Adenilson Pereira Nunes1
Renata Lívia Silva Fonseca Moreira de Medeiro2
Aurélia Gonçalves Leoncio Batista3
Lucyo Rodrigues Feliciano4
Jaddy Eveny de Abreu 5
1 Graduating in Nursing by UNIFSM
2 Teacher and Counsellor of the Bachelor of Nursing by UNIFSM
3 Graduating in Nursing by UNIFSM
4 Graduating in Nursing by UNIFSM
5 Graduating in Nursing by UNIFSM
The human immunodeficiency virus (HIV) is currently a major health problem, mainly because it is endemic and presents serious situations for those affected, where it is identified that there are around 36.9 million people in the world who suffer from are carriers of this virus, which proves to be a major problem for health entities, as this infection still has no cure, only treatment, however, when used correctly, it benefits patients where the cells responsible for immunity are regularized. , as well as a decrease in viral load (LIMA et al, 2023).
Given the 37 million individuals currently living with the virus, it is important to highlight that there has been a high growth inrecent years, as it was observed that in the last decade only 247,795 cases of the infection were identified in the country, however, given the data, it was observed that this growth represents the majority of the female population, however, in relation to the involvement in Brazil by Immunodeficiency Syndrome Acquired AIDS (AIDS), it has been proven that around 40 thousand new cases are recorded annually, observed in the last five years (BORGES et al, 2023).
In Brazil, only in 2019 were 41,919 cases of the HIV virus were reported and reported, where 25.6% of these carriers are found in the northeast region, what makes it worrying is that despite all the technological and scientific advances seen in recent years, large annual increases in both the virus and HIV and AIDS syndrome, increasing the concern of health and public health bodies in Brazil, where, according to the Ministry of Health (MS), it was identified that there were changes in infected individuals, who are currently being classified as sex workers and gold miners , as well as injectable drug users and Truck Drivers (LEITE et al, 2022).
Given all the processes involved in the representation of HIV/AIDS, considering sociocultural aspects, integratesocial and group action, it is observed that these patients go through various sufferings, mainly psychological, which when not controlled correctly can result in physical changes, opportunistic infections and adverse reactions to medications, as well as loss of autonomy, presence of other chronic diseases and depression , making it clear that it completely affects the living conditions of sufferers, especially their interpersonal relationships and lifestyle (ZEPEDA et al 2022).
The objectThe purpose of this study is to show the activities provided by nursing care for patients with human immunodeficiency, discussing care and prevalence, as well as prevention andcare that must be taken with these individuals.
The emergence of the HIV virus was observed for the first time in 1981, however, until then it was recognized as a disease that was linked to the malfunction of the immune system, this state of immunological deficiency is caused by the retrovirus of the Retroviridae family, which in addition to providing The emergence of AIDS also weakens the infected individual, making them prone to developing opportunistic diseases that would not normally be expressed in healthy people (BRANCO et al, 2020).
The incidence is quite alarming, with around 79.3 million individuals infected with the virus andidentified, in addition to 36.3 million deaths worldwide due to AIDS since the beginning and emergence of this epidemic as observed through the Joint United Nations Program that addresses issues related to HIV/AIDS, in addition, infection, as well as the disease still affects countless people, with an incidence of 1.5 million new infections and 680 deaths in 2020 alone, which shows the importance of implementing strategies and professional commitment to drive the reduction of cases, focusing on changing this scenario (ANTONINI et al, 2022).
The increase in cases year after year is increasing due tooccurrence of vulnerable and specific populations, which becomes quite worrying for all health entities, as a compromise is identified both in the quality of life of these patients and in their relations with society in general, which is why this virus is considered a chronic health condition, in addition to having major impacts on the economy of health systems (GÓIS et al, 2022).
It has been observed since the emergence of theAIDS that one of the main risk groups in the detection and transmission of the disease are female sex workers (FSW), who are currently called a key population due to the high level of infection, according to scientific data, the practicality of relating to different partners even even without the use of condoms, in addition to other characteristics that are correlated with health adversities, such as precarious conditions, low level of education and violence, thus favoring infection (BRAGA et al, 2021).
