Renata Karina Reis

Convivendo com a diferença: o impacto da sorodiscordância na vida afetivo-sexual de portadores do HIV/AIDS

Este estudio descriptivo, exploratorio y cualitativo, tuvo como objetivo describir y analizar el impacto de la serodiscordancia en la vida afectivo-sexual de individuos con HIV/aids que conviven con pareja heterosexual seronegativa al HIV. Fueron entre-vistados 11 portadores de HIV/aids que efectuaban seguimiento clinico ambulatorio en un hospital universitario de referencia del interior de San Pablo, Brasil. Los datos fueron recogidos a traves de entrevista individual grabada, y analizados segun analisis de la Prosa. La convivencia con la serodiscordancia impone a tales parejas el manejo de muchas dificultades relacionadas con su intimidad, ante la posibilidad de transmision del HIV al companero seronegativo, con impacto negativo en la experiencia de la sexualidad entre parejas serodiscordantes, repercutiendo eso en altera-ciones de la respuesta sexual humana y favoreciendo hasta la propia abstinencia sexual. Se pone de manifiesto la necesidad de atencion por parte de equipos interdisciplinarios para los portadores de HIB/aids y tambien de sus parejas, a fin de proporcionarles asistencia integral, contemplando la sexualidad y las dificultades derivadas de la serodiscordancia.The purpose of this descriptive-exploratory qualitative study was to describe and analyze the impact of serodiscordance on the affective-sexual life of HIV/AIDS patients who have HIV seronegative heterosexual partners. Eleven HIV/AIDS carriers in outpatient clinic follow-up were interviewed, in a reference university-hospital in the state of São Paulo. Data were collected through recorded individual interviews and analyzed according to Prose analysis. Living with HIV/AIDS serodiscordance implies these couples have to deal with several intimacy-related difficulties, due to the possibility of HIV transmission to the seronegative partner. This has a negative effect on serodiscordant partners, reflecting in changes in human sexual response, which could lead to sexual abstinence. Interdisciplinary care should be provided to HIV/AIDS carriers and their partners, thus providing comprehensive care regarding their sexuality and difficulties caused by serodiscordance.

Qualidade de vida de mulheres vivendo com o HIV/aids de um município do interior paulista

A terapia antirretroviral de alta potencia beneficia os individuos com HIV/aids na sobrevida, cronicidade e qualidade de vida. Este estudo de corte transversal, com abordagem quantitativa, objetivou avaliar a qualidade de vida de mulheres com HIV/aids, utilizando o WHOQOL - HIV bref e sua associacao com variaveis sociodemograficas. Foi realizado em dois ambulatorios especializados no atendimento a individuos com HIV/aids. De 106 mulheres participantes, 99,1% eram heterossexuais e 92,4% foram infectadas por via sexual. Dentre os dominios de qualidade de vida, espiritualidade obteve maior escore (65,7), seguido pelo fisico (64,7), psicologico (60,6), relacoes sociais (59,5). Menores escores foram atingidos nos dominios nivel de independencia (58,6) e meio ambiente (54,5). Evidenciou-se que os fatores baixo nivel socioeconomico e educacional tiveram associacao com diferentes dominios, denotando a relacao entre qualidade de vida e condicoes de vida. Concluiu-se que persistem os desafios no âmbito das relacoes sociais, afetivas, financeiras, requerendo intervencoes efetivas focando o empoderamento das mulheres com HIV/aids.High potency antiretroviral therapy brings benefits to people with HIV/AIDS, related to survival, chronicity and quality of life. The objective of this quantitative and cross-sectional study was to assess the quality of life of women with HIV/AIDS, using the WHOQOL--HIV bref and its association with sociodemographic variables. The study was performed in outpatient clinics specialized in care to HIV/AIDS patients. Of the 106 interviewed women, 99.1% were heterosexual and 92.4% were infected sexually. Among the domains of quality of life, spirituality had the highest score (65.7), followed by physical (64.7), psychological (60.6), social relationships (59.5). Level of independence (58.6) and environment (54.5) scored the lowest. The factors low socioeconomic and educational levels were associated with different domains of quality of life, showing the relationship between quality of life and living conditions. Challenges persist in the scope of social, affective and financial relations, which require effective interventions regarding empowerment of women with HIV/AIDS.

