Bakgrund: I världen lever 36,7 miljoner människor med HIV varav 7000 av dessa lever i Sverige. HIV/AIDS är en blodsmitta som klassificeras under smittskyddslagen där AIDS är det mest avancerade stadiet av HIV. Sjuksköterskor och  sjuksköterskestudenter i världen har varierande kunskap om sjukdomen och patienter som lever med HIV/AIDS beskriver att sjuksköterskors inställningar till dem skiftar. Syfte: Att beskriva sjuksköterskors och sjuksköterskestudenters inställningar till att vårda patienter som lever med HIV/AIDS. Metod: Genom en litteraturöversikt över den befintliga kunskapen inom det valda problemområdet har tio artiklar analyserats och sammanställts. Artiklarna är från databaserna CINAHL Complete och PubMed och är antingen kvalitativa eller kvantitativa. Resultat: I litteraturöversikten framträdde fem huvudteman och fyra underteman.   Huvudtemana berörde synen på HIV/AIDS och PLHA, rädsla för att smittas och försiktighetsåtgärder relaterat till inställningar, villighet till att vårda PLHA relaterat till erfarenhet, inställningar relaterat till utbildning samt faktorer relaterat till inställningar att vårda PLHA. Resultatet visade på både positiva och negativa inställningar som sjuksköterskor och sjuksköterskestudenter hade och hur kunskap, erfarenhet, utbildning och kön kunde kopplas till inställningarna. Diskussion: Styrkorna och svagheterna med författarnas utförande av denna litteraturöversikt diskuterades i metoddiskussionen. Utifrån Joyce Travelbees omvårdnadsteori, litteraturöversiktens bakgrund och ny forskning har resultatets huvudfynd diskuterats i resultatdiskussionen. Hur sjuksköterskor och sjuksköterskestudenter bedriver vården till PLHA i förhållande till den kunskap och de inställningar de har gentemot dem och hur detta uppfattades av patienterna, belyses i resultatdiskussionen. / Background: There are 36,7 million people living with HIV/AIDS around the world. About 7000 of these are living in Sweden. HIV/AIDS is a blood infection that is classified by the Swedish Communicable Disease Act. AIDS is the most advanced stage of the HIV disease. The knowledge of nurses and student nurses about HIV/AIDS varies in the world and their attitudes are described by PLHA as varying. Aim: To describe nurses’ and nursing students’ attitudes towards caring for patients living with HIV/AIDS. Method: A literature review to look over the current knowledge concerning the selected subject-matter was conducted by analysing ten selected scientific articles. The qualitative and the quantitative articles were from the CINAHL Complete and PubMed databases. Results: Five main themes and four sub themes emerged in this literature review. The main themes concerned the view about HIV/AIDS and PLHA, fear of contagion and safety precautions related to attitudes, willingness to care for PLHA related to experience, attitudes related to education and factors affecting the attitudes to caring for PLHA. The result showed both positive and negative attitudes that nurses and nursing students had. As well as how knowledge, experience, education and gender could relate to their attitudes. Discussion: The strengths and weaknesses of the authors’ execution of this literature review were discussed in the method discussion. The main findings in this literature review are discussed in the result discussion in relation to Joyce Travelbees theory, the background and complementary scientific articles. Also, nurses’ and nursing students’ way of caring for PLHA in relation to the knowledge and attitude they have against PLHA and how that is perceived by the patients are discussed.

