Ambiente domiciliar da criança nascida exposta ao HIV sob a perspectiva da teoria ambientalista

Abstract

Pauperization constitutes one of the main facets of the aids epidemic, which entails the possibility of unhealthy housing conditions for families affected by HIV. This condition implies precarious access to water, sanitation and hygiene practices. These situations can contribute to vulnerability, especially among children exposed to the virus at birth, to health problems like diarrhea, respiratory or opportunistic infections, allergies, verminoses, dermatological and eye affections. This reality indicates the need for nurses to deliver holistic care to children and their families, considering not only biological, prophylaxis and disease treatment aspects, but mainly the social and environmental context mothers and children are inserted in. The aim was to get to know the home environment of children exposed to HIV at birth from an Environmental Theory perspective, using photographs. This exploratory and descriptive study with a qualitative approach was based on the theoretical framework of Florence Nightingale’s Environmental Theory, in combination with the photovoice resource. The research was accomplished at the homes of 10 HIV-positive mothers and caregivers to children exposed to the virus at birth, living in Fortaleza, Ceará, Brazil. The research took place between January and April 2011. The following were used for data collection: Disposable camera, forms to collected health information associated with the home environment, digital camera, field diary. For data analysis, the methodological steps of the photovoice method were followed: previous analysis of photographic records; review; comparison between the photographs the researcher and the participants registered; and theorization based on the selected theoretical framework. By investigating the home environment, the following could be observed: a) Risks associated with the physical housing structure: respiratory infections due to wall infiltration and mold, cracks that favor the appearance of insects and rodents, accumulation of still water and garbage in the service area, risk for dengue fever and collapsing; b) Unclean air in the home and peridomiciliary environment: children’s exposure to the septic tank small, passive smoking, peridomiciliary air contamination by factories; c) Water used for consumption: purchasing of bottled water and risks of gastrointestinal infections due to lack of care with utensils (bottle, support); d) Sewage and basic sanitation network: open-air peridomiciliary sewage; e) Residential Lighting and Ventilation: Small number of windows, humidity, insuficiente natural lighting, compromised thermal comfort; f) Domestic cleaning: Presence of dirt and dust particles, housing conditions that enhance accumulated dirt; g) Risks associated with the peridomiciliary environment: inadquate garbage discarding on public roads. The presence of environmental theory elements was noteworthy in the mothers’ testimony. Unfavorable environmental conditions for the health of children exposed to HIV at birth could be visualized and reflected on, also regarding those conditions that can be modified through the use of simple resources that do not imply any great financial burden. This attitude is considered the initial step to change behaviors, permitting the reduction of health risks.