Adesão ao tratamento por indivíduos com a co-infecção HIV/tuberculose: revisão integrativa da literatura

This is an integrative review whose objective was to evaluate the evidences available in the literature about the factors associated to the compliance with the treatment by patients with the co-infection HIV/TB. Articles published in the period from 2002 to 2008, in the databases LILACS and MEDLINE were analyzed. The material was categorized according to the year of publication, periodical, study location and factors related to the compliance. The final sample included eight articles. The factors found, associated to the compliance with the treatment of the co-infection HIV/TB, related to: the individual and his lifestyle (previous TB treatment, fear of stigma and discrimination, use of chemical substances, depression, social support); the disease and the medication (type of medication regime, use of other medication, adverse effects, difficulty to diagnose TB in these patients); and the health services (operational problems to follow up the treatment, training of the professionals, supervision, different locations to treat TB and HIV).Trata-se de revisao integrativa cujo objetivo foi avaliar as evidencias disponiveis na literatura sobre os fatores associados a adesao ao tratamento por pacientes com a co-infeccao HIV/TB. Foram levantados artigos publicados no periodo de 2002 a 2008, nas bases de dados LILACS e MEDLINE. O material foi categorizado de acordo com ano de publicacao, periodico, local do estudo e fatores relacionados a adesao. A amostra final foi composta por oito artigos. Os fatores encontrados, associados a adesao ao tratamento da co-infeccao HIV/TB, relacionam-se: ao individuo e ao estilo de vida (tratamento previo de TB, receio de estigma e discriminacao, uso de substâncias quimicas, depressao, suporte social), a doenca e aos medicamentos (tipo de regime medicamentoso, uso de outros medicamentos, efeitos colaterais, dificuldade de diagnostico de TB nestes pacientes), e aos servicos de saude (problemas operacionais para acompanhar o tratamento, treinamento dos profissionais, supervisao, locais distintos para atendimento de TB e de HIV).

Vulnerabilidade ao HIV/AIDS e a prevenção da transmissão sexual entre casais sorodiscordantes

This exploratory, descriptive study aimed to describe and analyze the vulnerability of HIV serodiscordant couples. The research was developed at an Aids Outpatient Service in a city in the State of Sao Paulo. Data were collected through individual interviews with 11 HIV/AIDS carriers who had a known serodiscordant partner. Prose analysis was applied for data organization and analyses, and the concept of vulnerability was used as a theoretical reference. The naturalization of HID/AIDS related to an undetectable viral load, the invulnerability feeling that stems from the time spent together by the couple, and its influence in the maintenance of safe sex are vulnerability factors for seronegative sexual partners. Specialized services to assist HIV/AIDS carriers need to include sexual partners in actions promoted by healthcare professionals targeting prevention and/or education.Este estudio descriptivo e exploratorio que tuvo por objetivo describir y analizar la vulnerabilidad de parejas en que uno de sus componentes esta contaminado por el HIV; el estudio fue realizado en un Servicio de Ambulatorio Especializado en SIDA de un municipio del estado de Sao Paulo. Los datos fueron recolectados a traves de entrevistas individuales con 11 portadores del VIH/SIDA que conviven con companeros no contaminados por el virus VIH. Para la organizacion y el analisis de los datos, empleamos el metodo de analisis de Prosa y el concepto de vulnerabilidad como marco teorico. La naturalizacion de la infeccion del VIH/SIDA como enfermedad controlable por medicamentos, la creencia en la imposibilidad de la transmision del VIH relacionadas con carga viral indetectable, el sentimiento de invencibilidad que surge con el tiempo de convivencia entre la pareja y su influencia en la manutencion del sexo seguro son factores de vulnerabilidad para el companero sexual no contaminado. Los servicios especializados en la atencion a individuos con VIH/SIDA necesitan incluir al companero sexual en las acciones educativas/preventivas promovidas por los profesionales de la salud.Este estudo descritivo e exploratorio objetivou descrever e analisar a vulnerabilidade de casais sorodiscordantes ao HIV, e foi realizado em um Servico Ambulatorial Especializado em aids de um municipio do estado de Sao Paulo. Os dados foram coletados atraves de entrevistas individuais com 11 portadores do HIV/AIDS, que convivem com parceria sabidamente sorodiscordante. Para organizacao e analise dos dados, empregamos o metodo de analise de Prosa e o conceito de vulnerabilidade como referencial teorico. A naturalizacao da infeccao do HIV/aids como doenca controlavel por medicamentos, crenca na impossibilidade de transmissao do HIV relacionadas com carga viral indetectavel, sentimento de invencibilidade que surge com o tempo de convivio entre o casal, e sua influencia na manutencao do sexo seguro sao fatores de vulnerabilidade para a parceria sexual soronegativa. Servicos especializados no atendimento a individuos com HIV/aids necessitam incluir a parceria sexual nas acoes educativas/preventivas promovidas pelos profissionais de saude.