Syftet med denna undersökning är att beskriva hur närstående till en familjemedlem som lever med HIV/AIDS upplever att deras egen hälsa påverkas av detta, hur de hanterar sin livssituation och vilka förväntningar de har från samhällets håll när det gäller bemötanden och behandlingar. Sex anhöriga till en HIV-positiv deltog i studien. En kvalitativ induktiv metod användes och datainsamlingen genomfördes med hjälp av semistrukturerade intervjuer för att låta de närstående relativt fritt berätta om sina upplevelser. Intervjuerna spelades in och transkriberades för att sedan analyseras med hjälp av en manifest innehållsanalys resulterande i tre kategorier. De tre kategorier är upplevd hälsa, coping och förväntningarna. I resultatet framkom det att de närstående upplever att deras hälsa påverkas av att de lever med någon som har HIV/AIDS. De behöver mobilisera sina inre resurser och ta stöd från deras sociala nätverk för att kunna hantera sin livssituation. Slutsatsen blev den att en ökad allmänkunskap om HIV/AIDS behövs, särskilt för att utveckla insatser riktade till just de anhöriga till smittade. Det är av vikt att även deras röster hörs samt att deras inre och yttre resurser uppmärksammas och stärks. Interventioner för HIV-infekerade borde också gynna deras familjer. / The purpose of this study is to describe to what extent the family members of someone who is HIV/AIDS positive feel that their health is also affected by this, how they cope with this circumstance land what expectations they have regarding how they hope to be received and treated in society as a whole. 6 family members of an HIV/AIDS positive individual participated in the study. A qualitative inductive method was used for the study and the data collection was carried out using semi-structured interviews so as to allow the family members to relatively freely share of their experiences. The interviews were transcribed and then analyzed using a manifest content analysis, resulting in the three categories: perceived health, coping and expectations. The results show that the family members feel that their health is also affected by their relation to someone who is HIV/AIDS positive. They need to mobilize their internal resources and seek support from their social networks to be able manage their day-to-day lives. It was also concluded that a general increased in knowledge concerning HIV/AIDS is needed, especially with the goal of developing effective interventions specifically aimed at the family members of the HIV infected. It is important that their voices are heard and that their internal and external resources are both recognized and strengthened. Interventions for HIV positive individuals should also benefit the lives of their families.

Bakgrund: Humant Immunbristvirus har sedan upptäckten under 1980-talet tagit mer än 35 miljoner människors liv. I tidigare studier framkommer det att personer med HIV/AIDS utsätts för diskriminering och stigmatisering inom sjukvården. Syfte: Att beskriva sjuksköterskestudenters attityder till personer med HIV/AIDS och vilka faktorer som kan påverka deras attityder. Metod: En litteraturstudie innehållande 11 artiklar med kvantitativ ansats granskades, analyserades och sammanställdes. Databaserna som användes vid artikelsökningen var PubMed och CINAHL. Resultat: Det framkom att sjuksköterskestudenter hade både positiva och negativa attityder gentemot personer med HIV/AIDS. Sjuksköterskestudenter hade också olika negativa attityder till olika patientgrupper samt både positiv och negativa vilja att vårda personer med HIV/AIDS. Faktorer som framkom påverka attityderna var kunskaper och tidigare erfarenheter, studielängd, kön, ålder, land och religion. Konklusion: Sjuksköterskestudenters negativa attityder mot personer med HIV/AIDS har visat sig kunna förbättras genom ökad kunskap om HIV/AIDS. Genom att sjuksköterskeutbildningen organiseras på ett sådant sätt att studenterna får mer kunskaper om HIV/AIDS under studietiden kan de förbättrade kunskaperna leda till mindre negativa attityder och därmed förbättra livskvalitén hos personer med HIV/AIDS samt främja deras hälsa. / Background: The Human Immunodeficiency virus has, since its discovery in the 1980s, taken more than 35 million people's lives. Previous studies show that people with HIV/AIDS are subject to discrimination and stigmatization within health care. Aim: To describe nursing students’ attitudes towards people with HIV/AIDS and what factors that influence their attitudes. Method: A literature study containing 11 articles with a quantitative approach were reviewed, analyzed and compiled. The databases PubMed and CINAHL were used. Results: It was revealed that nursing students had both positive and negative attitudes towards people with HIV/AIDS. The nursing students also had various negative attitudes towards different patient groups as well as positive and negative willingness to care for people with HIV/AIDS. Factors that emerged to influence the attitudes were knowledge, previous experiences, length of study, age, gender, country and religion. Conclusion: Nursing students negative attitudes towards people with HIV/AIDS have been shown to be improved by more knowledge of HIV/AIDS. By organizing the nursing education in such a way that the students receive more knowledge about HIV/AIDS during their period of studies, the improved knowledge can lead to less negative attitudes, thus improving the quality of life of people with HIV/AIDS and promoting their health.

