O viver com HIV/aids na perspectiva de pessoas idosas atendidas em ambulatório especializado da cidade de São Paulo / Living with HIV/AIDS in the perspective of elderly people assisted at a specialised outpatient clinic in the city of São Paulo

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

The AIDS epidemic is one of the most serious Public Health problems of our time. With the spread of the Brazilian epidemic, the number of reported cases among the elderly has recently increased. In the present study living with HIV was investigated, from the perspective of elderly men and women under follow-up at the AIDS Clinic-HC/FMUSP. Seventy-five patients were interviewed in search of socio-demographic data, information on their sexual lives, risk perception of HIV exposure, circumstances involving disclosure of diagnosis and how it impacted on their lives, reported episodes of stigma and discrimination, as well as their perception of provided care, the difficulties they had to face, and their plans for the future. The study cohort comprised mainly white men (65.3% and 64%, respectively), with less than 5-year schooling and a median income of 600 reais. Time since HIV diagnosis ranged from 18 months to 17 years. As far as their living conditions were concerned, 28% reported to live alone and 52% to be caregivers. Though 66.7% were retired, elderly patients significantly contributed for the family income. Out of 47 sexually active patients, 30 informed having a steady partner, more likely, serodiscordant (70%). Most patients reported consistent condom use after HIV diagnosis. Risk perception of HIV exposure was low and most (74.7%) patients believed having acquired the infection in unsafe sex. Serodiagnosis was carried out more often after healthcare professionals recommendation (73.3%), as compared to patients own initiative (26.7%), in a hospital setting and without pre-test counselling (85.1%). Eleven patients reported having received the diagnosis from an indifferent healthcare worker or, alternatively, felt discriminated against at the time of disclosure. Diagnosis affected their relationships with sexual partners, mainly. Episodes of stigma and discrimination were experienced by 18.7%. As for their perception of provided care, even though patients reported easy access to the clinic and to necessary care tools (medication, laboratory tests and condoms), they lacked efficient communication with the healthcare team. Except for a higher proportion of men, no significant difference was seen, when patients diagnosed aged 60 or more were compared to those tested younger. Among their difficulties in living with HIV, elderly patients not only reported physical handicap, or the need for continuous clinical follow-up and medication and its adverse effects, but highlighted feeling lonely and isolated, and feared being discriminated against by relatives and healthcare workers. Identifying particular psychosocial features of living with HIV/AIDS in elderly life may help establish public care policies for this population at specialised centres. In addition, it may allow integrating prophylactic strategies in a comprehensive care approach to elderly men and women.

ASSUNTO(S)

sexualidade idoso efeitos psicossociais da doença. elderly people psychosocial effects of disease hiv aids síndrome de imunodeficiência adquirida sexuality hiv

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