Therefore, it is extremely important for nursing professionals to provide assistance to people with the human immunodeficiency virus (HIV), which causesacquired immunodeficiency syndrome (AIDS), as it is noted that when adequate care is practiced, as well as early diagnosis is made, all infected individuals tend to present lower risks of morbidity and mortality related to the disease, however, it is observed that The main challenges faced by these professionals are based on these patients’ access to health services as well as sustaining pharmacological adherence (LIMA et al, 2022).
Effectiveness is observed in the nurse’s performance, where, according to the literatureIt is clear from a scientific perspective that this professional has complete security, training and ability to act mainly in the care of those with the disease, as well as the virus, in which activities are identified. technical-scientific skills that haveas a basis for the development of actions related to the promotion, rehabilitation of these patients, protection and self-care, which favors with excellence the organization of theSystematization of Nursing Care (SAE), as follows in Resolution COFEN-358/2009 (SILVA et al, 2021).
However, the quality provided by the nursing professional isobserved through Primary Health Care (PHC), where this professional works in different ways, including consultations, home care, as well as educational actions through health education, primarily related to sexual and reproductive discussions, taking into account achieve all processes that favor certain individuals to become vulnerable to the HIV virus, whether institutional, family, sociocultural or behavioral, however, it is seen that the activities provided by nursing are organized according to the needs of each group that presents vulnerability, so when they seek to health units (NECO et al, 2023).
However, due to the high level of infection, care for people living with HIV/AIDS is increasingly requiring a different perspective, where it is necessary to intensify approaches that are comprehensive, complex and focus especially on (PHC), as it is the means of first contact with certain suspects of this disease, for this reason a manual was launched by the Ministry of Health (MS) with the purpose of implementing management to effectively manage this infection in PHC (COLAÇO et al, 2019).
In view of this, it is necessary to develop more preventive actions to minimize as many infections as possible, and it is essential that nursing professionals, as well as other professionals, are trained and understand the need for new strategies that can provide positive responses for the entire population, However, it is known that educational processes are one of the best ways to demystify the subject in detail, using technologies that can facilitate understanding in the teaching methodology, favoring improvements in care and facilitating health promotion, prevention and treatment modalities (MOTA et al, 2023).
In the present study, an integrative review of the literature was carried out, in whichand as a purpose to unite scientific information, being selected through Papers that presented in their proposal a relationship with the theme to be studied, thus contributing and verifying their data were used accessed the SCIELO (Scientific Electronic Library Online) and VHL (National Health Library) databases. The key words used were: Nursing care, human immunodeficiencyand antiretroviral.
The inclusion criteria used fhere: Papers found for the construction of the study published in the last five years, complete research, with full and free availability with objectives similar to the topic discussed, being in the following languages: Portuguese, English and Spanish. The exclusion criteria were: Information prior to 2018, incomplete, duplicated and unrelated to the topic.
In the study, what we propose to investigate is whether nursing care for the affected patient really Human immunodeficiency is effective in terms of control, handling and quality of life of individuals, as well as in preventing the disease. In view of this, we sought to answer the following question: What assistance is offered by the nursing professional when faced with a patient affected by human immunodeficiency? Next, theframe 1shows the studies found in the databases, in which it is possible to observe the number of Papers found using the descriptors directed to this research.
Table 01 –Presentation of Papers found in the databases:
SCIELO BVS |
Human immunodeficiency 435 9 |
|
Nursing assistance 4.016 337.066 |
Antiretroviral 288 39.418 |
|
Based on the research shown in table 01, 381,232 Papers were found in total, which went through a filtering process using the inclusion and exclusion criteria mentioned above. Figure 01 below shows the use of criteria to assist in choosing the Papers that were included in this study.
