Avaliação dos processos psicossociais concorrentes a adesão ao tratamento para HIV/AIDS

Abstract

The Ministry of Health defines adherence as a dynamic and multifactorial process that includes physical, psychological, social, cultural and behavioral aspects, which requires shared and co-responsible decisions between the person living with HIV, the team and the social network that assists them. Adherence to ART is linked to the frequency and performance of laboratory tests, consultations, access to drug withdrawals, in an interactive, dynamic, and continuous process. The aim of the study was to assess adherence and define the psychosocial processes that interfere with and facilitate treatment adherence for PLWHA. This is an exploratory observational study. The research used semi-structured instruments – Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral - CEAT-VIH - and Self-efficacy Expectancy Scale to follow Antiretroviral Prescription – and secondary data – laboratory monitoring of LTCD4+ cells and Viral Load – to compare with the results obtained in the instruments. The sample comprised 53 patients, 28 men (53%) and 25 women (47%), mean age 44.7 years, body weight 66.4kg and income 1.2 minimum wages. The researched group reached an average of adherence between 74.57% (CEAT-VIH) and 78.45% (Expected Self-Efficacy), considered by the Ministry of Health as acceptable, but not ideal while adhered. The analysis of laboratory monitoring of LTCD4+ cells and Viral Load defined that 45 (84.9%) participants were promising in the treatment. The facilitating psychosocial factors were: level of information about the disease and treatment, adaptation of the prescription, family and social support network, guaranteed access to services, procedures, and link to the multidisciplinary team. The complicating factors: social and lifestyle factors, fragile social and family network, negative beliefs about ARV use, factors directly related to medication use, and time of medication use. The differential of this study was to discuss the possibility of empowering professionals to ensure that patients become more independent and responsible "agents" of their treatment, by developing personalized strategies and using available technologies.