Gestantes portadoras de HIV/AIDS: aspectos psicológicos sobre a prevenção da transmissão vertical

Abstract

ResumoA gestação, em geral, repercute emocionalmente na mulher e, mais intensamente, quando associada a uma situação clínica comprometedora da saúde do filho, como na possibilidade de transmissão vertical do HIV. Nesse contexto, o presente estudo teve por objetivo investigar as significações subjetivas das gestantes portadoras de HIV sobre a realização das ações de prevenção da transmissão vertical. Para tanto, recorreu-se a uma investigação do tipo transversal, de natureza descritiva e exploratória, com abordagem qualitativa, da qual, segundo o critério de saturação do conteúdo, participaram 12 gestantes. Os resultados demonstraram que as gestantes têm dificuldades imediatas para aderir aos medicamentos antirretrovirais, relutância em aceitar a possível indicação do parto cesáreo e frustração, permeada por sentimentos de culpa, diante da impossibilidade de amamentação do filho. Observa-se, assim, a necessidade de ações de apoio socioemocional a serem desenvolvidas pelos profissionais de saúde, especialmente os psicólogos, para favorecer o enfrentamento da transmissão vertical.Palavras-chave: aspectos psicológicos; gestação; HIV; transmissão vertical de doença infecciosa. AbstractPregnant with HIV/AIDS: Psychological aspects related to the vertical transmission prevention. Gestation, in general, emotionally influences in women's life and, more intensively, when it's associated to a compromising clinical situation of the child's health, as in the possibility of a HIV vertical transmission. In this context, the current study aimed the investigation of the subjective meanings of the pregnant women who carry the HIV and that have been subjected to actions to prevent the vertical transmission. For that, a transversal, descriptive and exploratory -with a qualitative approach -investigation was used. In that investigation, according to the saturation of the content, 12 pregnant women participated. The results demonstrated that the pregnant women have difficulty to adhere the antiretroviral medications, reluctancy to accept the possible indication of a c-section and frustration, fulfilled with feelings of guilt due o the impossibility of breastfeeding their child. It was observed, therefore, the necessity of socio-emotional support actions that must be developed by the health professionals, mainly the psychologists, in order to cope with vertical transmission. ResumenGestantes portadoras de VIH/SIDA: Aspectos psicológicos sobre la prevención de la transmisión vertical. La gestación, en general, repercute emocionalmente en la mujer y, más intensamente, cuando asociada a una situación clínica comprometedora de la salud del hijo, como en la posibilidad de transmisión vertical del SIDA. En este contexto, el presente estudio tuvo por objetivo investigar las significaciones subjetivas de las gestantes portadoras del SIDA sobre la realización de las acciones de prevención de la transmisión vertical. Para ello, se recurrió a una investigación del tipo transversal, de naturaleza descriptiva y exploratoria, con abordaje cualitativ...

Epidemiological overview of HIV/AIDS in pregnant women from a state of northeastern Brazil

“…At this meeting, the member States of the UN report, in a statement, the commitment for 2020 to reduce new infections of HIV and the mortality rates of AIDS to less than 500 thousand a year. Some preventative measures are: realization of elective cesarean section, zidovudine monotherapy (AZT), antiretroviral management, administration of AZT during delivery and use of oral antiretroviral by the newborn exposed during birth until the 42nd day of life, and replacement of natural breastfeeding by bottle-feeding (47)(48)(49) .…”

Maternity perception by pregnant women living with HIV

“…They externalized fear of vertical HIV transmission during pregnancy, the side effects of medication, prejudice about the disease, and at the same time voiced feelings of overcoming through self-care, confidence in adhering to their therapy, and attempting to overcome prejudice and the diagnosis of HIV recently discovered prenatally, even if absorbing this is not an easy task. 1,[6][7][8][9][10] Studies have shown that although HIV-positive pregnant women have reported experiencing a normal pregnancy, peculiar situations are evidenced in the daily life of pregnant women who acquired this infection.…”

“…Feelings such as hope that all progresses well in the pregnancy, being able to have a child, being capable of taking the medication, witnessing the healing of AIDS, having a long life, having a "normal" life, and raising a healthy child are also commonly found in other studies. 8,9,12 Faced with the possibility of vertical transmission, most pregnant women living with HIV are engaged, adhering to their treatment and attending their appointments; learning about the disease, its evolution, and the manifestation of signs and symptoms; and changing their lifestyle in order to encourage the promotion of health. 1 The child therefore becomes the strength and encouragement to overcome the obstacles of living with HIV, thus benefiting the physical and mental health of the pregnant women.…”

“…It is through this dyad that the vast majority of pregnant women accept adhering to treatment in order to evade the possible guilt of transmitting the virus to their baby. 8 Studies indicate that prevention of vertical transmission has been the main motivating factor in adherence to antiretroviral therapy; however, denial of diagnosis, fear of being discovered by others, and the side effects of medication are factors limiting this. [14][15] In some cases, treatment is abandoned after the delivery, due to fact the mother no longer carries a potential risk of infecting her baby.…”

“…Studies show that pregnant women, although aware of the issue, revealed concern and fear of discrimination in relation to its limitation, mainly because some people would question them about not breastfeeding. 1,8 It was also observed that mothers who live with HIV experience conflicts and ambiguous feelings when discouraged from breastfeeding, because while suffering with a desire to engage in breastfeeding, they feel positive in preserving the health of the child. Thus, as a coping mechanism, they accept the situation.…”