Adesão à terapia antirretroviral em pessoas vivendo com HIV que são atendidas pela Rede de Atenção Psicossocial de Campo Grande, Mato Grosso do Sul, 2014-2018

Detalhes bibliográficos
Autor(a) principal: PRISCILLA ARASHIRO
Data de Publicação: 2021
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da UFMS
Texto Completo: https://repositorio.ufms.br/handle/123456789/4276
Resumo: Human immunodeficiency virus (HIV) infection remains a major public health concern in Brazil. Brazilian clinical treatment protocol recommends the initiation of antiretroviral therapy (ART) to all HIV-positive adults, even without immune compromisse. Currently, one of the biggest challenges are related to adherence to ART. Consumption of alcohol and other drugs in people living with HIV (PLHIV) have been associated with decreased adherence or discontinuation of ART. Individuals with mental disorders are at increased risk exposure to sexually transmitted infections. In Brazil, there are few studies that bring together mental health and adherence to ART. Another aggravating factor concerns the lack of communication and the dissociated work of health services specialized in mental health and infectious diseases. Thus, this study aimed to evaluate the adherence to ART in PLHIV who were who attending the facilities care of the Psychosocial Care Network of Campo Grande, from January 2014 to December 2018. The epidemiological clinical profile of PLHIV with moderate or severe mental disorders, the therapeutic regimens, and the adherence to ART were assessed based on data reported to SINAN (Brazil Information System for Notifiable Diseases) and to medical records. The proportion of PLHIV with mental disorders moderate or severe, linked to the RAPS attention points, during the study period was 8.8 cases per 1000 PLHIV. The predominant epidemiological profile was male, white or brown, heterosexual, with incomplete primary education. Were found percentages of 40.2% of co-infections; 44.4% indication of drug abuse; 35.5% of ideations or suicidal thoughts. The most prevalent founded disorder was substance and alcohol abuse, followed by depressive and anxiety disorders. Our results showed the low adherence to the ART in PLHIV with mental disorders. The immunological therapeutic failure was significant associated with mental disorders and with the presence of co-infections. The low ART adherence was significant associated with: people experiencing homelessness, abusive use of alcohol and illicit drugs, irregular attending at health services specialized in mental health and infectious diseases. These findings are important to support the actions care workers and for the planning of improvements of the lines of care. In addition, these data could also support the strengthening the lines of care of the Brazilian Health Unic System. Keywords: mental health, mental disorders, antiretroviral therapy, adherence.
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spelling 2022-01-17T20:23:21Z2022-01-17T20:23:21Z2021https://repositorio.ufms.br/handle/123456789/4276Human immunodeficiency virus (HIV) infection remains a major public health concern in Brazil. Brazilian clinical treatment protocol recommends the initiation of antiretroviral therapy (ART) to all HIV-positive adults, even without immune compromisse. Currently, one of the biggest challenges are related to adherence to ART. Consumption of alcohol and other drugs in people living with HIV (PLHIV) have been associated with decreased adherence or discontinuation of ART. Individuals with mental disorders are at increased risk exposure to sexually transmitted infections. In Brazil, there are few studies that bring together mental health and adherence to ART. Another aggravating factor concerns the lack of communication and the dissociated work of health services specialized in mental health and infectious diseases. Thus, this study aimed to evaluate the adherence to ART in PLHIV who were who attending the facilities care of the Psychosocial Care Network of Campo Grande, from January 2014 to December 2018. The epidemiological clinical profile of PLHIV with moderate or severe mental disorders, the therapeutic regimens, and the adherence to ART were assessed based on data reported to SINAN (Brazil Information System for Notifiable Diseases) and to medical records. The proportion of PLHIV with mental disorders moderate or severe, linked to the RAPS attention points, during the study period was 8.8 cases per 1000 PLHIV. The predominant epidemiological profile was male, white or brown, heterosexual, with incomplete primary education. Were found percentages of 40.2% of co-infections; 44.4% indication of drug abuse; 35.5% of ideations or suicidal thoughts. The most prevalent founded disorder was substance and alcohol abuse, followed by depressive and anxiety disorders. Our results showed the low adherence to the ART in PLHIV with mental disorders. The immunological therapeutic failure was significant associated with mental disorders and with the presence of co-infections. The low ART adherence was significant associated with: people experiencing homelessness, abusive use of alcohol and illicit drugs, irregular attending at health services specialized