Quality of life in women with HIV/aids in a municipality in the state of São Paulo

A terapia antirretroviral de alta potencia beneficia os individuos com HIV/aids na sobrevida, cronicidade e qualidade de vida. Este estudo de corte transversal, com abordagem quantitativa, objetivou avaliar a qualidade de vida de mulheres com HIV/aids, utilizando o WHOQOL - HIV bref e sua associacao com variaveis sociodemograficas. Foi realizado em dois ambulatorios especializados no atendimento a individuos com HIV/aids. De 106 mulheres participantes, 99,1% eram heterossexuais e 92,4% foram infectadas por via sexual. Dentre os dominios de qualidade de vida, espiritualidade obteve maior escore (65,7), seguido pelo fisico (64,7), psicologico (60,6), relacoes sociais (59,5). Menores escores foram atingidos nos dominios nivel de independencia (58,6) e meio ambiente (54,5). Evidenciou-se que os fatores baixo nivel socioeconomico e educacional tiveram associacao com diferentes dominios, denotando a relacao entre qualidade de vida e condicoes de vida. Concluiu-se que persistem os desafios no âmbito das relacoes sociais, afetivas, financeiras, requerendo intervencoes efetivas focando o empoderamento das mulheres com HIV/aids.High potency antiretroviral therapy brings benefits to people with HIV/AIDS, related to survival, chronicity and quality of life. The objective of this quantitative and cross-sectional study was to assess the quality of life of women with HIV/AIDS, using the WHOQOL--HIV bref and its association with sociodemographic variables. The study was performed in outpatient clinics specialized in care to HIV/AIDS patients. Of the 106 interviewed women, 99.1% were heterosexual and 92.4% were infected sexually. Among the domains of quality of life, spirituality had the highest score (65.7), followed by physical (64.7), psychological (60.6), social relationships (59.5). Level of independence (58.6) and environment (54.5) scored the lowest. The factors low socioeconomic and educational levels were associated with different domains of quality of life, showing the relationship between quality of life and living conditions. Challenges persist in the scope of social, affective and financial relations, which require effective interventions regarding empowerment of women with HIV/AIDS.

Aids e tuberculose: a coinfecção vista pela perspectiva da qualidade de vida dos indivíduos

Tuberculosis (TB) and HIV coinfection adversely affects the lives of individuals in both the biological and psychosocial aspects. Aiming to describe the quality of life of individuals with HIV/TB coinfection, this descriptive cross-sectional study was conducted in Ribeirão Preto-SP. Participants were HIV-seropositive individuals with and without TB, using the WHOQOL HIV BREF. 115 individuals who were HIV-positive participated: 57 were coinfected and 58 were not; most were male heterosexuals, predominantly aged 40-49 years. Of those coinfected, most had lower education and income. In assessing the quality of life the coinfected individuals showed lower results in all areas, with significant differences in the Physical, Psychological, Level of Independence and Social Relations areas. TB and HIV / AIDS are stigmatized diseases, and overlap of the two may have severe consequences on the physical and psychosocial health of the individual.A coinfeccao tuberculose (TB) e HIV afeta negativamente a vida dos individuos, tanto nos aspectos biologicos como nos psicossociais. Com o objetivo de descrever a qualidade de vida de individuos com coinfeccao HIV/TB, foi realizado este estudo descritivo, de corte transversal, no municipio de Ribeirao Preto-SP. Foram entrevistados individuos soropositivos para o HIV, com e sem TB, por meio do instrumento WHOQOL-HIV bref. Participaram 115 individuos soropositivos para o HIV - 57 coinfectados e 58 nao coinfectados; a maioria do sexo masculino, heterossexuais, faixa etaria predominante de 40-49 anos, com os coinfectados apresentando baixas escolaridade e renda; na avaliacao da qualidade de vida os coinfectados apresentaram resultados mais baixos em todos os dominios, com diferenca importante no Fisico, Psicologico, Nivel de Independencia e Relacoes Sociais. TB e HIV/aids sao doencas estigmatizadas historicamente e a sobreposicao das duas pode ter consequencias graves na saude fisica e psicossocial do individuo.

