Objective: to analyze the offering of health actions and services for the control of tuberculosis for people living with HIV/AIDS being followed up in the Specialized Care Services for HIV/AIDS in Ribeirão Preto, SP, Brazil. Method: quantitative, exploratory survey study. Participated 253 people living with HIV/AIDS followed up by this service, considering as inclusion criteria: individuals older than 18 years living in the city and not inmates. Data collection was conducted from January 2012 to May 2013 through interviews with the support of a specific instrument. Data were analyzed using indicators and a composite index. Results: the offering of services for the control of tuberculosis in people living with HIV/AIDS by municipal services was considered as intermediate, reinforcing the need for better planning for comprehensive assistance, coordination of professionals in teams and among the services network, in addition to professional training and continuing education. Conclusion: it is necessary to implement strategies that promote shared actions between TB and HIV / AIDS programs and between different services in order to strengthen the local care network, aimed at producing an individualized care, comprehensive and responsive.
Objetivou-se analisar a coordenação das ações e serviços de saúde na assistência às pessoas que vivem com HIV/AIDS. Trata-se de um estudo seccional com 301 pessoas que vivem com HIV/AIDS. A análise foi feita por técnicas descritivas, analise de variância e comparação múltiplas de médias. Encontrou-se que a coordenação da assistência foi satisfatória (média = 3,69 e DP = 1,74). As pessoas que vivem com HIV/AIDS utilizavam outros serviços de saúde além dos Serviços de Assistência Especializada em HIV/AIDS – SAE (Pronto Atendimento: 67%; atenção básica: 43,2%; outros serviços especializados: 23,6%; serviços privados: 15%). Os cinco SAE apresentaram diferentes desempenhos, bem como distintos contextos e composições assistenciais, entretanto adequado manejo dos aspectos clínicos em detrimento dos sociais. O fornecimento da guia de referência foi tido como satisfatório, entretanto a guia de contrarreferência insatisfatório. Há necessidade de estratégias que favoreçam o desenvolvimento de ações compartilhadas e cooperadas dentro das equipes dos SAE e entre os diferentes serviços com o intuito de fortalecer a produção de cuidado resolutivo.
Objectives: to identify the association between HIV/AIDS hospitalizations and factors that integrate individual, social, and programmatic vulnerabilities. Methods: a case-control study conducted in 2014 in a municipality in the state of São Paulo. “Cases” included people living with HIV (PLHIV) hospitalized and “control” those who were outpatients. Interviews were conducted using a tool with sociodemographic variables, clinical characteristics and other vulnerabilities. Data were analyzed by conditional logistic regression. Results: fifty-six cases and 112 control participated. Risk factors for HIV hospitalization were: unemployed and retired individuals; homeless people; non-antiretroviral users; individuals who did not regularly attend returns. Access to social workers was a protective factor for hospitalization. Conclusions: this research contributed to measure the social, individual and programmatic vulnerabilities that interfere with HIV worsening and, consequently, unfavorable outcome such as hospitalization.
RESUMENObjetivo: Analizar la oferta de acciones en los servicios de salud que prestan asistencia a las personas que viven con SIDA en el seguimiento de los servicios especializados del municipio de Ribeirão Preto-SP. Método: Estudo descriptivo, exploratorio, del tipo encuesta. Se llevaron a cabo entrevistas con cuestionario estructurado y análisis de datos por medio de estadísticas descriptivas. Resultados: La oferta de acciones y servicios de salud se la ve como regular. Para los 301 sujetos, la atención de rutina por el equipo de referencia; exáme-nes de laboratorio y facilitación de antirretrovirales, vacunas y preservativos obtuvieron evaluación satisfactoria. Evaluadas como regular la oferta de exámenes para la prevención y el diagnóstico de comorbilidades, e insatisfactoria la oferta de atención especializada por otros profesionales; de grupos de apoyo psicosocial y fármacos preventivos de efecto colateral de los antirretrovirales. Conclusión: Debilidades permean el seguimiento y la gestión del cuidado, con predominio del enfoque biologicista, centrado en el médico, en el que el control clínico y el acceso a la Terapia Antirretroviral se constituyen como el enfoque esencial de la asistencia prestada. DESCRIPTORES ABSTRACTObjective: To analyse the provision of health care actions and services for people living with AIDS and receiving specialised care in Ribeirão Preto, SP. Method: A descriptive, exploratory, survey-type study that consisted of interviews with structured questionnaires and data analysis using descriptive statistics. Results: The provision of health care actions and services is perceived as fair. For the 301 subjects, routine care provided by the reference team, laboratory tests and the availability of antiretroviral drugs, vaccines and condoms obtained satisfactory evaluations. The provision of tests for the prevention and diagnosis of comorbidities was assessed as fair, whereas the provisions of specialised care by other professionals, psychosocial support groups and medicines for the prevention of antiretroviral side effects were assessed as unsatisfactory. Conclusion: Shortcomings were observed in follow-up and care management along with a predominantly biological, doctor-centred focus in which clinical control and access to antiretroviral therapy comprise the essential focus of the care provided.
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