Fatores socioestruturais e comportamentais associados ao risco de infecção pelo HIV em jovens: análise subsidiada pelos elementos do Modelo Social Ecológico Modificado

• Autor(a) principal: Romero, Renata Olívia Gadelha
• Data de Publicação: 2022
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/26186
• topic: HIV; Jovens; Análises multinível; Comportamento; Estudo de validação; Young people; Multilevel analysis; Behavior; Validation study; VIH; Gente joven; Análisis multinivel; Comportamiento; Estudio de validación; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM

Introduction: Although the general trend of HIV infection has been decreasing, it is recognized that populations are not uniformly vulnerable or equally affected, assuming, depending on the location and/or age group, different scenarios. The increase in new infections, especially among young people, requires expanded and coordinated approaches to socio-structural and behavioral contexts. Objective: To analyze the behavioral and socio-structural factors associated with the risk of HIV infection in young people. Method: Supported by the theoretical-methodological framework of the Modified Social Ecological Model, this study was conducted in two stages: Methodological study and Cross-sectional study. The methodological study outlined the construction and validation of the instrument, based on three procedures: 1) Theoretical - definition of the items and elaboration of the instrument, 2) Empirical - selection of experts for the instrument validation process, from two rounds of the Delphi technique and 3) Analytical- content validation performed, in which the item with at least 80% agreement between the experts was considered valid. The instrument was submitted to the pre-test, as a semantic analysis requirement. The stage comprising the cross-sectional study involved a sample of 200 young people, aged between 15 and 24 years, recruited when they attended the service to perform the rapid HIV test. Data were collected through interviews with the support of the validated instrument, which included 45 eligibility and multiple-choice questions, organized into three domains: Domain I - Sociodemographic; Domain II- Sociostructural; Domain III- Behavioral. Bivariate analysis and Fisher's exact test were used to verify the association between the independent variables and the dependent variable (serological outcome), the weight of evidence analysis (Weight of Evidence) and the Score System model. The research was approved by the Research Ethics Committee, under opinion No. 3,935,713. Results: The prevalence of HIV in the population studied was 2%. The cases were diagnosed in young males, with male gender identity, homosexual sexual orientation, of mixed color and average schooling. The variables that showed statistical significance were: Domain I – sex (p=0.036) and sexual orientation (p=0.012); Domain II – who do you live with (p=0.024), sexual relationship in exchange for benefits (p=0.019), discrimination based on sexual orientation (p=0.007); Domain III – risk of having acquired HIV (p=0.048), relationship with someone who is HIV positive (p=0.019). The Score System statistical model showed that the self-perceived risk of HIV infection by young people was at a lower level than the risks identified by the model. Conclusion: The results show the importance of (re)knowledge of the heterogeneity and synergy caused by the multifaceted character of the HIV epidemic in the young population. The combined understanding of socio-structural and behavioral elements can support strategies more efficiently in identifying young people at high risk for infection, in addition to emphasizing priority access to HIV prevention methods.