Fatores associados ao abandono do tratamento de adolescentes e adultos jovens em um centro de referência para IST/HIV/AIDS

Abstract

The objective of this course was to analyze the associated factors to treatment abandonment in adolescents and young adults positive serology for HIV. It is set up as a quantitative and longitudinal study in which the medical records of the adolescents and young adults enrolled in the Specialized Care Service of the municipality of Feira de Santana / Bahia were analyzed from 2003 to December 2016. After the exclusion, 290 medical records of individuals between 13 and 24 years of age were reviewed, taking into account sociodemographic, clinical and follow-up variables in the service. A descriptive analysis was performed with frequencies, bivariate analysis, between categorical variables of choice, and survival analysis to estimate the median time of abandonment of treatment follow-up. Finally, for the statistically significant variables, the analysis was done by the Cox regression model. The study population is characterized by 73.4% young adults (20 to 24 years); 91.9% of black, brown or indigenous color; 64.5% heterosexual; 73.7% single, widowed or divorced; in addition, 56.2% have more than eight years of study. Of the 290 subjects analyzed, 59% presented the episode of treatment abandonment. When analyzing factors associated with dropout, age (p = 0.00), sexual orientation (p = 0.00), schooling (p = 0.00), resides in Feira de Santana (p = 0.02) and presence of opportunistic infection (p = 0.02), presented statistical significance for the event. In the log rank test, significance was found for schooling (p = 0.00) and presence of opportunistic infections (0.00). The median time to abandonment was 16 months. In the Cox model, significance was found for schooling (HR: 0.64, CI: 0.47-0.88) and for the presence of opportunistic infections (HR: 1.78, CI: 1.28-2, 48). The data found in the study, for the most part, corroborate with the literature. It identifies the juvelinization of the epidemic; feminization, although the incidence is still higher in the male population; heterosexualization; and pauperization, represented by the low level of schooling of those who left the monitoring. However, when discussed about the municipality of residence, the majority of the abandonment occurred in those living in the same city of the service, but its incidence is much higher when compared to the others. With regard to opportunistic infections, monitoring the service provides professionals with the knowledge of these events and these make the individual perceive the need to continue the service. The mean time of abandonment was 16 months, which shows us the greater vulnerability to abandonment at the beginning, due to the changes inherent in the treatment. Therefore, this study aimed to know the factors associated with abandonment so that coping strategies can be created and that prevent the occurrence of new episodes.