Adherence to HIV/Aids treatment among aids/ tuberculosis and drug users patients in Sao Paulo, Brazil. Sao Paulo (BR); 2006. [PhD Thesis – Faculdade de Saúde Pública da Universidade de São Paulo - Brazil].

Lima, Helena Maria Medeiros

Objective. Give subsidies for improve strategies and build a National Policy of Adherence, understanding as patient behavior related to best use of treatment. Patients with aids, tuberculosis and drug user have difficulties with adherence. Methods. Study descriptive, qualitative methodology – Rapid Assessment, Response and Evaluation (RARE) on four STD/ Aids public services in Sao Paulo. Health professionals who attend target-population (37 women, married, and between 40 – 45 years old) and patients (27, 18 years old or more, aids, tuberculosis and drug users, male, low level of education, single/ lonely, unemployed, with HIV diagnosed and aids treatment began more than 5 years ago). Results. Health professionals without previous experience in tuberculosis and psychoactive dependence. Fail technical knowledge about: interaction, genotyping, HIV sub-types, resistance, failure, multidrugresistant, tuberculosis. Requesting information from infectologist doctors. There is no standard policy for orientation about the side effects, tuberculosis prophylaxis, adherence and drugs (abstinence request). Patients ingesting all the day dose in one shot; failures to forgetting, to avoid side effects, drug use (alcohol) or non-revelation of the diagnosis; without communication. Switch doctor and/or services to change the antiretroviral scheme; crack users share pipes. Researched STD/Aids services do not have interaction with the Tuberculosis and Mental Health Program. Epidemiological and treatment documents are loosed and have no flow. Conclusions and recommendations. Health professionals could be benefit with capacity in tuberculosis and drugs to develop strategies to improve adherence, as Individual Adherence Plan and introduction of Harm Reduction Strategy. Recommendation to National Program of STD/Aids: develop a National Adherence Policy.

Adherence, Aids. Drugs, Public Health, Treatment, Tuberculosis

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