in mental health and infectious diseases. These findings are important to support the actions care workers and for the planning of improvements of the lines of care. In addition, these data could also support the strengthening the lines of care of the Brazilian Health Unic System. Keywords: mental health, mental disorders, antiretroviral therapy, adherence.A infecção pelo vírus da imunodeficiência humana (HIV) continua sendo um grande problema de saúde pública no Brasil. O atual protocolo clínico de tratamento brasileiro recomenda o início da terapia antirretroviral (TARV) a todos os adultos com sorologia positiva para o HIV, mesmo sem comprometimento imunológico. Atualmente, no contexto HIV/aids, um dos maiores desafios diz respeito à adesão da TARV. O consumo de álcool e outras drogas em pessoas vivendo com HIV (PVHIV) têm sido associados à diminuição da adesão ou descontinuidade da TARV. O indivíduo com transtornos mentais apresenta um risco aumentado de exposição em relação às infecções sexualmente transmissíveis. São poucos os estudos que aproximam saúde mental e adesão à TARV no Brasil. Outro aspecto complicador são que os serviços de assistências a esses indivíduos que trabalham dissociados. Deste modo, este estudo avaliou a adesão à terapia antirretroviral em PVHIV atendidas na CAPS e/ou eCR, no período de janeiro de 2014 a dezembro de 2018. Os objetivos constituem em descrever o perfil clínico epidemiológico de PVHIV com transtornos mentais moderados ou graves, descrever os esquemas terapêuticos e a adesão à TARV e identificar as variáveis associadas de má adesão à TARV. Fundamentado em dados primários (aplicação de questionário) e secundários (prontuários, sistemas de informações). A proporção de PVHIV com transtornos mentais moderados ou graves, vinculadas aos pontos de atenção da RAPS, no período de estudo foi de 8,8 casos a cada 1000 PVHIV. O perfil epidemiológico predominante foi do sexo masculino, brancos ou pardos, heterossexuais, com o ensino fundamental incompleto. Foram encontradas percentuais de 40,2% de coinfecções; 44,4% indicação do uso de drogas; 35,5% de ideações ou pensamentos suicidas. Em 1º lugar transtornos relacionados a abuso de substâncias e álcool, em 2º transtornos depressivos e 3º lugar transtornos ansiosos. Evidenciou-se baixa adesão à TARV em PVHIV com transtornos mentais. A falha terapêutica imunológica apresentou associação com os transtornos mentais, com a presença de coinfecções no período. Os resultados identificaram variáveis associadas à má adesão à TARV, como pessoas em situação de rua, ao uso abusivo de álcool e de drogas ilícitas, acompanhamentos irregulares nos serviços de saúde mental e infectologia. Os achados são importantes para auxiliar o trabalho das equipes de saúde e poderão subsidiar a proposição de melhorias das linhas de cuidado aperfeiçoando uma rede integrada para melhoria da saúde desse público atendido nessas regiões, além de gerar conhecimentos para o fortalecimento das políticas de cuidado no âmbito do SUS. Palavras-chave: saúde mental, transtornos mentais, terapia antirretroviral, adesão.Fundação Universidade Federal de Mato Grosso do SulUFMSBrasilHIV/aids, saúde mental, adesão.Adesão à terapia antirretroviral em pessoas vivendo com HIV que são atendidas pela Rede de Atenção Psicossocial de Campo Grande, Mato Grosso do Sul, 2014-2018info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisEverton Falcao de OliveiraPRISCILLA ARASHIROinfo:eu-repo/semantics/openAccessporreponame:Repositório Institucional da UFMSinstname:Universidade Federal de Mato Grosso do Sul (UFMS)instacron:UFMSTHUMBNAILDissertacao-PRISCILLA-ARASHIRO-PPGDIP.pdf.jpgDissertacao-PRISCILLA-ARASHIRO-PPGDIP.pdf.jpgGenerated Thumbnailimage/jpeg1127https://repositorio.ufms.br/bitstream/123456789/4276/3/Dissertacao-PRISCILLA-ARASHIRO-PPGDIP.pdf.jpg667b4210494364adf7949bee3b2b402dMD53TEXTDissertacao-PRISCILLA-ARASHIRO-PPGDIP.pdf.txtDissertacao-PRISCILLA-ARASHIRO-PPGDIP.pdf.txtExtracted texttext/plain199114https://repositorio.ufms.br/bitstream/123456789/4276/2/Dissertacao-PRISCILLA-ARASHIRO-PPGDIP.pdf.txt313dae8be3e16ac6e8231cd8f7c82f9fMD52ORIGINALDissertacao-PRISCILLA-ARASHIRO-PPGDIP.pdfDissertacao-PRISCILLA-ARASHIRO-PPGDIP.pdfapplication/pdf983662https://repositorio.ufms.br/bitstream/123456789/4276/1/Dissertacao-PRISCILLA-ARASHIRO-PPGDIP.pdfe045694b54f15169ae576217538755f9MD51123456789/42762022-01-18 03:01:27.869oai:repositorio.ufms.br:123456789/4276Repositório InstitucionalPUBhttps://repositorio.ufms.br/oai/requestri.prograd@ufms.bropendoar:21242022-01-18T07:01:27Repositório Institucional da UFMS - Universidade Federal de Mato Grosso do Sul (UFMS)false
dc.title.pt_BR.fl_str_mv Adesão à terapia antirretroviral em pessoas vivendo com HIV que são atendidas pela Rede de Atenção Psicossocial de Campo Grande, Mato Grosso do Sul, 2014-2018
title Adesão à terapia antirretroviral em pessoas vivendo com HIV que são atendidas pela Rede de Atenção Psicossocial de Campo Grande, Mato Grosso do Sul, 2014-2018
spellingShingle Adesão à terapia antirretroviral em pessoas vivendo com HIV que são atendidas pela Rede de Atenção Psicossocial de Campo Grande, Mato Grosso do Sul, 2014-2018
PRISCILLA ARASHIRO
HIV/aids, saúde mental, adesão.
