otros profesionales; de grupos de apoyo psicosocial y fármacos preventivos de efecto colateral de los antirretrovirales. Conclusión: Debilidades permean el seguimiento y la gestión del cuidado, con predominio del enfoque biologicista, centrado en el médico, en el que el control clínico y el acceso a la Terapia Antirretroviral se constituyen como el enfoque esencial de la asistencia prestada. DESCRIPTORES ABSTRACTObjective: To analyse the provision of health care actions and services for people living with AIDS and receiving specialised care in Ribeirão Preto, SP. Method: A descriptive, exploratory, survey-type study that consisted of interviews with structured questionnaires and data analysis using descriptive statistics. Results: The provision of health care actions and services is perceived as fair. For the 301 subjects, routine care provided by the reference team, laboratory tests and the availability of antiretroviral drugs, vaccines and condoms obtained satisfactory evaluations. The provision of tests for the prevention and diagnosis of comorbidities was assessed as fair, whereas the provisions of specialised care by other professionals, psychosocial support groups and medicines for the prevention of antiretroviral side effects were assessed as unsatisfactory. Conclusion: Shortcomings were observed in follow-up and care management along with a predominantly biological, doctor-centred focus in which clinical control and access to antiretroviral therapy comprise the essential focus of the care provided.

Risk management in providing specialized care for people living with AIDS

“…The three provision dimensions with the lowest rates of satisfaction corroborate the observation that, despite advances in the treatment of HIV/AIDS, gaps in care are primarily focused on support to living with the infection and the psychosocial care needs, which in turn have repercussions on the ability of autonomy for self-care (2,20) . A study developed in southeastern Brazil signaled weaknesses in the provision of specialized service actions in meeting needs that were not related to clinical management and drug treatment, including those related to diagnosing and managing opportunistic infections, with TB being among them (2) .…”

“…A study developed in southeastern Brazil signaled weaknesses in the provision of specialized service actions in meeting needs that were not related to clinical management and drug treatment, including those related to diagnosing and managing opportunistic infections, with TB being among them (2) . Such a fact demonstrates that in different socioeconomic and programmatic realities, there are similar weaknesses in care management in the context of specialized services.…”

“…These demands require care planning actions based on responsive care models to its chronicity (1)(2) . Since the implementation of Antiretroviral therapy (ART), global evidence on variations in mortality patterns associated to its aggravation gave prominence to some comorbidities with the potential capability to generate losses in the survival of people undergoing treatment (3)(4)(5) .…”

“…Thus, for lower risk chronic conditions, supported self-care technologies would be employed with a focus on primary care services, while higher risk conditions would require a greater concentration of specialized care (1) . Among the programmatic factors associated with managing the risk of morbid events, the following can be highlighted: access to information, resources and technologies for the prevention/early diagnosis/treatment of opportunistic infections; access to tests and antiretroviral drugs/therapy (ART); addressing the biopsychosocial repercussions of diagnosis/ illness/treatment; and strengthening social support networks aimed at improving the quality of life for people under supervision/undergoing treatment (2,11) . Therefore, this study aimed to analyze the provision of actions related to clinical risk management in providing specialized care for people living with AIDS.…”

Potencialidades e fragilidades da rede de cuidado da pessoa com HIV/Aids

“…Associated with these strategies and aiming to serve people affected by HIV/AIDS better, the health care actions constitute the necessary support for people living with the disease and their families in the search for solutions that may arise from their experiences in network (6) .…”