This thesis is concerned with the structure, analysis and numerical solution of the mathematical models used to estimate the transmission dynamics of the Human Immunodeficiency Virus (HIV)) the causative agent of Acquired Immune Deficiency Syndrome (AIDS). Investigations show that the devised deterministic mathematical models in term of system of first-order non-linear ordinary differential equations (ODEs) follow the stochastic nature of the problem at any time. In this thesis a generic form of the deterministic mathematical models is introduced which mirrors the transmission dynamics of HIV/AIDS in populations with different states of affairs, which leads to the division of large-scale and complex mathematical models. When analysing and;or solving a large-scale system of ODEs numerically, the key element in speeding up the process is selecting the maximum possible time step. This work introduces some new techniques used to estimate the maximum possible time step, avoiding the appearance of chaos and divergence in the solution when they are not features of the system. The solution to these mathematical models are presented graphically and numerically, aiming to identify the effect of the anti-HIV therapies and sex education in controlling the disease. The numerical results presented in this thesis indicate that lowering the average number of sexual partners per year is more effective in controlling the disease than the current anti-HIV treatments. For the purpose of this study the mathematical software 'Mathematica 3.0' was used to solve the system of differential equations, modelling HIV/AIDS propagation. This package also provided the graphical detail incorporated in the thesis.

Introdução: Com a cronicidade da aids após a introdução da terapia antirretroviral outras necessidades são observadas no cotidiano das pessoas vivendo com o vírus da imunodeficiência humana (HIV)/aids. A mensuração da qualidade de vida desta população auxilia na avaliação da sua situação clínica. Considerando-se que os instrumentos existentes são do século passado e não contemplam novos avanços científicos, a elaboração de um novo instrumento auxiliará na avaliação da qualidade de vida perante a atual realidade das pessoas vivendo com HIV/aids. Objetivo: Elaborar e validar uma escala psicométrica para avaliação de qualidade de vida de pessoas vivendo com HIV/aids. Metodologia: Trata-se de um estudo metodológico, de elaboração e validação de uma escala. O estudo contemplou as etapas de elaboração dos itens, validação de face e conteúdo por um comitê de juízes, validação semântica e estudo de campo com a avaliação da confiabilidade e extração de fatores. O comitê de juízes foi composto por quatro especialistas e um membro da população-alvo. A validação semântica contou com 25 pessoas vivendo com HIV/aids que estavam em seguimento nos Serviços de Atendimento especializados no município de Ribeirão preto. No estudo de campo participaram 100 indivíduos dos mesmos serviços. A confiabilidade foi avaliada através da consistência interna mensurada pelo Alfa de Cronbach. Para a extração dos fatores foi realizada a Análise Fatorial Exploratória. Para análises dos dados foram utilizados o software IBM® SPSS versão 23.0 e o software R versão 3.4.1. Os aspectos éticos foram contemplados, sendo que estudo foi aprovado pelo Comitê de Ética em Pesquisa da Escola de enfermagem de Ribeirão Preto (CAAE 50811815.7.0000.5393; nº 060/2016). Resultados: Na validação semântica, o instrumento foi ajustado conforme a sugestão dos participantes desta etapa, ficando 51 itens como escala inicial. No estudo de campo a avaliação da consistência interna obteve valores de ? superior a 0,60 nos domínios com exceção do fator três que apresentou valor igual a 0,46. Na análise fatorial exploratória foram excluídos 27 itens com carga fatorial < 0,50, resultando em 24 itens alocados em sete fatores, conforme análise paralela. Conclusão: Conclui-se que o instrumento elaborado apresenta confiabilidade dos itens para avaliação da qualidade de vida de pessoas vivendo com HIV/aids, no entanto, se faz necessário a realização das demais validades que contemplam a avaliação das propriedades psicométricas / Introduction: With the chronicity of AIDS after the introduction of antiretroviral therapy, other needs are observed in the daily lives of people living with human immunodeficiency virus (HIV) / AIDS. The measurement of the quality of life of this population helps in the evaluation of its clinical situation. Considering that the existing instruments are of the last century and do not contemplate new scientific advances, the elaboration of a new instrument will help in the evaluation of the quality of life in the current reality of people living with HIV / AIDS. Objective: To elaborate and validate a psychometric scale to evaluate the quality of life of people living with HIV / AIDS. Methodology: This is a methodological study, of elaboration and validation of a scale. The study included the elaboration of the items, validation of face and content by a committee of judges, semantic validation and field study with the evaluation of reliability and extraction of factors. The panel of judges was composed of four experts and one member of the target population. Semantic validation counted on 25 people living with HIV / AIDS who were being followed up at the Specialized Care Services in the city of Ribeirão Preto. In the field study 100 individuals from the same services participated. Reliability was assessed by the internal consistency measured by Cronbach\'s Alpha. For the extraction of factors, the Exploratory Factor Analysis was performed. Data analysis was performed using IBM® SPSS software version 23.0 and software R version 3.4.1. Ethical aspects were considered, and the study was approved by the Research Ethics Committee of the Nursing School of Ribeirão Preto (CAAE 50811815.7.0000.5393; no. 060/2016). Results: In the semantic validation, the instrument was adjusted according to the suggestion of the participants of this stage, getting 51 items as initial scale. In the field study the internal consistency evaluation obtained values of ? higher than 0.60 in the domains except for factor three that presented value equal to 0.46. In the exploratory factor analysis, 27 items with a factorial load <0.50 were excluded, resulting in 24 items allocated in seven factors, according to a parallel analysis. Conclusion: It is concluded that the instrument elaborated presents reliability of the items to evaluate the quality of life of people living with HIV / AIDS, however, it is necessary to perform the other validities that contemplate the evaluation of psychometric properties

