Gravidez em adolescente com infecção pelo HIV/AIDS / Pregnancy in an adolescent infected by HIV/AIDS

O objetivo é descrever um caso de adolescente grávida e portadora de HIV e analisar a vivência da maternidade nesse contexto. Foi aplicado o método descritivo mediante o estudo de caso. Realizou-se entrevista semi-estruturada com uma adolescente, vivenciando sua terceira gestação em dezembro de 2003, em Fortaleza-CE. Os achados indicam: baixo nível socioeconômico, abandono escolar, ausência de uso de preservativo, parceiro sexual sorodiscordante; reduzido intervalo de tempo entre as gestações, não adesão à terapêutica para reduzir transmissão vertical, indução de aborto, oferecimento do aleitamento natural em decorrência da falta de outros alimentos e relato de intercorrências mamárias. Conclui-se que a mãe-adolescente convive com déficit das condições socioculturais e econômicas, não reconhecendo a AIDS como problema.

Nursing interventions in the Kingston Paediatric and Perinatal HIV/AIDS Programme in Jamaica

BACKGROUND: Nursing care has been the [quot]grass roots[quot] of healthcare management even before nursing became a profession. Literature on the nursing experience with HIV is minimal and so it is challenging to comment on, or to compare experiences. PURPOSE: This paper highlights the nursing interventions as a key feature in the ongoing development and success of a prevention of mother-to-child HIV transmission (pMTCT) programme in a resource-limited setting. METHOD: In the Kingston Paediatric and Perinatal HIV/AIDS Programme, the nurses and midwives were carefully selected and then trained in the management of preventing mother-to-child transmission (pMTCT) of HIV/AIDS, voluntary counselling and testing and the identification and nursing management of paediatric and perinatal HIV/AIDS. The sites of the programme included three large maternity centres and four paediatric centres, with several feeder clinics for pregnant women. A nurse coordinator supervised the interventions at each site. A multidisciplinary team followed protocol-driven management for the care of pregnant HIV-positive women and children. There was strong collaboration with the Jamaican government and other agencies. RESULTS: The nursing interventions served to: sensitize and encourage other healthcare workers in the care of persons living with HIV/AIDS; sensitize persons in the community about the disease; improve the comfort level of women and families with accessing healthcare; enable prospective data collection for programme assessment and research purposes and to enhance multidisciplinary collaboration to widen the scope of patient care and prevent duplication of healthcare services. CONCLUSION: Nursing intervention is a vital part of a pMTCT HIV programme; however, ongoing education and training of the entire healthcare team needs to be continued in order to strengthen the programme. It is hoped that much of what is done in the Kingston Paediatric and Perinatal HIV/AIDS Programme will become integrated in the nursing management of maternal and child health nationally