Figure 01: Presentation of the selection of Papers using the inclusion criteria:
Papers found through database searches: 381,232
Papers published between 2015 and 2021: 46,579
Papers published in years prior to 2018: 334,653
Complete Papers: 18,632
Incomplete Papers: 27,948
Papers excluded by reading the title: 13,043
Remaining Papers: 5,589
Papers that were repeated in the database: 2,236
Remaining Papers: 3,354
Papers excluded after reading the abstract: 2013
Remaining Papers: 1,341
Papers deleted after reading the Paper in full: 946
Papers included after complete reading of the Papers: 395
Papers selected to participate in this study: 13
When finishing the filtering of Papers found through database searches,9 Papers were selected for this study. Table 02 shows some details of these selected Papers, such as the year of publication and database where it was found.
Table 02-Presentation of the synthesis of Papers organized by title/year/database.
| Title | Year | Data base | ||||
01. | Humanistic reflections in specialized HIV care services. | 2020 | SCIELO | ||||
02. | Prevalence and factors associated with late diagnosis of HIV infection in a city in São Paulo | 2022 | SCIELO | ||||
03. | Representational content of health care network professionals on HIV in counseling. | 2022 | SCIELO | ||||
04. | Sexual, reproductive health and health status of female sex workers in 12 Brazilian cities. | 2021 | SCIELO | ||||
05. | Psychometric properties of the instrument for evaluating nursing care provided to individuals with HIV/AIDS. | 2022 | SCIELO | ||||
06. | Specialized nursing terminology in the care of people with AIDS. | 2021 | SCIELO | ||||
07. | Nursing care for adolescents Immunodeficiency Virus. | vulnerable | to | the | Acquired | 2023 | VHL |
08. | care for people living with HIV/AIDS in primary health care. | 2019 | SCIELO | ||||
09. | Educational technologies for HIV prevention in black people: scoping review. | 2023 | SCIELO | ||||
10. | Nursing care for adolescents Immunodeficiency Virus. | vulnerable | to | the | Acquired | 2023 | VHL |
11. | Educational technologies for HIV prevention in black people: scoping review. | 2023 | SCIELO | ||||
12. | Use of HIV prevention methods and contexts of sexual practices among gay and bisexual adolescents, transvestites and transgender women in São Paulo, Brazil. | 2023 | SCIELO | ||||
13. | Construction and validation of educational technology to prevent HIV/AIDS in women deprived of their liberty. | 2023 | SCIELO | ||||
When selecting Papers for the study with the nursing care approach to patients affected by human immunodeficiency, all Papers that are included bring a discussion about this subject, thus considering it of great importance for participating in the study.
The Papers used were published between the years 2019 and 2023, with 01 Paper published in 2019, 01 Paper published in 2020, 02 Papers published in 2021, 03 Papers published in 2022 and 02 Papers published in year 2023.
The selected Papers bring discussions about the most current scientific literature on nursing care for patients diagnosed with human immunodeficiency.
Table 01 shows a summary of the objectives and results of the Papers that were used in this study. .
Table 01.– Summary of the objectives and results of the Papers included in the study.
PAPER NO. | AUTHORS | GOALS | RESULTS |
01 | Branco et a l . , 2 0 2 0 . | To report the experience of medical students in the sixth period at the Centro Universitário Metropolitano da Amazônia, in Belém/PA, during classes in the Clinical Skills module (Infectious Diseases Axis) at the Health Care Center for Acquired Infectious Diseases. | It was observed that the emergence of the HIV virus was observed for the first time in 1981, however, until then it was recognized as a disease that was linked to the malfunction of the immune system, this state of immunological deficiency is caused by the retrovirus of the Retroviridae family that In addition to causing the emergence of AIDS, it also weakens the infected individual, making them prone to developing opportunistic diseases that would not normally occur in healthy people. |
02 | A n t o n i n i et al.,2022. | To identify the prevalence and factors associated with late diagnosis of Human Immunodeficiency Virus (HIV) infection in a municipality in São Paulo. | Of the 829 (100%) new HIV cases, 290 (35.0%) were diagnosed with AIDS. The majority of the population was male and aged between 15 and 34. Oral candidiasis and weight loss greater than 10% were the main symptoms associated with AIDS. It was observed that people with less education and older people were more prone to late diagnoses. |
