Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da Universidade Federal do Ceará (UFC) |
Texto Completo: | http://www.repositorio.ufc.br/handle/riufc/60772 |
Resumo: | In 2017, the Brazilian Unified Health System (SUS) incorporated the Pre-exposure Prophylaxis to HIV (PrEP) as an additional strategy to the classic methods of prevention against infection by the Acquired Immunodeficiency Virus (HIV) already in place. PrEP consists of using a co-formulated tablet of tenofovir (TDF) and emtricitabine (FTC), capable of providing up to 96% protection against HIV. Given its recent incorporation, studies investigating its use in this setting are needed. Under this aspect, the main objective of this work was to analyze PrEP in specialized services in Ceará. This paper is a cross-sectional, analytical study, with a quantitative approach, based on secondary data obtained from the Logistic Control System of Medicines (SICLOM). Thus, the study population covered users using PrEP, registered in this system, from December 2017 to June 2020, and those with less than 180 days in using the method or who did not have the third monitoring consultation registered in SICLOM were excluded. Data collection occurred in May and June 2020. We used the Statistic Package for Social Sciences (SPSS) software for the statistical analyses and expressed the results descriptively and inferentially. Furthermore, bivariate and multivariate analyses were performed to investigate the association between the selected variables, especially the relationship between sociodemographic characteristics and risk factors for HIV infection, under full adherence to PrEP (using all doses within 90 days). At the time of data collection, 412 subjects were registered in SICLOM; however, only 231 participated in the study. Most participants were male (80.1%; n=185), gay (61.9%; n=143), with a mean age of 32±8.6 years (range 19 to 62 years old). The average time of method use was 15±5.9 months. Regarding risk factors for HIV infection, 8.7% (n=20) reported having sex in exchange for money, drugs or housing, 58.9% (n=136) reported alcohol use, 19.5% (n=45) marijuana use, and 6.1% (n=14) alcohol and marijuana use. Regarding the use of TDF/FTC, only 5.6% (n=13) had a degree of adherence lower than 80%. In this context, it was observed that characteristics of users, such as sexual practice in exchange for money, drugs, housing, and homosexuality, impacted full adherence to TDF/FTC (p= 0.033; p=0.049, respectively). In addition, another factor evidenced was the increase in the number of users who started not using condoms in any of the relationships when compared before PrEP use and after 90 and 180 days of its initiation (p<0.001). In this period, there was no statistically significant difference regarding the increase in the prevalence of sexually transmitted infections and the number of sexual partners. It was possible to observe that a significant portion of the PrEP users consumes alcohol, erection stimulants, and illicit drugs; however, this habit did not influence adherence to the TDF/FTC, which proved satisfactory (95% of the individuals had an adherence level >80%). Our findings may provide support for the comprehensive care of PrEP users since it allows us to learn about their characteristics and risk practices for HIV infection, among other determinants and associated factors. |
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Análise da profilaxia pré-exposição ao HIV em serviços especializados do CearáAntirretroviraisHIVControle de Doenças TransmissíveisProfilaxia Pré-ExposiçãoServiços de SaúdeIn 2017, the Brazilian Unified Health System (SUS) incorporated the Pre-exposure Prophylaxis to HIV (PrEP) as an additional strategy to the classic methods of prevention against infection by the Acquired Immunodeficiency Virus (HIV) already in place. PrEP consists of using a co-formulated tablet of tenofovir (TDF) and emtricitabine (FTC), capable of providing up to 96% protection against HIV. Given its recent incorporation, studies investigating its use in this setting are needed. Under this aspect, the main objective of this work was to analyze PrEP in specialized services in Ceará. This paper is a cross-sectional, analytical study, with a quantitative approach, based on secondary data obtained from the Logistic Control System of Medicines (SICLOM). Thus, the study population covered users using PrEP, registered in this system, from December 2017 to June 2020, and those with less than 180 days in using the method or who did not have the third monitoring consultation registered in SICLOM were excluded. Data collection occurred in May and June 2020. We used the Statistic Package for Social Sciences (SPSS) software for the statistical analyses and expressed the results descriptively and inferentially. Furthermore, bivariate and multivariate analyses were performed to investigate the association between the selected variables, especially the relationship between sociodemographic characteristics and risk factors for HIV infection, under full adherence to PrEP (using all doses within 90 days). At the time of data collection, 412 subjects were registered in SICLOM; however, only 231 participated in the study. Most participants were male (80.1%; n=185), gay (61.9%; n=143), with a mean age of 32±8.6 years (range 19 to 62 years old). The average time of method use was 15±5.9 months. Regarding risk factors for HIV infection, 8.7% (n=20) reported