Abandono de Tratamento de Pessoas com HIV e Retorno após Busca Ativa: Contribuições para Enfermagem

Abstract

With the advancement of treatment of Human Immunodeficiency Virus (HIV) and the in-crease in life expectancy, HIV started to be considered a chronic condition, which reaffirms the need for comprehensive care to people living with HIV (PLHIV). However, one of the challenges to be faced is medication adherence, since treatment abandonment can occur, in-creasing the chance of complications and progression to aids, thus negatively impacting quali-ty of life. Faced with this, it is necessary to recognize the reasons for treatment abandonment and establish intervention methods to bring these patients back to the health service. The pre-sent study aims to describe the perspective of people who abandoned HIV treatment and re-turned to the service after an active search. This is a qualitative exploratory-descriptive piece of research carried out with PLHIV who had abandoned treatment. The study was carried out in the capital of Mato Grosso do Sul State, in a station specialized in PLHIV care. Data were collected from April to August 2021, by means of semi-structured, audio-recorded interviews later submitted to Bardin's content analysis. The 24 male participants were aged between 23 and 63 years (average 37.9), and reported themselves as brown (13), black (six), white (four) and yellow (one). Regarding marital status, 13 were single, eight had partners, two were wid-owed and one was divorced. The time of diagnosis ranged from two to 23 years (mean 8.5), the mean time of the abandonment period was 333 days (minimum of 114 and maximum of 1249), and six people reported weight loss, sore throat, pain in lower limbs, weight gain, weakness and tiredness. The PLHIV reported that changes in health care occurred at the be-ginning of treatment, but have not remained over time. In addition, they pointed out factors that helped them deal with the disease, such as their acceptance and involvement in the church community and health service, the perspective of being a father and the possibility of helping other people in the same condition. The reasons for dropping out treatment were the absence of signs and symptoms, the lack of a support network, the bond breaking with health profes-sionals, the difficulty in reaching the specialized service, the medication side effects and the COVID-19 pandemic. Among the motivations for their return to treatment, the following points were mentioned: the desire to live and feel good, the willing to take care of the family and the fact of having overcome the initial phase of treatment, considered the worst one. The active search, by telephone approach, was the strategy used to rescue these patients, consid-ered positive for the return to treatment. In conclusion, the flaws found in the health care network can influence the continuity of treatment and are subject to intervention to rescue the absent patient, in addition to improving treatment adherence. A special attendance is neces-sary to get to know the individuals and the context in which they are inserted, and to preco-ciously identify the risk factors and behaviors that can lead to treatment abandonment. Based on that, subsidies are generated for the development of search strategies and the elaboration of interventions to rescue PLHIV and bring them back to the service.