ABSTRACT
O artigo analisa a adesão dos cidadãos ao teste rápido de despistagem do VIH no Centro de Aconselhamento e Deteção Precoce do VIH/sida (CAD) da cidade de Bragança (Nordeste de Portugal). Em concreto, procura-se examinar o papel do diagnóstico rápido na luta contra a infeção pelo VIH/sida no quadro do sistema público de saúde português, compreender as circunstâncias subjacentes à procura do serviço e interpretar as percepções e práticas dos utentes do CAD objecto desta pesquisa. Em termos metodológicos, tratou-se de um estudo de caso assente em inquirição etnográfica, articulando observação direta, diálogos informais e entrevistas, a que se associou uma extensa pesquisa documental e estatística. Os resultados apurados permitem afirmar que o teste rápido proporcionou um contributo muito positivo para a luta contra a infeção pelo VIH/sida, facilitando o acesso dos cidadãos ao conhecimento praticamente imediato do seu estado serológico e melhorando o seguimento destes por parte dos técnicos de saúde. A chamada dissipação da incerteza, na sequência de uma situação de risco, é o principal motivo que leva os utentes a realizar o teste rápido...
The article examines the adherence of citizens to the quick test for HIV in the Counseling and Early Detection of HIV/AIDS Center (CAD), in the city of Bragança (Northeast Portugal). Specifically, it seeks to examine the role of a fast diagnosis in the fight against AIDS within the Portuguese public health system, to understand the circumstances underlying the demand for the service and to interpret the perceptions and practices of CAD users. In terms of methodology, it was a case study based on ethnographic inquiry, linking direct observation, informal conversations and interviews, which was associated with extensive documental and statistic research. The results obtained allow us to state that the quick test gave a very positive contribution to the fight against HIV/AIDS infection, facilitating citizen access to knowledge of their serological status almost instantly and improving their follow-up by health technicians. The so-called dissipation of uncertainty, following sexual risk behavior, is the main reason that leads users to perform a quick test...
Subject(s)
Humans , Male , Female , HIV , Sex Counseling , Anthropology, Cultural , Delivery of Health Care , Risk-Taking , Sexual Behavior , Acquired Immunodeficiency Syndrome/diagnosis , Anonymous Testing , Serologic Tests , PortugalABSTRACT
Com base em revisão bibliográfica discute-se a literatura produzida nos anos de 1999 a 2011, no campo da saúde coletiva, sobre uma importante estratégia de prevenção da transmissão do HIV: o aconselhamento e testagem anti-HIV. O artigo realiza um balanço da literatura internacional, analisando criticamente os aspectos mais assinalados pela comunidade científica, apontando divergências e convergências entre os estudos e identificando lacunas que possam estimular o desenvolvimento de novas pesquisas neste campo temático. Como resultado, evidenciou-se que os processos de decisão de realizar um teste e a experiência da testagem são discutidos na literatura com abordagens fragmentadas, sejam de ordem individual ou institucional. Para compreender diversas dimensões implicadas na adoção de uma prática preventiva como o teste HIV, é preciso contemplar indicadores sociais tais como gênero, religião, identidade sexual, raça/cor, e relacioná-los às políticas públicas e à operacionalização dos serviços de saúde. O uso expressivo do conceito de risco (aliado às categorias de grupo, comportamento, percepção) e de escalas quantitativas para aferir a percepção individual do risco como uma barreira para a realização do teste ilustra o foco excessivo sobre uma dimensão individual e parcial do problema.
Subject(s)
Humans , Male , Female , HIV , Counseling , Social Indicators , Public Policy , HIV Seropositivity , Acquired Immunodeficiency Syndrome , Anonymous Testing , Qualitative Research , RiskABSTRACT
Este artigo apresenta e discute uma experiência de sala de espera no âmbito da atenção às doenças sexualmente transmissíveis - DST, desenvolvida em um serviço especializado na atenção às DST, localizado em Porto Alegre-RS. O objetivo da sala de espera foi oferecer uma possibilidade de prevenção e educação em saúde, tendo por base uma abordagem participativa e problematizadora, buscando diferenciar-se da lógica prescritiva, centrada na transmissão de informação, hegemonicamente presente nos serviços de saúde. A atividade ocorreu diariamente, antecedendo a consulta médica de homens que procuravam o serviço para atendimento relacionado às DST. Entendida como uma atividade relativa ao campo de competências profissionais (Campos, 2002), foi coordenada por duplas de residentes multiprofissionais (Psicólogos, Nutricionistas, Enfermeiros e Assistentes Sociais). A abordagem da sala de espera utilizou-se das contribuições da prática do aconselhamento em HIV/Aids, buscando trabalhar com aspectos afetivos/emocionais, informativos e avaliação de riscos. Através de uma perspectiva problematizadora, buscou-se interrogar e colocar em análise as relações que as pessoas estabelecem com a sexualidade, as DST e o uso do preservativo. Esta intervenção propiciou maior acesso a informações (sobre as DST, insumos de prevenção, tratamento e testagem anti-HIV) e discussão sobre aspectos relacionados às repercussões das DST na vida afetiva e sexual, reconfigurando o momento de espera em um momento de prevenção e educação em saúde.
