O desafio do HIV em idosos : atuação de médicos da atenção primária à saúde em Porto Alegre/RS

Abstract

The aging of the Brazilian population has been increasing in the last years, it is estimated that by 2025 Brazil will have approximately 30 million people aged 60 or over. Recent data, Epidemiological Bulletin HIV / AIDS 3 (2018), show that HIV cases continue to grow, with 364 infected aged 55 or older in 2016 and as of 2017/30/06, 132 cases have been reported. Primary care physicians, in several situations, present an outdated perception regarding the HIV/AIDS problem in the current scenario, since the invisibility of the elderly sexuality enhances risk situations during their management leading to a late diagnosis. Objective: To compare the performance of family and community doctors and general practitioners regarding primary and secondary prevention for HIV infection in the elderly population in Primary Care in the city of Porto Alegre/RS. Methodology: This is a crosssectional, mixed study in which an online questionnaire was applied to medical doctors working at UBS or ESF at Primary Care in Porto Alegre/RS. The questionnaire was sent to 213 physicians, by e-mail informed by the Municipal Health Department of Porto Alegre, 15 e-mails returned (full mailbox or error in the e-mail provided), so 198 doctors received the same questionnaire. At the end of 30 days of collection, 40 people completed the questionnaire, two answers were excluded because they were not part of the professionals included in the research (gynecologist and nurse). There were 38 valid responses. Results: The 38 participants had between 26 and 67 years of age, with a mean of 42 ± 10 years, presenting between 1 and 30 years of primary care, with a mean of 11.5 ± 9 years, 39.5% (15) were general practitioners and 60.5% (23) were family and community medical doctors, more than half (55.2%) were working in ESF, 31.6% in UBS and 13.2% in mixed units. The nationality of the participants, 81.7% declared to be Brazilian, 7.9% Venezuelan and the other 10.4% (Argentine, Cuban, Guatemalan and Uruguayan). When questioned to religion, 52.6% declared to be Catholic and 13.2% Spiritist, compared to 34.2% who said they had no religion. 71% of them expressed that they have elderly patients with HIV diagnosis and when asked if they treat these patients in the unit, only 44.7% reported treating the elderly in the unit. Still, 56.5% of CFM and 53.3% of general practitioners reported that they did not follow this patient at the unit. Conclusions: It was evidenced that it is not a routine for PC doctors to perform primary and secondary prevention actions regarding HIV infection in the elderly.