title_short Adesão à terapia antirretroviral em pessoas vivendo com HIV que são atendidas pela Rede de Atenção Psicossocial de Campo Grande, Mato Grosso do Sul, 2014-2018
title_full Adesão à terapia antirretroviral em pessoas vivendo com HIV que são atendidas pela Rede de Atenção Psicossocial de Campo Grande, Mato Grosso do Sul, 2014-2018
title_fullStr Adesão à terapia antirretroviral em pessoas vivendo com HIV que são atendidas pela Rede de Atenção Psicossocial de Campo Grande, Mato Grosso do Sul, 2014-2018
title_full_unstemmed Adesão à terapia antirretroviral em pessoas vivendo com HIV que são atendidas pela Rede de Atenção Psicossocial de Campo Grande, Mato Grosso do Sul, 2014-2018
title_sort Adesão à terapia antirretroviral em pessoas vivendo com HIV que são atendidas pela Rede de Atenção Psicossocial de Campo Grande, Mato Grosso do Sul, 2014-2018
author PRISCILLA ARASHIRO
author_facet PRISCILLA ARASHIRO
author_role author
dc.contributor.advisor1.fl_str_mv Everton Falcao de Oliveira
dc.contributor.author.fl_str_mv PRISCILLA ARASHIRO
contributor_str_mv Everton Falcao de Oliveira
dc.subject.por.fl_str_mv HIV/aids, saúde mental, adesão.
topic HIV/aids, saúde mental, adesão.
description Human immunodeficiency virus (HIV) infection remains a major public health concern in Brazil. Brazilian clinical treatment protocol recommends the initiation of antiretroviral therapy (ART) to all HIV-positive adults, even without immune compromisse. Currently, one of the biggest challenges are related to adherence to ART. Consumption of alcohol and other drugs in people living with HIV (PLHIV) have been associated with decreased adherence or discontinuation of ART. Individuals with mental disorders are at increased risk exposure to sexually transmitted infections. In Brazil, there are few studies that bring together mental health and adherence to ART. Another aggravating factor concerns the lack of communication and the dissociated work of health services specialized in mental health and infectious diseases. Thus, this study aimed to evaluate the adherence to ART in PLHIV who were who attending the facilities care of the Psychosocial Care Network of Campo Grande, from January 2014 to December 2018. The epidemiological clinical profile of PLHIV with moderate or severe mental disorders, the therapeutic regimens, and the adherence to ART were assessed based on data reported to SINAN (Brazil Information System for Notifiable Diseases) and to medical records. The proportion of PLHIV with mental disorders moderate or severe, linked to the RAPS attention points, during the study period was 8.8 cases per 1000 PLHIV. The predominant epidemiological profile was male, white or brown, heterosexual, with incomplete primary education. Were found percentages of 40.2% of co-infections; 44.4% indication of drug abuse; 35.5% of ideations or suicidal thoughts. The most prevalent founded disorder was substance and alcohol abuse, followed by depressive and anxiety disorders. Our results showed the low adherence to the ART in PLHIV with mental disorders. The immunological therapeutic failure was significant associated with mental disorders and with the presence of co-infections. The low ART adherence was significant associated with: people experiencing homelessness, abusive use of alcohol and illicit drugs, irregular attending at health services specialized in mental health and infectious diseases. These findings are important to support the actions care workers and for the planning of improvements of the lines of care. In addition, these data could also support the strengthening the lines of care of the Brazilian Health Unic System. Keywords: mental health, mental disorders, antiretroviral therapy, adherence.
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