Vulnerability and prevention of sexual HIV transmission among HIV/AIDS serodiscordant couples

This exploratory, descriptive study aimed to describe and analyze the vulnerability of HIV serodiscordant couples. The research was developed at an Aids Outpatient Service in a city in the State of Sao Paulo. Data were collected through individual interviews with 11 HIV/AIDS carriers who had a known serodiscordant partner. Prose analysis was applied for data organization and analyses, and the concept of vulnerability was used as a theoretical reference. The naturalization of HID/AIDS related to an undetectable viral load, the invulnerability feeling that stems from the time spent together by the couple, and its influence in the maintenance of safe sex are vulnerability factors for seronegative sexual partners. Specialized services to assist HIV/AIDS carriers need to include sexual partners in actions promoted by healthcare professionals targeting prevention and/or education.Este estudio descriptivo e exploratorio que tuvo por objetivo describir y analizar la vulnerabilidad de parejas en que uno de sus componentes esta contaminado por el HIV; el estudio fue realizado en un Servicio de Ambulatorio Especializado en SIDA de un municipio del estado de Sao Paulo. Los datos fueron recolectados a traves de entrevistas individuales con 11 portadores del VIH/SIDA que conviven con companeros no contaminados por el virus VIH. Para la organizacion y el analisis de los datos, empleamos el metodo de analisis de Prosa y el concepto de vulnerabilidad como marco teorico. La naturalizacion de la infeccion del VIH/SIDA como enfermedad controlable por medicamentos, la creencia en la imposibilidad de la transmision del VIH relacionadas con carga viral indetectable, el sentimiento de invencibilidad que surge con el tiempo de convivencia entre la pareja y su influencia en la manutencion del sexo seguro son factores de vulnerabilidad para el companero sexual no contaminado. Los servicios especializados en la atencion a individuos con VIH/SIDA necesitan incluir al companero sexual en las acciones educativas/preventivas promovidas por los profesionales de la salud.Este estudo descritivo e exploratorio objetivou descrever e analisar a vulnerabilidade de casais sorodiscordantes ao HIV, e foi realizado em um Servico Ambulatorial Especializado em aids de um municipio do estado de Sao Paulo. Os dados foram coletados atraves de entrevistas individuais com 11 portadores do HIV/AIDS, que convivem com parceria sabidamente sorodiscordante. Para organizacao e analise dos dados, empregamos o metodo de analise de Prosa e o conceito de vulnerabilidade como referencial teorico. A naturalizacao da infeccao do HIV/aids como doenca controlavel por medicamentos, crenca na impossibilidade de transmissao do HIV relacionadas com carga viral indetectavel, sentimento de invencibilidade que surge com o tempo de convivio entre o casal, e sua influencia na manutencao do sexo seguro sao fatores de vulnerabilidade para a parceria sexual soronegativa. Servicos especializados no atendimento a individuos com HIV/aids necessitam incluir a parceria sexual nas acoes educativas/preventivas promovidas pelos profissionais de saude.

