Funcionalidade e associação com características socioeconômicas, demográficas, clínicas e de hábitos de vida de pessoas com HIV/AIDS no Ceará

Abstract

Introduction:The increase in longevity of people living with HIV/AIDS (PLWHA) due to the advent of antiretroviral therapy has led to the emergence of new challenges, such as the socioeconomic, clinical situation and life habits that, among others, can beconfigured conditions associated with the risk of disability that could compromise the functioning in an integral way. Objective:To analyze and describe the functioning profile and its association with the socioeconomic, demographic, clinical and lifestyle characteristics of PLWHA under outpatient follow-up at a referral hospital for infectious diseases in Ceará. Method:Observational, cross-sectional study with a quantitative approach between the months of May and October 2019, in patients infected with HIV ≥ 18 years, recruited consecutively, regardless of gender. Those with cognitive impairment were excluded. Data collection took place by completing questionnaires with self-reported answers, about socioeconomic, demographic and lifestyle habits, lasting20 minutes. As for the assessment of functioning, the WHODAS 2.0 instrument, version 36 items, was applied, with a 20-minute interview. Clinical data were obtained from the participant's medical record. The analysis was performed using SPSS software version 23. Descriptive statistics were performed and normality was studied using the Shapiro-Wilk test. The significance between the independent variables and the functioning domains was verified using the Mann-Whitney, Kruskal-Wallis and Spearman correlation tests. Variables that presented p ≤ 0.2 were again compared to the functioning measures in a multiple analysis using linear regression with logarithmic link function. Statistical significance was identified by a p value ≤ 0.05. Results:Low functioning wasobserved in the domains of participation, cognition, mobility, interpersonal and general relationships. About 121 (60.5%) of PLWHA were male and 65 (32.5%) were aged between 31 and 40 years. The average family income per capita was R $ 923.10 (± 1,088.30),96 (48%) declared to have paid/self-employed work. The average level of education was 10.1 years (± 5.5 years), 89 (44.5%) were born in cities in the interior of the State and 120 (60%) people currently lived in Fortaleza. About 105 (52.5%) of PLWHA declared themselves never smokers, 148 (74%) denied alcoholism and 182 (91%) drug addiction. One hundred and eleven (55.5%) did not perform physical exercise and among those who did, 62 (31%) declared a practice ≥ three times a week and 61 (30.5%) practiced aerobic exercises. Viral load <50 copies/ml was presented in 165 (82.5%) cases, 114 (57%) had CD4+ T lymphocytes ≥ 500 cells/mm3and 114 (57%) were clinically asymptomatic. The mean time of HIV infection was 10.1 years (± 7.5) and HAART was 9.6 years (± 11.7). In the multiple analysis regression models, work activity was associated (p <0.05) with the domains of cognition, mobility, self-care, interpersonal relationships, participation and general. Skin color (p <0.05) impacted the domains of life activities and participation, as well as the social group by income per capita (p <0.05) with the participation domain. The frequency of physical exercise (p <0.05) was significant for the domains of cognition, mobility, life activities, participation and general. Conclusion:The functioning domains showed a state of disability in the studied HIV population. Work activity, skin color, social groups by income and frequency of physical exercise were significantly associated with the domains of functioning and the importance of considering social characteristics in understanding this biopsychosocial indicator was highlighted.