Subject(s)
Humans , Male , Female , HIV , Sex Counseling , Comprehensive Health Care , Sexually Transmitted Diseases , Health Education , Reproductive Medicine , Reproductive Health Services , Acquired Immunodeficiency Syndrome , Anonymous TestingABSTRACT
Background: With millions of South Africans infected with human immunodeficiency virus (HIV) and less than 10of the population aware of their HIV status; HIV counselling and testing (HCT) is the first step in any attempt to reduce the number of new infections. For those who test negative; HCT personalises the risks and reinforces preventative messages whilst for those who are positive; it is the gateway to accessing counselling and care. The Health Belief Model postulates that knowledge and attitude influence behaviour. The aim of this study was to determine whether knowledge of HIV and the attitude of patients referred for HCT correlated with a willingness to test for HIV. Methods: One hundred and seventy two patients referred for HCT were randomly selected over a three month period. Data were collected by a research assistant using the modified standardised World Health Organization (WHO)-Global AIDS Project (GAP) questionnaire.Results: Ninety per cent of the participants demonstrated sound knowledge of HIV; acquired immune deficiency syndrome (AIDS) and HCT. Despite the 90of the participants with sound knowledge only 71.5of the participants tested for HIV. There was no statistically significant difference in knowledge between those who tested and those who did not test for HIV. Twenty five per cent of those who refused to test stated that they had already made up their mind not to test for HIV before the counselling session. Conclusions: Despite excellent knowledge of HIV; a significant number of patients referred for HCT do not test for HIV
Subject(s)
Anonymous Testing , Attitude , HIV Infections , Perception , South AfricaABSTRACT
Es frecuente que, en el ámbito de la investigación, sea ésta biomédica o social, se utilicen expresiones como sinónimas, aun teniendo significados diferentes. Es el caso de las palabras "anónimo" y "confidencial". Siendo conceptos diversos, tienen en común referirse a una información que se considera susceptible de protección, en razón de que su conocimiento por terceros puede dañar al titular de la misma. En muchos casos, la utilización indistinta de las palabras "anónimo", "confidencial" o "reservado" juega en contra del adecuado diseño y resultado de los estudios, puesto que se promete anonimato a los sujetos de investigación, siendo imposible que esto se cumpla.
It is frequent that in social or biomedical research certain expressions are used as synonymous, even having different meanings. This is the case of "anonymous" and "confidential". Being diverse concepts, they have in common to refer to an information considered to be susceptible of protection, since knowledge by third parties may damage the owner of the information. In many cases, the equivalent use of the words "anonymous", "confidential" or "reserved" plays against the adequate design and study outcomes, since anonymity is promised to research subjects, when it is impossible to comply.
É frequente que, no âmbito da pesquisa, biomédica ou social, sejam utilizadas expressões como sinônimas, ainda que tendo significados diferentes. É o caso das palavras "anônimo" e "confidencial". Sendo conceitos distintos, têm em comum referir-se a uma informação que se considera suscetível de proteção, em razão de que seu conhecimento por terceiros pode causar dano ao titular da mesma. Em muitos casos, a utilização indistinta das palavras "anônimo", "confidencial" ou "reservado" joga contra o adequado projeto e resultado dos estudos, posto que se promete anonimato aos sujeitos de pesquisa, sendo impossível que isto se cumpra.