Compliance with the treatment by patients with the co-infection HIV/tuberculosis: integrative literature review

This is an integrative review whose objective was to evaluate the evidences available in the literature about the factors associated to the compliance with the treatment by patients with the co-infection HIV/TB. Articles published in the period from 2002 to 2008, in the databases LILACS and MEDLINE were analyzed. The material was categorized according to the year of publication, periodical, study location and factors related to the compliance. The final sample included eight articles. The factors found, associated to the compliance with the treatment of the co-infection HIV/TB, related to: the individual and his lifestyle (previous TB treatment, fear of stigma and discrimination, use of chemical substances, depression, social support); the disease and the medication (type of medication regime, use of other medication, adverse effects, difficulty to diagnose TB in these patients); and the health services (operational problems to follow up the treatment, training of the professionals, supervision, different locations to treat TB and HIV).Trata-se de revisao integrativa cujo objetivo foi avaliar as evidencias disponiveis na literatura sobre os fatores associados a adesao ao tratamento por pacientes com a co-infeccao HIV/TB. Foram levantados artigos publicados no periodo de 2002 a 2008, nas bases de dados LILACS e MEDLINE. O material foi categorizado de acordo com ano de publicacao, periodico, local do estudo e fatores relacionados a adesao. A amostra final foi composta por oito artigos. Os fatores encontrados, associados a adesao ao tratamento da co-infeccao HIV/TB, relacionam-se: ao individuo e ao estilo de vida (tratamento previo de TB, receio de estigma e discriminacao, uso de substâncias quimicas, depressao, suporte social), a doenca e aos medicamentos (tipo de regime medicamentoso, uso de outros medicamentos, efeitos colaterais, dificuldade de diagnostico de TB nestes pacientes), e aos servicos de saude (problemas operacionais para acompanhar o tratamento, treinamento dos profissionais, supervisao, locais distintos para atendimento de TB e de HIV).

Living with the difference: the impact of serodiscordance on the affective and sexual life of HIV/AIDS patients

Este estudio descriptivo, exploratorio y cualitativo, tuvo como objetivo describir y analizar el impacto de la serodiscordancia en la vida afectivo-sexual de individuos con HIV/aids que conviven con pareja heterosexual seronegativa al HIV. Fueron entre-vistados 11 portadores de HIV/aids que efectuaban seguimiento clinico ambulatorio en un hospital universitario de referencia del interior de San Pablo, Brasil. Los datos fueron recogidos a traves de entrevista individual grabada, y analizados segun analisis de la Prosa. La convivencia con la serodiscordancia impone a tales parejas el manejo de muchas dificultades relacionadas con su intimidad, ante la posibilidad de transmision del HIV al companero seronegativo, con impacto negativo en la experiencia de la sexualidad entre parejas serodiscordantes, repercutiendo eso en altera-ciones de la respuesta sexual humana y favoreciendo hasta la propia abstinencia sexual. Se pone de manifiesto la necesidad de atencion por parte de equipos interdisciplinarios para los portadores de HIB/aids y tambien de sus parejas, a fin de proporcionarles asistencia integral, contemplando la sexualidad y las dificultades derivadas de la serodiscordancia.The purpose of this descriptive-exploratory qualitative study was to describe and analyze the impact of serodiscordance on the affective-sexual life of HIV/AIDS patients who have HIV seronegative heterosexual partners. Eleven HIV/AIDS carriers in outpatient clinic follow-up were interviewed, in a reference university-hospital in the state of São Paulo. Data were collected through recorded individual interviews and analyzed according to Prose analysis. Living with HIV/AIDS serodiscordance implies these couples have to deal with several intimacy-related difficulties, due to the possibility of HIV transmission to the seronegative partner. This has a negative effect on serodiscordant partners, reflecting in changes in human sexual response, which could lead to sexual abstinence. Interdisciplinary care should be provided to HIV/AIDS carriers and their partners, thus providing comprehensive care regarding their sexuality and difficulties caused by serodiscordance.

Working Education Program in Health: transforming experience of nursing teaching and practice

This is an experience report of tutors from nursing Working Education Program in Health ( PET- Saúde ) from the Federal University of Alagoas, from May 2009 to April 2010. The objective of the nursing PET-Saúde was to develop health education actions aimed at the needs of the communities attended by the Family Health Units in Maceio, Alagoas. We conducted a health planning guided by the problem-based methodology. The activities resulted in changes in student learning and in the practice of nurses PET-Saúde , indicating the importance of this program for teaching and practice of nursing.