having sex in exchange for money, drugs or housing, 58.9% (n=136) reported alcohol use, 19.5% (n=45) marijuana use, and 6.1% (n=14) alcohol and marijuana use. Regarding the use of TDF/FTC, only 5.6% (n=13) had a degree of adherence lower than 80%. In this context, it was observed that characteristics of users, such as sexual practice in exchange for money, drugs, housing, and homosexuality, impacted full adherence to TDF/FTC (p= 0.033; p=0.049, respectively). In addition, another factor evidenced was the increase in the number of users who started not using condoms in any of the relationships when compared before PrEP use and after 90 and 180 days of its initiation (p<0.001). In this period, there was no statistically significant difference regarding the increase in the prevalence of sexually transmitted infections and the number of sexual partners. It was possible to observe that a significant portion of the PrEP users consumes alcohol, erection stimulants, and illicit drugs; however, this habit did not influence adherence to the TDF/FTC, which proved satisfactory (95% of the individuals had an adherence level >80%). Our findings may provide support for the comprehensive care of PrEP users since it allows us to learn about their characteristics and risk practices for HIV infection, among other determinants and associated factors.Em 2017, foi incorporada, ao Sistema Único de Saúde (SUS), a Profilaxia Pré-exposição ao HIV (PrEP), no intuito de ser uma estratégia adicional aos métodos clássicos de prevenção contra infecção pelo Vírus da Imunodeficiência Humana (HIV) já existentes. A PrEP consiste na utilização de comprimido coformulado de tenofovir (TDF) e entricitabina (FTC), capaz de fornecer até 96% de proteção contra o HIV. Tendo em vista a recente incorporação desta profilaxia, faz-se necessário estudos que investiguem a sua utilização neste cenário. Sob este aspecto, o objetivo principal deste trabalho foi analisar a PrEP em serviços especializados do Ceará. Trata-se de estudo transversal, analítico, com abordagem quantitativa, a partir de dados secundários obtidos do banco de dados eletrônico do Sistema de Controle Logístico de Medicamentos (SICLOM). Desta forma, a população do estudo abrangeu os usuários em uso de PrEP, cadastrados neste sistema, no período de dezembro de 2017 a junho de 2020, e foram excluídos aqueles com menos de 180 dias em uso do método ou que não tivessem a terceira consulta de monitoramento registrada no SICLOM. A coleta de dados ocorreu nos meses de maio e junho de 2020. Utilizou-se do software Statistic Package for Social Sciences (SPSS) para as análises estatísticas, sendo os resultados expressos de forma descritiva e inferencial. Ademais, realizou-se análises bivariada e multivariada, com finalidade de investigar a associação entre as variáveis selecionadas, principalmente a relação entre as características sociodemográficas e fatores de risco para infecção pelo HIV, sob a plena adesão à PrEP (uso de todas as doses no período de 90 dias). No momento da coleta de dados, um total de 412 sujeitos estavam cadastrados no SICLOM; porém, apenas 231 participaram do estudo. A maioria dos participantes era do sexo masculino (80,1%; n=185), homossexuais (61,9%; n=143), com idade média de 32±8,6 anos (variação entre 19 e 62 anos). O tempo médio de uso do método foi de 15±5,9 meses. No tocante aos fatores de risco para infecção pelo HIV, 8,7% (n=20) relataram fazer sexo em troca de dinheiro, droga ou moradia, 58,9% (n=136) informaram o consumo de álcool, 19,5% (n=45) de maconha, e 6,1% (n=14) de álcool e maconha. Com relação ao uso de TDF/FTC, apenas 5,6% (n=13) tiveram o grau de adesão inferior a 80%. Nesse contexto, foi observado que características dos usuários, como a prática sexual em troca de dinheiro, drogas e moradia e o homossexualismo, impactaram na plena adesão ao TDF/FTC (p= 0,033; p=0,049, respectivamente). Além disso, outro fator evidenciado foi o aumento no número de usuários que passaram a não usar preservativo em nenhuma das relações, quando comparado antes do uso de PrEP, e após 90 e 180 dias do seu início (p<0,001). Considerando esse mesmo período, não houve diferença estatisticamente significativa no que diz respeito ao aumento da prevalência de infecções sexualmente transmissíveis e do número de parcerias sexuais. Foi possível observar, com os resultados alcançados, que uma significativa parcela dos usuários-PrEP consomem álcool, estimulantes de ereção, e drogas ilícitas; no entanto, este hábito não influenciou na adesão ao TDF/FTC, que se mostrou satisfatória (95% dos indivíduos tiveram grau de adesão >80%). Nossos achados podem fornecer subsídios para o apoio no cuidado integral dos usuários-PrEP, visto que permite conhecer as suas características e práticas de risco para infecção pelo HIV, dentre outros fatores determinantes e associados.Fonteles, Marta Maria de FrançaFrança, Francisco Álisson Paula de2021-09-30T19:57:52Z2021-09-30T19:57:52Z2021-07-27info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfFRANÇA, F. A. P. Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará. 2021. 85 f. Dissertação (Mestrado em Ciências Farmacêuticas) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2021. Disponível em: http://www.repositorio.ufc.br/handle/riufc/60772http://www.repositorio.ufc.br/handle/riufc/60772porreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2021-10-14T11:58:54Zoai:repositorio.ufc.br:riufc/60772Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T18:15:54.837174Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false |
