Factors associated with therapeutic success in HIV-positive individuals in southern Brazil

Silveira, Marysabel Pinto Telis; Maurer, Patricia; Guttier, Marília Cruz; Moreira, Leila Beltrami

doi:10.1111/jcpt.12233

Cited by 12 publications

(15 citation statements)

References 18 publications

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“…The sociodemographic variables (age, education level, race, housing status, household income) were collected through a semi-structured questionnaire, previously used for other studies. 13,14 Other information obtained included: form of contamination, years of contamination, people who live with them that are contaminated with the virus, prescribed medications, drug allergies, smoking status, frequency of condom use, and knowledge about proper condom use. Information extracted from the medical records included marital status, partner's status, and all the CD4 count and viral load results for each pregnant woman that participated in the study.…”

Section: Methodsmentioning

confidence: 99%

Quality of Life of Pregnant Women Living with HIV/AIDS

Silveira

Müller

2016

Rev Bras Ginecol Obstet

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Objective to evaluate the quality of life of HIV positive (HIVþ) pregnant women using the HIV/AIDS Target Quality of Life (HAT-QoL) instrument. Methods cross-sectional study, conducted between May 2014 and November 2015, with HIVþ pregnant women selected by convenience sampling. Sociodemographic and behavioral data were collected through interviews, and the HAT-QoL questionnaire was applied. Clinical and laboratorial data were collected from medical records. Results twenty-seven pregnant women participated in the study. Their mean age was 27 years (standard deviation -SD: 7.3). The majority (59%) had up to 8 years of education, 52% identified themselves as white, 56% were unemployed, and 59% had a household income higher than the minimum wage. The mean infection time by the virus was 68.4 months (5.7 years). The majority (74%) were contaminated with HIV through sexual intercourse, and 67% declared not having a HIVþ relative. Regarding the use of condoms, 41% reported using them sporadically, and the same number did not have proper knowledge about them. Only 23 patients (85%) reported having been prescribed antiretrovirals. Fourteen (64%) had a CD4 count higher than 500 cells/mm 3 , and 13 pregnant women (59%) had an undetectable viral load. The scores from the quality of life questionnaire dimensions that were more affected are: infection "disclosure concerns" (mean: 39.8; SD: 27

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Section: Methodsmentioning

confidence: 99%

Quality of Life of Pregnant Women Living with HIV/AIDS

Silveira

Müller

2016

Rev Bras Ginecol Obstet

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“…Considering this context, it is common for Brazilian and Paraguayan HIV patients living in Paraguay to cross the border to seek for healthcare in the Brazilian border city. Although prognostic factors for HIV infection are recognizably of socioeconomic 28,29,30,31 , laboratorial 32,33,34 and clinical 35,36,37 nature, the effect of regional mobility or cross-border healthcare in the prognosis of HIV patients remains non-studied. Taylor et al 38 suggest that HIV patients who cross international boundaries, adopting the pattern of pendulum migration for healthcare are less adherent to medications due to causes of individual (fear of experiencing side effects during the trip, changes in daily schedule, and the idea that the travel is a form of vacations in which they can take "vacations" from medication), social (fear of the stigma that leads the patient to hide the medication and forget to take it) and health (dispensing medications for only one month, and difficulty to travel more than once a month for healthcare) nature 38 .…”

Section: Introductionmentioning

confidence: 99%

Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina

2019

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The act of crossing an international border for healthcare is a reality in border areas and the flow is in the direction of the city with more human and healthcare resources. Although several prognostic factors related to HIV+ patients are known, the prognostic value of this type of mobility for long term care is still neglected. This study compares the prognosis of HIV patients from three groups, one involved in regional mobility, another in cross-border mobility in search for healthcare and the reference group which is composed by patients living in the same city of the health facility. This is a retrospective cohort study using medical records from a healthcare service in Brazil. Following survival analysis with log-rank test and Cox proportional hazard models, overall survival had no significant difference between patients who were involved in regional (HR = 1.03; 95%CI: 0.69-1.54; p = 0.89) or international (HR = 1.07; 95%CI: 0.58-1.97; p = 0.83) mobility and those who were not. This lack of difference was kept when adjusted for known prognostic factors. In this retrospective cohort study, exposure to both regional and international migration did not have a significant association with the risk of death by any cause in crude or adjusted analyses for already known prognostic factors. This is the first study to consider the prognostic role of cross-border healthcare for HIV patients. Despite these findings, the need of monitoring the extent and the clinical and demographic characteristics of healthcare demand originated in the other side of the border and the use of these data for decision making in health management is emphasized.

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“…Studies demonstrate that the adherence to antiretroviral therapy can also be influenced by the reduction of barriers to accessing health services; use of health technologies, such as welcoming, bonding, accountability, and trust in the service; and, improvement of the interpersonal relationships with health professionals 1 - 4 .…”

Section: Discussionmentioning

confidence: 99%

“…In the early 1990s, an important milestone in the treatment of Acquired Immunodeficiency Syndrome (AIDS) was the development of high-potency combined antiretroviral therapy 1 . The great benefit generated by the use of this therapy was the prolongation of the survival of people who acquired this disease, since it ceased to be considered fatal, but rather a chronic condition 2 .…”

Section: Introductionmentioning

confidence: 99%

Noncompliance in people living with HIV: accuracy of defining characteristics of the nursing diagnosis

Silva

Costa

Neto

et al. 2017

Rev. Latino-Am. Enfermagem

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Objective:to evaluate the accuracy of the defining characteristics of the NANDA International nursing diagnosis, noncompliance, in people with HIV. Method:study of diagnostic accuracy, performed in two stages. In the first stage, 113 people with HIV from a hospital of infectious diseases in the Northeast of Brazil were assessed for identification of clinical indicators of noncompliance. In the second, the defining characteristics were evaluated by six specialist nurses, analyzing the presence or absence of the diagnosis. For accuracy of the clinical indicators, the specificity, sensitivity, predictive values and likelihood ratios were measured. Results:the presence of the noncompliance diagnosis was shown in 69% (n=78) of people with HIV. The most sensitive indicator was, missing of appointments (OR: 28.93, 95% CI: 1.112-2.126, p = 0.002). On the other hand, nonadherence behavior (OR: 15.00, 95% CI: 1.829-3.981, p = 0.001) and failure to meet outcomes (OR: 13.41; 95% CI: 1.272-2.508; P = 0.003) achieved higher specificity. Conclusion:the most accurate defining characteristics were nonadherence behavior, missing of appointments, and failure to meet outcomes. Thus, in the presence of these, the nurse can identify, with greater security, the diagnosis studied.

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Factors associated with therapeutic success in HIV-positive individuals in southern Brazil

Abstract: When undetectable viral load, CD4+ cell count ≥200 cells/mm(3) and treatment adherence above 95% are included in the definition of therapeutic success, the rate was elevated (90%) and the factors associated were previous history of adherence to HAART and previous undetectable viral load.

Cited by 12 publications

References 18 publications

Quality of Life of Pregnant Women Living with HIV/AIDS

Quality of Life of Pregnant Women Living with HIV/AIDS

Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina

Noncompliance in people living with HIV: accuracy of defining characteristics of the nursing diagnosis

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