Subject(s)
Anonymous Testing , Biomedical Research , Confidentiality , Legislation as Topic , ChileABSTRACT
Due to the high prevalence and morbidity sexually transmitted diseases are highly relevant to public health, especially for women. OBJECTIVES: To determine and compare the behavioral and biological risks associated with human immunodeficiency virus acquisition. METHODS: A group of 253 women who voluntarily sought anonymous testing were interviewed to find out their behavioral risk. Biological risk was identified by means of gynecological exam, colposcopy as well as blood and cervicovaginal sampling for serological and microbiological exams. Using known traditional risk factors, a table of scores classified the subjects into high, low and absent for behavioral and biological risks. Frequency and percentage of each risk was tabulated and the correlation between risks was obtained by calculating the Kappa statistic. RESULTS: 79.8 percent of subjects were found to have behavioral risks, and 79.1 percent biological risks. It was also found that 66.7 percent of the women (169) with high behavioral risk also had high biological vulnerability. However, 31 out of 51 women without any behavioral risk had biological vulnerability 12.2 percent. The Kappa statistic demonstrated low agreement between the latter risks [K = 0.05 95 percent CI (-0.06 to 0.17)]. CONCLUSION: Women who seek care in centers for anonymous testing have high biological risk, which is neither proportional nor concurrent to behavioral risk. The low concordance found between these risks suggests the need for routine gynecological investigation (clinical and microbiological) for all women.
Subject(s)
Adult , Female , Humans , Anonymous Testing , HIV Infections/transmission , Risk-Taking , Cross-Sectional Studies , HIV Infections/diagnosis , Risk Factors , Sexual BehaviorABSTRACT
Este estudo caracteriza o perfil dos usuários que procuraram os Centros de Testagem Anônima (CTAs) em Santa Catarina, Brasil, em 2005, e determina os fatores associados à contaminação pelo HIV. Foi realizado um estudo retrospectivo transversal em pessoas que freqüentaram os CTAs. Foram analisados os dados de 22.846 entrevistas realizadas no momento pré-teste, 64,7 por cento sexo feminino e 35,3 por cento masculino. A prevalência de HIV positivo encontrada nesses exames foi de 2 por cento no sexo feminino e 5,6 por cento no masculino. Utilizou-se análise bivariada e multivariada com regressão de Poisson. Os fatores de risco independentes para o contágio pelo DST/HIV no sexo feminino foram: faixa etária, estado civil, escolaridade, situação profissional, recorte populacional, risco do parceiro fixo, uso de preservativo e motivo para não usar preservativo com parceiro fixo. No sexo masculino foram: faixa etária, escolaridade, tipo de parceiro, recorte populacional, risco do parceiro, uso de preservativo e motivo para não usar preservativo com parceiro fixo. A soropositividade para homens e mulheres apresenta-se diferente, merecendo abordagens preventivas diferenciadas.
This study analyzes the user profile of HIV Testing and Counseling Centers in Santa Catarina State, Brazil, in 2005, and factors associated with HIV infection. The methodology employed a retrospective, cross-sectional study of individuals who attended Testing and Counseling Centers. Data from 22,846 interviews were analyzed (64.7 percent women and 35.3 percent men). HIV prevalence was 2.0 percent in women and 5.6 percent in men. Statistical analysis used bivariate and multivariate Poisson regression by gender. According to the Poisson regression, factors associated with HIV+ status were age bracket, schooling, marital status, professional situation, population group, steady partner's risk status, condom use, and reason for not using condoms with steady partner; for men, the independent variables were age bracket, schooling, type of partner, population group, steady partner's risk status, condom use, and reason for not using condoms with steady partner. HIV+ patterns differed between men and women, so that customized preventive approaches are needed.
