Risk-factors for non-adherence to antiretroviral therapy

Cross-sectional study analyzed as case-control to identify risk factors for non-adherence to antiretroviral therapy. We studied 412 out-clinics HIV infected subjects of three public hospitals of Recife, Pernambuco. The objective was to examine the association between non-adherence to the antiretroviral therapy and biological, social-behavior and demographics and economic factors, factors related to the disease and/or treatment, factors related to life habits and depression symptoms. Variables significantly associated with non-adherence to antiretroviral therapy were: time elapsed since HIV diagnosis (p = 0.002), daily dose (p = 0.046), use of alcohol (p = 0.030) and past drug use (p = 0.048), and borderline p-values were found for educational level (p = 0.093) and family monthly income (p = 0.08). In the multivariable analysis, the factors that remained in the final model were family monthly income, time period with HIV infection and use of alcohol. No association was observed between non-adherence to antiretroviral therapy and gender, age, sexual orientation, marital status, educational level and place of residence. Based on our results and the local situation we suggest: assessment of social needs; training of partners and/or families on supporting adherence, creation of "adherence groups" to motivate and to reassure patients on the benefits of treatment; counseling and/or psychotherapy for alcohol drinkers

O programa de saúde escolar no município de Ribeirão Preto El programa de salud escolar en el municipio de Ribeirão Preto The primary school health care program at the municipality of Ribeirão Preto

O presente artigo relata a trajetória do Programa de Assistência Primária de Saúde Escolar (PROASE) no município de Ribeirão Preto e traz algumas reflexões sobre esta proposta.<br>El presente estudio relata el trayecto del Programa de Atención Primaria de Salud Escolar (PROASE) en el municipio de Ribeirão Preto y trae algunas reflexiones sobre esta propuesta.<br>The present article reports on the trajectory of the Primary School Health Care Program (PROASE) at the municipality of Ribeirão Preto and describes some reflections about this proposal

Rede social e desempenho de programas de saúde: uma proposta investigativa Social network and performance of health programs: an investigative proposal

Para alcançar a descentralização dos serviços de saúde no Brasil, tem sido necessário um grande esforço. Este implica essencialmente a construção de práticas inovadoras. Diversos pesquisadores têm enfrentado o desafio de produzir estudos para avaliar a implantação dos programas de saúde. Algumas pesquisas, em andamento atualmente, têm apontado as relações interpessoais como responsáveis importantes que explicam os diferentes desfechos. Pretende-se neste artigo desenvolver uma discussão sobre a importância das relações interpessoais na implementação de programas de saúde a partir do aporte da análise de redes sociais, propondo que as investigações voltadas à compreensão das flutuações de performances dos programas de saúde incorporem tal perspectiva.<br>Major effort has been necessary to achieve decentralization of the health programs in Brazil, therefore essentially implying the creation of innovative practices. A number of researchers have been facing the challenge to carry on studies evaluating the implementation of health programs. Some ongoing research has been indicating interpersonal relations as an important factor, which explains the different consequences. This paper intends to discuss the importance of interpersonal relations in the implementation of health programs starting from the contribution of social network's analyses. Investigations towards the comprehension of performance variations in health programs which incorporate such outlook will be proposed