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Master's Dissertation
DOI
https://doi.org/10.11606/D.22.2008.tde-03112008-100451
Document
Author
Full name
Maria Fernanda Cabral Kourrouski
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2008
Supervisor
Committee
Lima, Regina Aparecida Garcia de (President)
Carvalho, Ana Maria Pimenta
Cervi, Maria Célia
Title in Portuguese
Adesão ao tratamento: vivências de adolescentes com HIV/AIDS
Keywords in Portuguese
Adesão
Adolescente
AIDS
Enfermagem
HIV
Abstract in Portuguese
A AIDS é uma manifestação clínica avançada da infecção pelo vírus da imunodeficiência humana (HIV), tendo se tornado um dos maiores problemas de saúde pública do mundo devido ao aumento do número de casos, alto custo da terapêutica, seqüelas físicas e emocionais e aos altos índices de mortalidade. Com o advento da terapia antiretroviral, a sobrevida destas pessoas aumentou e, desta forma, esta doença tem sido considerada uma condição crônica. Crianças que adquiriram o HIV na infância, seja por transmissão vertical ou outros meios, chegam à fase da adolescência, enfrentando conflitos característicos deste momento, os quais se agravam quando aliados a uma condição crônica incurável, como a AIDS, na qual é necessário acompanhamento periódico de saúde, com consultas médicas e uso de medicamentos diários. O presente estudo é de natureza descritivo-exploratória, com análise qualitativa dos dados. Tem por objetivo compreender o processo de adesão dos adolescentes com HIV/AIDS ao tratamento e identificar as causas que podem levar à não adesão. Foram selecionados nove adolescentes, com idades entre 12 a 18 anos, em seguimento na Unidade Especializada de Tratamento de Doenças Infecciosas, de um hospital escola do interior do estado de São Paulo, em uso de terapia antiretroviral, que adquiriram o HIV na infância¸ bem como os responsáveis por estes adolescentes. A coleta de dados foi realizada mediante entrevistas. Na análise, os dados foram organizados em torno de dois temas centrais - o viver com HIV/AIDS e a adesão ao tratamento medicamentoso. Ao conhecermos a experiência destes adolescentes e seus cuidadores, observamos as dificuldades por eles enfrentadas diante de uma doença que traz estigma e discriminação e tais dificuldades podem influenciar na adesão medicamentosa destas pessoas. Observamos que os adolescentes procuram viver e sentirem-se normais, como seus pares, entretanto, na sociedade ainda existe preconceito em relação ao HIV/AIDS, o que os levam a vivenciarem o dilema de revelar ou não o status sorológico e, muitas vezes, quando o revelam ou este é descoberto, sofrem com o estigma e discriminação. Seus cuidadores permanecem almejando a cura e relatam terem medo de perder os adolescentes, por já terem vivenciado situações semelhantes com outros familiares. Os adolescentes sonham com um futuro, incluindo casamento e filhos. Mencionam dificuldades com a terapêutica medicamentosa, seja pelo sabor desagradável dos medicamentos ou pela lembrança da doença. Os adolescentes mencionaram também a importância e os benefícios dos antiretrovirais, salientando que a finalidade dos mesmos é evitar outras doenças e contribuir para a cura do HIV/AIDS. Os resultados do estudo possibilitaram identificar aspectos que necessitam de intervenção por parte da equipe de saúde, objetivando obter-se uma melhor adesão dos adolescentes ao tratamento.
Title in English
Treatment adherence: experiences of adolescents with HIV/AIDS
Keywords in English
adherence
adolescent
AIDS
HIV
nursing.
Abstract in English
AIDS is an advanced clinical manifestation of infection by the human immunodeficiency virus (HIV), it has become one of worlds major public health problems due to the increase in the number of cases, high costs of treatment, physical and emotional sequelae and high mortality rates. The arrival of the antiretroviral therapy has increased the patients survival, hence, this disease is currently considered a chronic condition. People who have acquired HIV in childhood, through vertical transmission or other means, get to adolescence and start to face the conflicts characteristic of this moment of life. These conflicts worsen when associate to an incurable chronic condition, as AIDS, in which is necessary periodic health follow, with medical appointments and daily use of drugs, what is permeated by stigma and discrimination. It is a descriptive-exploratory study, with qualitative methodological approach, which aimed to understand the adherence process of adolescents with HIV/AIDS to treatment, and identify the causes that can lead to non-adherence. The subjects were nine adolescents, aged between 12 and 18 years old, in use of antiretroviral therapy, who acquired HIV during childhood and are under follow-up at the Infectious Diseases Specialized Treatment Unity of a university hospital in the interior of São Paulo state, as well as the ones responsible for the adolescents. The data collection was carried out through semi-structured interview with the adolescents and non-structured interview with the ones responsible for them. In the analysis, the data were organized around two central themes living with HIV/AIDS and adherence to medication therapy. While describing the adolescents and their caregivers experience, we observe the difficulties faced by them when facing a disease that brings so much stigma and discrimination, and in which way this can influence in the medication adherence of these people. The study showed us the adolescents try to live and feel normal, as other people of their age. However, there is still much prejudice in society in relation to HIV/AIDS, what makes them live the dilemma of revealing or not their serologic status and, many times, when they reveal or it is found out by the school, neighbors and family, they suffer with the discrimination and stigma inherent to the disease. Their caregivers still long for cure and mention fear of losing the adolescents, as they have been through similar situations before. The adolescents dream of a future, including marriage and children. These facts influence in the adherence to treatment and the difficulty in taking medications, for the unpleasant taste, the memory of the disease or for thinking that it can lead them to death, as if it was the solution for their problems. The adolescents know the importance and benefits of antiretrovirals, verbalizing that their purpose is to avoid diseases and contribute to healing. These facts can be explained by the vulnerability of the period of life they are going through - adolescence, and for the fact that it still is an incurable disease. The results of the study enabled the identification of aspects which need intervention, aiming a better adherence to treatment.
 
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Publishing Date
2008-11-24
 
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