dc.title.none.fl_str_mv |
Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará |
title |
Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará |
spellingShingle |
Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará França, Francisco Álisson Paula de Antirretrovirais HIV Controle de Doenças Transmissíveis Profilaxia Pré-Exposição Serviços de Saúde |
title_short |
Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará |
title_full |
Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará |
title_fullStr |
Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará |
title_full_unstemmed |
Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará |
title_sort |
Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará |
author |
França, Francisco Álisson Paula de |
author_facet |
França, Francisco Álisson Paula de |
author_role |
author |
dc.contributor.none.fl_str_mv |
Fonteles, Marta Maria de França |
dc.contributor.author.fl_str_mv |
França, Francisco Álisson Paula de |
dc.subject.por.fl_str_mv |
Antirretrovirais HIV Controle de Doenças Transmissíveis Profilaxia Pré-Exposição Serviços de Saúde |
topic |
Antirretrovirais HIV Controle de Doenças Transmissíveis Profilaxia Pré-Exposição Serviços de Saúde |
description |
In 2017, the Brazilian Unified Health System (SUS) incorporated the Pre-exposure Prophylaxis to HIV (PrEP) as an additional strategy to the classic methods of prevention against infection by the Acquired Immunodeficiency Virus (HIV) already in place. PrEP consists of using a co-formulated tablet of tenofovir (TDF) and emtricitabine (FTC), capable of providing up to 96% protection against HIV. Given its recent incorporation, studies investigating its use in this setting are needed. Under this aspect, the main objective of this work was to analyze PrEP in specialized services in Ceará. This paper is a cross-sectional, analytical study, with a quantitative approach, based on secondary data obtained from the Logistic Control System of Medicines (SICLOM). Thus, the study population covered users using PrEP, registered in this system, from December 2017 to June 2020, and those with less than 180 days in using the method or who did not have the third monitoring consultation registered in SICLOM were excluded. Data collection occurred in May and June 2020. We used the Statistic Package for Social Sciences (SPSS) software for the statistical analyses and expressed the results descriptively and inferentially. Furthermore, bivariate and multivariate analyses were performed to investigate the association between the selected variables, especially the relationship between sociodemographic characteristics and risk factors for HIV infection, under full adherence to PrEP (using all doses within 90 days). At the time of data collection, 412 subjects were registered in SICLOM; however, only 231 participated in the study. Most participants were male (80.1%; n=185), gay (61.9%; n=143), with a mean age of 32±8.6 years (range 19 to 62 years old). The average time of method use was 15±5.9 months. Regarding risk factors for HIV infection, 8.7% (n=20) reported having sex in exchange for money, drugs or housing, 58.9% (n=136) reported alcohol use, 19.5% (n=45) marijuana use, and 6.1% (n=14) alcohol and marijuana use. Regarding the use of TDF/FTC, only 5.6% (n=13) had a degree of adherence lower than 80%. In this context, it was observed that characteristics of users, such as sexual practice in exchange for money, drugs, housing, and homosexuality, impacted full adherence to TDF/FTC (p= 0.033; p=0.049, respectively). In addition, another factor evidenced was the increase in the number of users who started not using condoms in any of the relationships when compared before PrEP use and after 90 and 180 days of its initiation (p<0.001). In this period, there was no statistically significant difference regarding the increase in the prevalence of sexually transmitted infections and the number of sexual partners. It was possible to observe that a significant portion of the PrEP users consumes alcohol, erection stimulants, and illicit drugs; however, this habit did not influence adherence to the TDF/FTC, which proved satisfactory (95% of the individuals had an adherence level >80%). Our findings may provide support for the comprehensive care of PrEP users since it allows us to learn about their characteristics and risk practices for HIV infection, among other determinants and associated factors. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-09-30T19:57:52Z 2021-09-30T19:57:52Z 2021-07-27 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
FRANÇA, F. A. P. Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará. 2021. 85 f. Dissertação (Mestrado em Ciências Farmacêuticas) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2021. Disponível em: http://www.repositorio.ufc.br/handle/riufc/60772 http://www.repositorio.ufc.br/handle/riufc/60772 |
identifier_str_mv |
FRANÇA, F. A. P. Análise da profilaxia pré-exposição ao HIV em serviços especializados do Ceará. 2021. 85 f. Dissertação (Mestrado em Ciências Farmacêuticas) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2021. Disponível em: http://www.repositorio.ufc.br/handle/riufc/60772 |
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http://www.repositorio.ufc.br/handle/riufc/60772 |
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