Subject(s)
Humans , Male , Female , Anonymous Testing , Counseling , Health Profile , HIV Seropositivity , Acquired Immunodeficiency Syndrome/epidemiology , Age Factors , Brazil , Multivariate Analysis , Prevalence , Retrospective Studies , Socioeconomic FactorsABSTRACT
Background :Voluntary counseling and testing (VCT) has become a cornerstone intervention in the fight ; against HIV .Current evidence suggests that it is cost- effective in changing behaviour and preventing HIV infection .A number of studies have demonstrated some of the factors which are associated with both intention and actual use of VCT services. However; studies which show various factors combine to influence intention and subsequently the use of VCT services are generally lacking .We employed structural Equation Modelling (SEM) to examine the relationship between factors involved in use of VCT services. Method the AMOS program version 6 was used for our data analysis and data from a population based survey in Zambia (2003) was used to fit the model. Results the proposed model fitted well for the population. Fitness indices fell within assepted tanges; GFI=0.998; AGFI=0.994 and RMSEA= 0.025.The model fitted well accross age group (young/older participations) ; residence (rural/urban) and sex( male and female participants) .All standardized regression weight were significant at 95 confidence level except for regression weight between self-rated health and willingness. Psychological distress was positively associated with health use; depression; self-rated risk and willingness (intention; but negatively associated with self-rated health .willgness (intention) was positively associated with participation in VCT. Conclusion SEM was successfully used to explore how various determinants interact to influence the use of VCT services and most of our theoretical assumptions were supported by empirical finding .Self -rated health was a key explanatory parameter for psychological distress and the intention to use VCT services
Subject(s)
Adult , Anonymous Testing , HIV Infections , Self-AssessmentABSTRACT
The series of 231 HIV-infected women were recruited in Chonburi Hospital, Thailand. Demographic, gynecologic factors were interviewed Pap smear was performed and classified based on the Bethasda system (1991) by a cytotechnologist. All abnormal Pap smear slides were reviewed by a cytopathologist. The prevalence of LSIL, HSIL and SCCA were 2.2%, 8.3% and 2.2%, respectively. There was statistically significant association between the duration of HIV infection and occurrence of SIL and SCCA. (p = 0.007) CONCLUSION: The present study showed a high prevalence of SIL and SCCA in-HIV-infected women at Chonburi Hospital.
Subject(s)
Adult , Anonymous Testing , Antigens, Neoplasm/analysis , Carcinoma, Squamous Cell/complications , Uterine Cervical Dysplasia/complications , Female , HIV Seropositivity/complications , Humans , Prevalence , Serpins/analysis , Thailand/epidemiology , Biomarkers, Tumor/analysis , Uterine Cervical Dysplasia/complications , Uterine Cervical Neoplasms/complications , Vaginal SmearsABSTRACT
O algoritmo de testes sorológicos para detecção de soroconversão recente para o HIV (STARHS) (Janssen et al., 1998) foi empregado neste estudo para discriminar infecções recentes e crônicas pelo HIV e estimar a incidência da infecção por HIV com amostras de soro provenientes de gestantes, usuários de Centro de Testagem e Aconselhamento (CTA) e indivíduos com suspeita de infecção recente pelo HIV. A associação entre os padrões de bandas presentes no teste de Western blot para HIV-1(WB) e os resultados do STARHS foi avaliada. Foram analisadas 106 amostras de soro de gestantes, 42 de usuários de CTA, 06 de soroconvertores recentes para o HIV (média de 188 dias) e 37 de indivíduos suspeitos de infecção recente pelo HIV. Estimativas de soroincidência de HIV de 0,2 (IC 95 por centos, 0,041-0,608) e 3,3 (IC 95 por cento, 1,426-6,345) por 100 amostras de soro-ano foram observadas com a análise das amostras de gestantes, de 1999 a 2002, e de usuários de CTA, de 2000 a 2001, respectivamente. Os padrões de intensidade de cor das bandas observadas na análise das amostras de soro deste estudo por meio de WB sugerem que há associação entre ausência ou intensidade baixa da banda gp41 e infecção recente [OR=16,44(IC 95%, 6,32 -42,75; p<0.001] e presença das bandas p55, p24 e p17, em intensidade de forte, e infecção crônica [OR=7,01(IC 95%, 3,05-16,14); p<0,001]... (AU)
