RESUMO
OBJECTIVES: The aims of this study were to describe patients' experiences after single-tablet regimen (STR) desimplification and its impact on self-reported treatment adherence and quality of life. METHODS: We performed a survey among all patients from the multicenter cohort of the Spanish HIV/AIDS Network who had desimplified the STRs dolutegravir/abacavir/lamivudine (DGT/ABC/3TC) or rilpivirine/tenofovir disoproxil fumarate/emtricitabine to their separate components (DTG + generic ABC/3TC or RPV + generic TDF/FTC) between December 2016 and November 2018. RESULTS: Among 216 patients who fulfilled inclusion criteria, 138 (63.9%) completed the questionnaire. Most of the patients (78.3%) knew what generic drugs are, only 8.7% believed that treatment with 2 pills is less effective than treatment with an STR, and 67.4% agreed that it is reasonable to take 2 pills instead of 1 for HIV treatment to decrease costs for the health care system. After desimplification, 13.0% of the patients stated they had more secondary effects, 8.0% had forgotten one or more doses more frequently than before, and 10.9% had sometimes forgotten to take 1 pill, but not the other. A proportion of 30.4% reported not being happy to take more pills a day, and 10.1% experienced a worse quality of life after the treatment desimplification. CONCLUSIONS: After STR desimplification, most of the patients had a fair knowledge about generic antiretrovirals, and they agreed to desimplify their STR to decrease costs. Although almost a third of the respondents were not happy to take 2 pills a day, only a minority reported worse adherence or quality of life.
Assuntos
Fármacos Anti-HIV , Infecções por HIV , Fármacos Anti-HIV/uso terapêutico , Combinação de Medicamentos , Emtricitabina/uso terapêutico , Infecções por HIV/tratamento farmacológico , Humanos , Lamivudina/uso terapêutico , Qualidade de Vida , Inquéritos e Questionários , Comprimidos , Tenofovir/uso terapêuticoRESUMO
The Agreement of the Council of Ministers of November 30, 2018 approving instructions to eliminate certain medical causes of exclusion in access to public employment, such as HIV, diabetes, celiac disease and psoriasis, has meant an important advance in the protection of the labor rights of people in these conditions. Since then, the tables of medical exclusions have been revised and modified for the National Police, National Police, the Civil Guard, the Customs Surveillance Corps, the Corps of Penitentiary Institutions Assistants, the Military Training Centers, the Training Centers, for the incorporation to the Troops and Marines scales and the National School of Police. In addition, the repeal of the Orders of the National Police (Order of January 11, 1988) and the regulatory modification of the Civil Guard (Order PCI/155/2019) guarantee that the diagnosis of HIV, diabetes, celiac disease and psoriasis, will continue without being an impediment for access to the National Police and the Civil Guard in the calls for the next exercises. So, that the mere diagnosis of a disease such as HIV, diabetes, celiac disease and psoriasis will not be a generic cause for exclusion from public employment, but will take into account medical advances and existing scientific evidence, as well as the health situation of each person.
El Acuerdo del Consejo de Ministros de 30 de noviembre de 2018, por el que se aprueban instrucciones para eliminar ciertas causas médicas de exclusión en el acceso al empleo público, como el VIH, la diabetes, la enfermedad celíaca y la psoriasis, ha supuesto un importante avance en la protección de los derechos laborales de las personas con estas condiciones. Desde entonces, se han revisado y modificado los cuadros de exclusiones médicas de convocatorias para el ingreso en la Policía Nacional, la Guardia Civil, los Cuerpos de Vigilancia Aduanera, el Cuerpo de Ayudantes de Instituciones Penitenciarias, los Centros Docentes de Formación Militar, los Centros Docentes de Formación para la incorporación a las Escalas de Tropa y Marinería y la Escuela Nacional de Policía. Además, la derogación de la Orden de la Policía Nacional (Orden de 11 de enero de 1988) y la modificación de la Orden de la Guardia Civil (Orden PCI/155/2019) garantizan que el diagnóstico del VIH, la diabetes, la enfermedad celíaca y la psoriasis dejarán de ser un impedimento para el acceso a la Policía Nacional y a la Guardia Civil en las convocatorias de los próximos ejercicios. Así, el mero diagnóstico de una enfermedad como el VIH, la diabetes, la enfermedad celíaca y la psoriasis, no será una causa genérica de exclusión de un empleo público, sino que se tendrán en cuenta los avances médicos y la evidencia científica existente, así como la situación de salud de cada persona.
Assuntos
Clero , Intervenção Coronária Percutânea , Emprego , Humanos , Polícia , EspanhaRESUMO
This study focuses on actions at the political and administrative level in Spain in relation to the implementation of pre-exposure prophylaxis (PrEP). We analysed a whole range of different formal initiatives taken by the political and administrative actors involved. The information was obtained from official public data sources. As of February 2018, PrEP had not been implemented. The decision is dependent on both state and regional governments. The Ministry of Health and some Autonomous Regions are working on different interventions, but without providing an implementation timetable. The political parties have kept a very low profile in terms of initiatives related to the implementation of PrEP. From a legal point of view, proceedings are passing back and forth with the extension of the patent. The role of intergovernmental and interdepartmental institutions is very important for the implementation of PrEP in Spain.