03 | Góis et al, 2022. | Analyze the representational content of health network professionals about the human immunodeficiency virus in counseling. | The categories emerged: Social prejudices that compromise confidentiality and privacy at reception; vulnerabilities that consolidate pre-test advice; and HIV status and treatment make testing urgent. The representational contents about the human immunodeficiency virus, such as social prejudices, vulnerabilities, serological status and treatment, are related to the difficulties in guaranteeing the secrecy and privacy of reception practices, the emphasis on pre-infection test counseling, the urgency of test as per point of care. |
04 | Braga et al., 2021. | Investigate differences in indicators of sexual and reproductive health and health status of female sex workers in 12 Brazilian cities. | The total sample consisted of 4,328 female sex workers. Coverage of Pap smears, human immunodeficiency virus and syphilis testing, and prenatal care indicators varied by 20 percentage points or more. Pap smear coverage ranged from 53.4% in Recife to 73.0% in Porto Alegre. The highest percentage of female sex workers who had never been tested for human immunodeficiency virus and syphilis was in Fortaleza (36.8 and 63.8%, respectively). Prenatal coverage ranged from 61.1% in Salvador to 99.0% in Curitiba. In five cities, the proportion of female sex workers who disclosed their sex worker status to health services was greater than 20.0%. |
05 | Lima et al., 2022. | To evaluate the psychometric properties of the Brazilian version of the Quality of Care Through the Patient’s Eyes - HIV (QUOTE- HIV). | QUOTE-HIV is structured into two components, Importance and Performance; therefore, two models were generated at the end of the factor analysis, one for each component. Both models were statistically validated and presented satisfactory reliability parameters. Regarding convergent validity, positive and significant correlations were found between the scores obtained by the QUOTE-HIV and Newcastle Satisfaction with Nursing Scales (NSNS) domains, except for the performance domain in the importance component. |
06 | S i l v a e t al., 2021. | Build and validate in terms of content a specialized Nursing terminology, in the care of adults living with AIDS, based on the Seven-Axis Model of the International Classification for Nursing Practice. | 2,000 terms were extracted. The standardization resulted in 557 pertinent terms, 319 of which were included and 238 were not included in the International Classification for Nursing Practice. 522 terms were validated by experts, 319 of which were constant and 203 were non-constant, which reached an agreement index ≥ 0.80. |
07 | Neco et al., 2023. | Analyze the contextual aspects of healthcare assistancenursingto theteenagersin a situation ofvulnerabilityto theHIV. | Eight studies were selected, categorized into subthemes following eachadolescentin a situation ofvulnerabilityto theHIV/AIDSthe insertion of theadolescentvulnerable toHIV/AIDSatPrimary Health Care;nursing careTheteenagersin situationvulnerabilityto theHIV/AIDSatPrimary Health CareIt ispoliciespublic aimed atteenagersin situationvulnerabilityto theHIV/AIDS. |
08 | C o l a ç o e t al., 2019. | Understand the process of care for people with HIV/AIDS in Primary Health Care in a capital in southern Brazil. | The results were described in two categories: “The intersubjective encounter in the face of vulnerability due to HIV/AIDS”, and, “Accepting needs and formulating actions in the face of reality”. Through these categories, potentialities and weaknesses were highlighted, such as: reception, longitudinality of care, active search, home visits, bonding and, on the other hand, lack of a formal flow of care for people living with HIV/AIDS, lack of a line HIV/AIDS care and medical/centered care. |
09 | Mota et al., 2023. | Map the educational technologies implemented to prevent HIV among black people. | There were 14 studies published between 1999 and 2020. The main impacts on the health of black people involved a reduction in rates of unprotected sex, greater use of condoms, a decrease in risky behaviors, minimization of the number of partners, greater request for HIV tests and an increase in use of pre- exposure prophylaxis (PrEP). |
10 | Lima et al., 2023. | Analyze scientific productions about the effectiveness of interventions using motivational interviewing for adherence to antiretroviral therapy by people with the human immunodeficiency virus. | The motivational interview was applied in person and associated with telephone calls, home visits, audio tapes, information booklets, counseling, cognitive- behavioral and cognitive-social theories. The studies included in this review showed that interventions using motivational interviewing increased adherence to antiretrovirals by people with human immunodeficiency virus. |
11 | Borges et al., 2023. | Describe the process of developing and validating educational technology to prevent the Human Immunodeficiency Virus in the female population deprived of liberty. | The items in the material were relevant, obtaining a total Content Validity Index of (CVIt=0.87) for specialists and (CVIt=0.95) for women. The experts evaluated the booklet, classifying it with a “superior” level of recommendation (average of 91%). There were adjustments, reaching, in the end, an agreement rate above 88.7%. |
