Acesso aos serviços de saúde e o diagnóstico tardio da infecção pelo HIV.

Abstract

INTRODUCTION: In spite of HIV / AIDS prevention measures, in order to obtain a previous diagnosis of the infection, a user evaluator for treatment still presents late presentations. The late diagnosis of HIV infection represents a continuing and worrying challenge for the control of the HIV / AIDS epidemic. Among the factors associated with the late diagnosis of HIV infection, reference is made to those referring to access to health services that make up the network of care for people living with HIV / AIDS. OBJECTIVE: To analyze the factors related to access to health services that influence the late diagnosis of HIV infection in a capital city of Northeast Brazil. METHOD: This is an epidemiological, observational, analytical and cross-sectional study with a quantitative approach. The research was carried out in the city of João Pessoa, capital of the State of Paraíba, from April to May. The sample was of stratified random type, consisting of 285 users. The data collection instrument used was a questionnaire, applied through an interview, containing questions according to different scales of responses, such as dichotomous and categorical. Data were stored and analyzed in SPSS Statistics Software, version 20.0. In compliance with Resolution CNS 466/2012, the survey was appraised and approved under Opinions no. 1,932,530 and 1,870,281. RESULTS: Among the sociodemographic variables, 57.5% of the participants were male, 68.8% were heterosexual and 58.2% were brown; 47.0% of the participants were unmarried and 60% had children. Regarding the number of years of study, 42.7% answered that they have more than 12 years of study, compared to 41.1% who have 1 to 8 years of study. In terms of occupation, 22.1% reported being unemployed, while 21.8% were employed. Regarding the type of infection with the virus, 60.0% of the respondents reported that it occurred through sexual intercourse with men. The time to start ART was less than one month for 42.5% of the participants. Regarding the time of diagnosis of HIV infection, 54.4% were diagnosed less than one year. As to the prevalence of late diagnosis, 41.8% were diagnosed very late. The main reason reported for seeking the service to perform the HIV test was by medical indication (28.8%) and by presenting symptoms of AIDS (28.4%). There was an association between the variables, "motive sought to perform HIV test" and "attitude after the discovery of the diagnosis" with the occurrence or not of late diagnosis (p <0.001); 41.6% of the participants who sought the service for presenting patients with some AIDS symptom were diagnosed late. CONCLUSIONS: Thus, it is suggested that strategies be created to change the reality found, focusing on the target populations, since individuals do not recognize that they are at risk of contamination. New ways of including these individuals in HIV-focused care programs should be developed, the provision of RT in primary care should be expanded, and health education should be provided for the entire population.