Individual satisfaction with HIV/AIDS care in Belo Horizonte, Brazil.

Individual satisfaction is associated with increased retention in HIV/AIDS care services and adherence to treatment. This study assessed factors associated with individual satisfaction at the initiation of antiretroviral therapy and compared the proportions of satisfaction at the initiation of antiretroviral therapy and after three months of follow-up. Face-to-face interviews were carried out among 398 individuals of three HIV/ AIDS healthcare services in Belo Horizonte, Brazil. Variables included sociodemographic and clinical characteristics, perception about healthcare services, and domains of quality of life. Individuals that rated the quality of healthcare services as good or very good were classified as satisfied. A logistic regression analysis of the association between independent variables and individual satisfaction was performed. The proportion of individual satisfaction with healthcare services was 95.5% at the initiation of antiretroviral therapy and 96.7% after three months and these changes were not statistically significant (p = 0.472). The physical domain of quality of life was found to be associated with satisfaction at the initiation of antiretroviral therapy (OR = 1.38; CI = 1.11-1.71; p = 0.003). Training and supervision of health professionals for addressing the needs of individuals with lower levels of physical domain of quality of life may improve satisfaction with HIV/ AIDS care.

Neuropsychiatric adverse drug reactions and associated factors in a cohort of individuals starting dolutegravir-based or efavirenz-based antiretroviral therapy in Belo Horizonte, Brazil.

OBJECTIVE: To measure the incidence of neuropsychiatric adverse drug reactions (ADRs) in individuals living with HIV who initiated antiretroviral therapy (ART) with first-line regimens containing dolutegravir (DTG) or efavirenz (EFV) and associated factors. METHODS: Prospective cohort study with individuals living with HIV who started ART with DTG or EFV associated with tenofovir disoproxil and lamivudine in Belo Horizonte, Brazil. Sociodemographic, clinical, and laboratory data were collected from September 2015 to October 2018 in three specialized HIV care services through interviews, clinical records, and computerized systems. We analysed the frequency of neuropsychiatric ADRs recorded in clinical records 12 months after starting antiretroviral use, and the associated factors were investigated using binary logistic regression. RESULTS: A total of 152 (35.1%) of the 433 individuals included had neuropsychiatric ADRs. The incidence density was 35.3/100 person-years. The subjects mainly had sleep disorders and disturbances (21.3%), neurological disorders (13.9%), headaches (8.1%), and anxiety disorders and symptoms (3.0%), more frequently in individuals using EFV. A lower likelihood of neuropsychiatric ADRs was associated with using a DTG-based antiretroviral regimen (OR = 0.24; 95% CI = 0.14-0.40) and anxiety or depression signs and symptoms at the onset of treatment (OR = 0.57; 95% CI = 0.37-0.89). CONCLUSION: The incidence of neuropsychiatric ADRs was high in individuals starting ART with a lower likelihood of using a DTG-based regimen. The DTG-based regimen had a better safety profile for neuropsychiatric ADRs than the EFV-based regimen.

Trends in HIV post-exposure prophylaxis following sexual exposure in Brazil (2011-2019).

We examined trends in the prevalence of post-exposure prophylaxis following sexual exposure (PEPSE) per million population (2011-2019) and the proportion of repeated PEPSE within 365 days of the first PEPSE dispensing (2011-2018) in Brazil. We also compared the prevalence of repeated PEPSE according to patient and health services characteristics in 2018. The prevalence of PEPSE increased 55.5% from 2011 to 2019. Repeated PEPSE increased 11.8%, reaching 8.4% among people with their first dispensing in 2018. The prevalence of repeated PEPSE was higher in cis men or trans women (versus cisgender women); homosexuals (versus heterosexuals); and people aged 25-29 years (versus other age groups). We also observed greater prevalence of repeated PEPSE in HIV services in populous cities or services with elevated caseloads. Our findings highlight the need for strategies to reduce repeated PEPSE and promote other HIV-prevention technologies, particularly among young adults, cisgender men, transgender women, and homosexuals.

RESUMEN: Examinamos las tendencias de la prevalencia de uso de la profilaxis posterior a la exposición sexual (PEPSE) por millón de población (2011­2019) y la proporción de PEPSE repetida dentro de los 365 días de la primera dispensación de PEPSE (2011­2018) en Brasil. También comparamos la prevalencia de PEPSE repetida según las características del paciente y de los servicios de salud en 2018. La prevalencia de PEPSE aumentó un 55,5% de 2011 a 2019. La PEPSE repetida aumentó un 11,8%, alcanzando el 8,4% entre las personas con su primera dispensación en 2018. La prevalencia de PEPSE repetida fue mayor en hombres cis o mujeres trans (versus mujeres cisgénero); homosexuales (versus heterosexuales); y personas de 25 a 29 años (versus otros grupos de edad). También observamos una mayor prevalencia de repetición en los servicios de VIH de las ciudades más pobladas o con un elevado número de clientes. Nuestros hallazgos ponen de manifiesto la necesidad de estrategias para reducir la repetición de la PEPSE y promover otras tecnologías de prevención del VIH entre los adultos jóvenes, especialmente los hombres, las trans y los homosexuales.

Relaçäo entre mudanças de vida e síndrome de crise: abordagem preventiva da enfermagem na saúde mental comunitária / Symptoms representative of the syndrom of crisis and the changes of life experimented by the clientage studies

As diferentes mudanças de vida, conforme ressaltam vários autores, constituem os principais fatores de desencadeamento da síndrome de crise, figurando atualmente como um dos principais problemas de saúde mental. Este estudo visa verificar os sintomas representativos da síndrome de crise e as mudanças de vida experimentadas pela clientela estudada. A amostra envolveu cem clientes assistidos em ambulatórios de um hospital universitário em Natal - Rio Grande do Norte. Adotou-se como instrumento de pesquisa um formulário de entrevista, sendo a parte de detecçäo da síndrome de crise fundamentada no instrumento de Halpern e a de identificaçäo de mudanças de vida, baseada na escala estabelecida por Holmes e Rahe. Os resultados obtidos permitiram evidenciar-se a incidência da síndrome de crise, destacando-se como principais fatores a doença e as dificuldades financeiras, implicando numa reflexäo sobre o que se vem oferecendo na assistência e reformulaçäo dos programas, em termos de prevençäo primária.

Módulo auto-instrucional: pressäo venosa central e assistência de enfermagem / Self-instructional module: central venous pressure and nursing care

Demonstraçäo de um processo ensino-aprendizagem de pressäo venosa central através de módulo. Objetiva a verificaçäo correta da pressäo, com e sem aparelho de ventilaçäo artificial; relacionamento de material necessário para sua instalaçäo; atividades adequadas a serem tomadas diante de possíveis alteraçöes e cuidados de enfermagem que atendam aos aspectos bio-psicossociais do paciente.