Sorologia anti-HIV e aconselhamento pré-teste em gestantes na região noroeste do Paraná, Brasil

Perception of pre- and post-HIV test counseling among patients diagnosed with aids in adolescence HIV test counseling for adolescents

Pre- and post-HIV test counseling has singular importance in adolescence, since it is a phase of great changes, and AIDS is an incurable chronic disease. In order to comprehend the perception of young people with AIDS diagnosed in adolescence regarding the counseling received upon testing, we conducted 39 in-depth interviews, with 23 in female patients and 16 male patients, and then analyzed the data with extensive reading, categorization and interpretation on a comprehensive basis. The results revealed that less than one third received pre-test counseling (30.8%), which often was limited to the explanation of the reason of the test, and 51.2% were counseled post-test. We found that most patients were unaccompanied when receiving the communication of their seropositivity, some of which were later informed by the adolescent's guardian. Some patients felt secure after counseling, realizing that the disease is something that would not change their lives, if they properly followed the guidelines. On the other hand, the feelings of desperation and suicide expressed by some of the patients may have been influenced by the lack of adequate counseling. We have concluded that, for the improved management of the epidemic, there is a need to enhance the communications of health professionals, especially those that are in primary care, pre-natal services, gynecology and family health strategy.

Comprehensiveness and programmatic vulnerability to stds/hiv/aids in primary care




This study aimed to identify programmatic vulnerability to STDs/HIV/AIDS in primary health centers (PHCs). This is a descrip - tive and quantitative study carried out in the city of São Paulo. An online survey was applied (FormSUS platform), involving administrators from 442 PHCs in the city, with responses received from 328 of them (74.2%), of which 53.6% were nurses. At - tention was raised in relation to program - matic vulnerability in the PHCs regarding certain items of infrastructure, prevention, treatment, prenatal care and integration among services on STDs/HIV/AIDS care. It was concluded that in order to reach comprehensiveness of actions for HIV/ AIDS in primary health care, it is necessary to consider programmatic vulnerability, in addition to more investment and reor - ganization of services in a dialogue with the stakeholders (users, multidisciplinary teams, and managers, among others).




Avaliação das ações de controle da sífilis e do HIV na assistência pré-natal da rede pública do município do Rio de Janeiro, Brasil

OBJETIVOS: avaliar a adequação das ações de controle da sífilis e do HIV na assistência pré-natal realizada em unidades do Sistema Único de Saúde do Município do Rio de Janeiro, Brasil. MÉTODOS: estudo transversal, realizado em 2007-2008, por meio de entrevistas com 2353 gestantes, análise de cartões de pré-natal e dados obtidos junto a 102 profissionais de saúde. Para avaliação da adequação da assistência foi elaborado um modelo lógico-operacional, tendo como referência normativa os protocolos assistenciais dos programas de assistência pré-natal e de DST/Aids do Ministério da Saúde. Foi considerado adequado o cumprimento de 100% das ações previstas para cada idade gestacional. RESULTADOS: foram identificadas falhas no aconselhamento das gestantes, na realização dos exames sorológicos, no tratamento dos casos de sífilis e na abordagem dos parceiros. Na análise bivariada, gestantes com início tardio da assistência pré-natal e número inadequado de consultas apresentaram pior adequação de todas as ações, exceto do aconselhamento anti-HIV. CONCLUSÕES: problemas no início precoce do prénatal, na garantia do número mínimo de consultas, no manejo adequado das gestantes e seus parceiros e, principalmente, no resultado sorológico oportuno da infecção pela sífilis e pelo HIV, são barreiras ao melhor controle da transmissão vertical dessas doenças.