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Doctoral Thesis
DOI
https://doi.org/10.11606/T.22.2010.tde-16112010-102151
Document
Author
Full name
Lis Aparecida de Souza Neves
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2010
Supervisor
Committee
Gir, Elucir (President)
Bertolozzi, Maria Rita
Canini, Silvia Rita Marin da Silva
Nogueira, Jordana de Almeida
Santos, Claudia Benedita dos
Title in Portuguese
Qualidade de vida de indivíduos com a coinfecção HIV/tuberculose no município de Ribeirão Preto - SP
Keywords in Portuguese
aids
apoio social
HIV
qualidade de vida
tuberculose
Abstract in Portuguese
A tuberculose (TB) é a infecção oportunista mais associada com o HIV/aids; sua associação com o HIV afeta negativamente a vida dos indivíduos, tanto nos aspectos biológicos como nos psicossociais. A debilidade física aliada ao estigma e a discriminação de ambas as enfermidades podem levar ao isolamento social e à restrição dos relacionamentos, prejudicando a manutenção da rede social de apoio e a qualidade de vida do indivíduo com a coinfecção HIV/TB. Objetivo: avaliar a qualidade de vida de indivíduos com a coinfecção HIV/TB e comparar com a qualidade de vida de indivíduos soropositivos para o HIV. Materiais e Métodos: trata-se de estudo descritivo, de corte transversal, realizado por meio de entrevista com pacientes soropositivos para o HIV e com coinfectados HIV/TB, em acompanhamento ambulatorial no município de Ribeirão Preto; foram utilizados os instrumentos WHOQOL HIV bref, Escala de Suporte Social para Pessoas Vivendo com HIV/AIDS e instrumento para caracterização socioeconômica. Resultados: participaram 115 indivíduos soropositivos para o HIV, sendo 57 coinfectados com TB e 58 não coinfectados; a maioria era do sexo masculino, heterossexuais, predominando a faixa etária de 40 a 49 anos, com os coinfectados apresentando escolaridade e renda inferiores aos demais. Cerca de um terço dos indivíduos com TB ativa soube da sua soropositividade recentemente; a maioria apresentava contagem de linfócitos TCD4 menor que 200 células/mm3 e uso recente da terapia antirretroviral, diferentemente dos pacientes soropositivos que apresentaram melhores indicadores clínicos e uso de ARV há mais tempo. A forma clínica de TB mais comum foi a pulmonar, mas com taxas elevadas de extra pulmonar. Na avaliação da qualidade de vida os indivíduos coinfectados apresentaram escores médios mais baixos do que os não coinfectados em todos os domínios, com diferença importante no Físico, Psicológico, Nível de Independência e Relações Sociais. Os valores do suporte social foram intermediários, mas com ampla variabilidade de escores; houve associações estatísticas entre o suporte social e quase todos os domínios de qualidade de vida, exceto Espiritualidade. Conclusões: O grande número de pacientes coinfectados com baixo nível sócioeconômico evidenciou a estreita relação da dupla infecção com a exclusão social, apontando TB e HIV/aids como doenças de magnitude que ultrapassa as barreiras biológicas. A qualidade de vida dos indivíduos com a coinfecção HIV/TB foi pior do que a dos soropositivos sem TB em todos os domínios. O suporte social tem um papel importante ao amenizar conseqüências negativas de eventos estressantes, podendo diminuir o efeito do preconceito de ambas as enfermidades e afetando diretamente a qualidade de vida do indivíduo coinfectado.
Title in English
Quality of life in people carrying an HIV/Tuberculosis coinfection in the municipality of Ribeirão Preto (SP)
Keywords in English
AIDS
HIV
quality of life
social support
tuberculosis
Abstract in English
Tuberculosis (TB) is the opportunist infection mostly associated with HIV/AIDS; its association with HIV affects a person's living in a negative way, both in biological and psychosocial aspects. The physical weakness linked to the stigma and the discrimination on both diseases may lead to social isolation and to restriction in relationships, harming the maintenance of social links for support and the person's quality of life with HIV/TB co-infection. Objective: Assessing the quality of life of people carrying HIV/TB co-infection and compare it with the quality of life of people serum-positive for HIV. Materials and Methods: This is a descriptive study, with transversal cutting, accomplished by means of interviewing serum-positive patients for the HIV and HIV/TB co-infected undergoing ambulatory follow-up in Ribeirão Preto county; we used WHOQOL HIV bref tools, Social Support Inventory for People who are Positive or Have Aids and an instrument for socio-economic featuring. Results: 115 HIV serum-positive people took part, 57 of them co-infected with TB and 58 non-co-infected; most of them were male, heterosexuals, mostly in their 40's; those co-infected presented schooling and income inferior to the rest. About one-third of those stricken by active TB had come to know about their being serum-positive only very recently; most presented lymphocytes figures TCD4 inferior to 200 cells/mm3 and recent use of anti-retroviral therapy, different from serum-positive patients which presented better clinics indexes and use of ARV for a longer time. The most common clinic form of TB was the lung one, but with high levels of extra lung ones. In the assessment of quality of life, co-infected people showed lower average scores than those non-co-infected in all levels, with important difference in Physical, Psychological, Level of Independence and Social Relations. The values of social support were intermediate, but with wide range of scores; there was some association between social support and nearly all levels of quality of life, with exception of spirituality. Conclusions: The large number of co-infected patients with low socio-economic level stressed the narrow relation of double infection with social exclusion, showing TB and HIV/AIDS as diseases with a magnitude that transcends biological barriers. Quality of life of people carrying HIV/TB co-infection was worse than those serum-positive without TB in all levels. Social support has an important role in soothing negative consequences of stressing events, and it may minimize the effect of prejudice on both diseases and influencing in a direct way the quality of life of a co-infected person.
 
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Publishing Date
2010-11-22
 
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