Adesão ao tratamento da tuberculose em pessoas coinfectadas com o HIV

Abstract

Introduction: The control of Tuberculosis-HIV co-infection is a challenge for public health, insofar as, despite the existence of available diagnosis and treatment, tuberculosis (TB) is responsible for more than a quarter of deaths in individuals with AIDS. Moreover, people living with HIV/AIDS are the ones who most abandon TB treatment. Objective: To investigate adherence to tuberculosis treatment in patients co-infected with HIV. Materials and methods: Descriptive cross-sectional study with a quantitative-qualitative approach carried out in two cities of the state of Paraíba: João Pessoa and Campina Grande. The study population corresponded to all TB-HIV co-infected patients who had TB diagnosis and treatment in the year 2016 (N = 51). The census sample was obtained through the following inclusion criteria: patients over 18 years who completed TB treatment by June 30, 2017 and with preserved communication and comprehension skills; and exclusion: patients who did not live in the study sites, and those institutionalized and/or deprived of liberty (n = 35) and the theoretical saturation of the data was n = 22. Data collection was during July to October 2017, through interviews that used a semi-structured instrument and a voice recorder. The analysis of quantitative data were through the creation of simple frequency tables and descriptive measures and techniques of bivariate inferential statistics using the SPSS statistical package (version 13.0). Statistical tests were applied at the 5% level of significance. The qualitative analysis took place through Content Analysis, contemplating the phases of pre-analysis, material exploration and the categorization process. The accomplishment of the research obeyed the guidelines of Resolution 466/12 of the National Health Council and approved by the Ethics Committee of the State University of Paraíba. Results: There was predominance of males, from the adult to the young age, low levels of schooling, with exposure to violence, being unable to work after illness, late diagnosis of TB and performed by public hospitals. It was also evidenced new cases, pulmonary form, TB cure, and lack of anti-tuberculostatic and antiretroviral drugs. Furthermore, the interviews revealed facilities and difficulties in adhering to TB treatment. Conclusion: The study identified social, health-disease, and health care characteristics of patients who developed TB-HIV co-infection. It also revealed the facilities and difficulties experienced by patients during the treatment of TB and fragilities in the specialized care services in tracking and diagnosing TB in the population living with HIV - AIDS (PLWHA). There was evidence that the exposure to violence, withdrawal from occupational activities, and lack of medication during treatment were challenges during the adhesion process.