12 | Leite et al., 2022. | To quantitatively analyze results of rapid tests for human immunodeficiency virus (HIV), syphilis and chronic hepatitis in the prison population in a penitentiary complex in Salvador (BA). | 6,160 men were studied, with the majority (93.1%) being black and mixed race, residents of Salvador (65.8%), with a predominant education level of primary education (65.3%). Of the people deprived of liberty, 581 (9.4%) tested positive for one or more STIs, with syphilis being the most prevalent (80%). The variables age over 25 years old [RP = 1.37 CI95% (1.17-1.61)] and level of education without higher education [PR = 2.16 CI95% (1.04-4.49 )] were associated with a higher rate of test positivity, while not sharing drugs at some point in life proved to be a protective factor for test positivity [PR = 1.28 95% CI (1.07-1.53)] . |
13 | Zepeda et al., 2022. | Understand the meanings and meanings attributed by people with HIV/AIDS to the process of living with this virus/disease. | Living with HIV/AIDS is a social phenomenon in which it is not possible to separate the process of adaptation to the disease from the social relationships that are (re)constructed throughout life. It also involves stigmatization, rejection and isolation. |
According to research by Branco et al (2020), the emergence of the HIV virus was observed for the first time in 1981, however, until then it was recognized as a disease that was linked to the malfunction of the immune system, this state of deficiency The immune system is caused by the retrovirus of the Retroviridae family, which, in addition to causing the emergence of AIDS, also weakens the infected individual, making them prone to developing opportunistic diseases that would not normally occur in healthy people.
In an epidemiological, analytical and retrospective study carried out by Antonini et al (2022) it wasobserved how widespread the disease is, in which 79.3 million individuals were infected with the virus, 36.3 million deaths have been identified worldwide due to AIDS since the beginning and appearance of this epidemic, according to the Program United Nations group that deals with issues related to HIV/AIDS, in addition, it was seen that the infection, as well as the disease, still affects countless people, where there was an incidence of 1.5 million new infections and 680 deaths in the year alone 2020, which shows the importance of implementing strategies and professional commitment to drive the reduction in cases, focusing on changing this scenario.
Given this, Góiset al(2022) justifies this increase in cases every year and increasingly due to vulnerable and specific populations, which becomes quite worrying for all health entities, as a compromise is identified in both the quality of life of these patients and the its relations with society in general because this virus is considered a chronic health condition, in addition to having major impacts on the economy of health systems.
According to Bragaet al(2021) it has been observed since the emergence of the AIDS epidemic that one of the main risk groups in the detection and transmission of the disease are female sex workers (FSW), who are currently called the key population due to the high level of infection, according to the authors due to the practicality of relating to different partners even without the use of condoms, in addition to other characteristics that are correlated with health adversities such as precarious conditions, low level of education and violence, thus favoring infection.
Therefore, according to research and guidance from Limaet al(2022) it is extremely important for nursing professionals to provide assistance to people with the human immunodeficiency virus (HIV), which causesacquired immunodeficiency syndrome (AIDS), as it is noted that when appropriate care is practiced, as well as early diagnosis is made, all infected individuals tend to present lower risks of morbidity and mortality related to the disease, however, according to the The authors observed that the main challenges faced by these professionals will be based on these patients’ access to health services as well as sustaining pharmacological adherence.
Silva’s studyet al(2021) addresses precisely this effectiveness in the nurses’ performance, showing that this professional has total security, training and ability to act mainly in the care of those with the disease, as well as the virus, in which activities are identifiedtechnical-scientific skills that haveas a basis for the development of actions related to the promotion, rehabilitation of these patients, protection and self-care, which favors with excellence the organization of theSystematization of Nursing Care (SAE), as follows in Resolution COFEN-358/2009.