The Serological Testing Algorithm for Recent HIV Seroconversion (STARHS) (Jansssen et al., 1998) has been employed in this study to discriminate recent and chronic HIV infections and estimate HIV incidence on HIV-positive sera samples from pregnant women (PW), Voluntary Counseling and Testing (VCT) attendees, and persons suspected to be recently infected by HIV. The association between banding patterns observed on the HIV-1 Western blot test and STARHS results was assessed. A total of 106 samples from PW, 42 samples from VCT attendees, 06 samples from HIV serconverters (mean of 188 days), and 37 samples from subjects under recent HIV-infection suspicion has been analyzed. HIVseroincidence estimates of 0.2 (95% CI, 0.041-0.608) and 3.3 (95% CI, 1.426 6.345) per 100 sera samples-years were observed for PW, from 1999-2002, and for CTA population, from 2000-2001, respectively. The patterns of color intensity of bands observed in the analysis of sera samples from this study suggest association between absence or weak reactivity at gp41 region and recent infection [OR = 16.44 (95% CI, 6.32 42.75); p<0.00], and between strong reactivities at p55, p24, and p17 bands and chronic infection [OR = 7.01(95%CI, 3.05 16.14); p<0.001]. Data from the present study suggest that the evaluation of antiHIV antibodies profiles from specimens stored in sera banks and of raw data from WB performed for HIV/Aids diagnosis could be useful on HIV incidence estimates using serological algorithms, especially when epidemiological and socio-demographic data are available. (AU)
Subject(s)
Humans , Female , Pregnancy , Pregnant Women , Anonymous Testing , Blotting, Western , HIV Infections/epidemiologyABSTRACT
O algoritmo de testes sorológicos para detecção de soroconversão recente para o HIV (STARHS) (Janssen et al., 1998) foi empregado neste estudo para discriminar infecções recentes e crônicas pelo HIV e estimar a incidência da infecção por HIV com amostras de soro provenientes de gestantes, usuários de Centro de Testagem e Aconselhamento (CTA) e indivíduos com suspeita de infecção recente pelo HIV. A associação entre os padrões de bandas presentes no teste de Western blot para HIV-1(WB) e os resultados do STARHS foi avaliada. Foram analisadas 106 amostras de soro de gestantes, 42 de usuários de CTA, 06 de soroconvertores recentes para o HIV (média de 188 dias) e 37 de indivíduos suspeitos de infecção recente pelo HIV. Estimativas de soroincidência de HIV de 0,2 (IC 95 por centos, 0,041-0,608) e 3,3 (IC 95 por cento, 1,426-6,345) por 100 amostras de soro-ano foram observadas com a análise das amostras de gestantes, de 1999 a 2002, e de usuários de CTA, de 2000 a 2001, respectivamente. Os padrões de intensidade de cor das bandas observadas na análise das amostras de soro deste estudo por meio de WB sugerem que há associação entre ausência ou intensidade baixa da banda gp41 e infecção recente [OR=16,44(IC 95%, 6,32 -42,75; p<0.001] e presença das bandas p55, p24 e p17, em intensidade de forte, e infecção crônica [OR=7,01(IC 95%, 3,05-16,14); p<0,001]...
The Serological Testing Algorithm for Recent HIV Seroconversion (STARHS) (Jansssen et al., 1998) has been employed in this study to discriminate recent and chronic HIV infections and estimate HIV incidence on HIV-positive sera samples from pregnant women (PW), Voluntary Counseling and Testing (VCT) attendees, and persons suspected to be recently infected by HIV. The association between banding patterns observed on the HIV-1 Western blot test and STARHS results was assessed. A total of 106 samples from PW, 42 samples from VCT attendees, 06 samples from HIV serconverters (mean of 188 days), and 37 samples from subjects under recent HIV-infection suspicion has been analyzed. HIVseroincidence estimates of 0.2 (95% CI, 0.041-0.608) and 3.3 (95% CI, 1.426 6.345) per 100 sera samples-years were observed for PW, from 1999-2002, and for CTA population, from 2000-2001, respectively. The patterns of color intensity of bands observed in the analysis of sera samples from this study suggest association between absence or weak reactivity at gp41 region and recent infection [OR = 16.44 (95% CI, 6.32 42.75); p<0.00], and between strong reactivities at p55, p24, and p17 bands and chronic infection [OR = 7.01(95%CI, 3.05 16.14); p<0.001]. Data from the present study suggest that the evaluation of antiHIV antibodies profiles from specimens stored in sera banks and of raw data from WB performed for HIV/Aids diagnosis could be useful on HIV incidence estimates using serological algorithms, especially when epidemiological and socio-demographic data are available. (AU)
Subject(s)
Humans , Female , Pregnancy , Pregnant Women , HIV Infections/epidemiology , Anonymous Testing , Blotting, WesternABSTRACT
HIV sentinel surveillance was performed in five provinces of Morocco in 1993, expanded to 10 provinces in 1996. The activity was done by unlinked anonymous testing procedures. We analysed the data from 1993 to 1999. The groups studied were sexually transmitted infections, clinic attendees, pregnant women and patients with pulmonary tuberculosis. The results show that overall HIV prevalence rate over the whole period in 10 cities was 0.10% [45/44,233]. Casablanca had a significantly high rate with 0.39% [10/2567]. The patients with pulmonary tuberculosis displayed the highest prevalence with 0.36% [9/2530]. These data confirm the assumption that the HIV epidemic is low in Morocco. However, the increase of HIV prevalence lately calls for reinforcing preventive measures to limit its spread