However, Necoet al(2023) says that the quality provided by the nursing professional is observed through Primary Health Care (PHC), where this professional works in different ways, including consultations, home care, as well as educational actions through education in health, primarily related to sexual and reproductive discussions, with a view to reaching all processes that favor certain individuals to become vulnerable to the HIV virus, whether institutional, family, sociocultural or behavioral, however, the authors highlight that the activities provided by nursing are organized according to the needs of each group that is vulnerable when they seek health facilities.
As a resultIn essence, the research by Colaço et al (2019) justifies that due to the high level of infection, care for people living with HIV/AIDS is increasingly requiring a different perspective, where it is necessary to intensify approaches that are integral, complex and focuses especially on (APS), as it is the means of first contact with certain suspects of this disease, for this reason, a manual was launched by the Ministry of Health (MS) with the purpose of implementing management to handle this infection in PHC is effective.
Nonetheless,Furthermore, for Mota et al (2023), it is important to develop more prevention actions to minimize as many infected people as possible, and it is essential that nursing professionals, as well as other professionals, are trained and understand the need for new strategies that can provide positive responses. for the entire population, however, it is known that educational processes are one of the best ways to demystify the subject in detail, using technologies that can facilitate understanding in teaching methodology, favoring improvements in care and facilitating health promotion, prevention and modalities of treatment.
According to data from scientific research, it was observed that human immunodeficiency is a virus that causes acquired immunodeficiency syndrome, a disease that is chronic in nature and is transmitted through contagion and sexual intercourse. In view of this, the support of nursing professionals is necessary, as it has been observed that their assistance provides effectiveness in controlling and handling this illness, mainly through actions related to promotion, rehabilitation and self-care.interventions by health entities forensure a better quality of life and minimize the risks of infection, morbidity, mortality and opportunistic diseases.
ANTONINI, M, et al. Prevalência e fatores associados ao diagnóstico tardio da infecção por HIV em um município de são Paulo. Texto contexto - enferm. v.31, n.2, 2022.
BORGES, A, V, S, S, et al. Construção e validação de tecnologia educacional para prevenção do HIV/ aids em mulheres privadas de liberdade. Cogitare Enferm. v.28, n.4, 2023.
BRANCO, b, b, et al. Reflexões humanísticas em serviço de atendimento especializado em HIV. Rev. Bioét. v.28, n.1,2020.
BRAGA, L, P, et al. Saúde sexual, reprodutiva e situação de saúde de mulheres profissionais do sexo em 12 cidades brasileiras, 2016. Rev. bras. Epidemiol. v.24, n.1, 2021.
COLAÇO, A, D, et al. O cuidado à pessoa que vive com HIV/aids na atenção primária à saúde. Texto contexto - enferm. v.28, n.1, 2019.
GÓIS, A, R, S, et al. Conteúdos representacionais de profissionais da rede de atenção à saúde sobre HIV no aconselhamento. Enferm. glob. vol.21, n.68, 2022 .
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LEITE, A, G, S, et al. Testes rápidos de HIV, sífilis e hepatites crônicas na população carcerária em um complexo penitenciário de Salvador (BA), Brasil. Ciênc. saúde coletiva v.27, n.12, 2022.
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MOTA, N, P, et al. Tecnologias educativas para prevenção do HIV em pessoas negras: revisão de escopo. Rev. Gaúcha Enferm. v.44, n.2, 2023.
NECO, K, K, S, et al. Assistência de enfermagem a adolescentes em situação de vulnerabilidade ao
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SILVA, B, C, O, et al. Terminologia especializada de enfermagem no cuidado às pessoas com aids. Acta Paul Enferm. v.34, n.4, 2021.
ZEPEDA, K, G, M, et al. Significados e significados atribuídos pelas pessoas com
HIV/aids à sua vida com esse vírus/doença. Rev. Bras. Enferm. v.75, n.3, 2022.