There are repeated calls in the literature for the implementation and evaluation of evidence based HIV prevention programmes. This study aimed to evaluate a life-skills theatre performance for adolescents promoting safer sex behaviour against aspects of an established AIDS risk reduction theory. The study used a quasi-experimental research design, and was operationalised through the use of a questionnaire measuring knowledge, attitudes and perceptions conducive to HIV/AIDS risk reduction. Bandura’s (1990) Social Cognitive Theory (SCT) provided a conceptual framework for the development of the instrument. A further aim of the study was to establish whether the instrument would yield a factor structure that could be linked to Social Cognitive Theory using a principal components factor analysis. A sample of 392 adolescent high school learners in Grades 10 and 11 at two high schools in Naledi, Soweto completed the evaluation instrument. A sample of 165 learners were exposed to the play prior to completion of the evaluation instrument. A sample of 227 learners completed the questionnaire before the play was scheduled to be performed and were thus considered a control group. The effects of exposure to the play, gender, age, grade and whether the learners reported that they were sexually active formed the independent variables in the analysis, which were examined for their influences on the theoretical constructs measured by the instrument through analysis of variance (ANOVA). The results indicated that learners at both schools had a reasonably high level of knowledge, attitudes and perceptions conducive to HIV/AIDS risk reduction. However, learners at the control school scored significantly higher on the factors tapped by the questionnaire than learners attending the school exposed to the play. Possible reasons for these differences are discussed in the report. The results also highlighted significant differences between Grade 11 and Grade 10 learners in knowledge, attitudes and perceptions conducive to HIV/AIDS risk reduction. The physical age of the learner did not appear to be as important as educational level and/or possible social peer group norms on responses to the instrument.

Este trabalho se compõe a partir de etnografia documental e estudo social-epidemiológico voltado à compreensão dos processos sociais, jurídicos e históricos que permeiam as infecções pelo HIV entre os grupos mais atingidos, Para tanto, buscou-se a análise, intepretação e problematização de dados oficiais, tendo como principal clivagem a operacionalização de viriáveis estatísticas como forma de identificação daqueles que são mais vulneráveis à epidemia. Além disso, o trabalho tenta visibilizar os processos históricos de luta por direitos humanos e visibilidade dentro do contexto da epidemia de AIDS e suas consequências para o campo da Saúde Pública. / This work is composed from documentary ethnography and socialepidemiological study aimed at understanding the social, legal and historical processes that permeate HIV infections among the groups most affected. Therefore, we sought to analysis, intepretação and questioning the \"official\" data through the operation of viriáveis statistics as a way to identify those that are more \"vulnerable\" to the epidemic of viriáveis statistics as a way to identify those that are more \"vulnerable\" to the aids epidemic. In addition, the work attempts to make visible the historical processes of struggle for human rights and visibility within the context of the AIDS epidemic and its consequences for the field of Public Health.

As Infecções Sexualmente Transmissíveis (IST) ainda constituem um grave problema de saúde pública que assola cada vez mais o público feminino, sendo acentuada pela vulnerabilidade individual, social e programática. Assim, este estudo teve como objetivo identificar e analisar as vulnerabilidades de mulheres quilombolas do Rio Trombetas (PA) para as IST/HIV/aids. Trata-se de um estudo exploratório, descritivo, prospectivo, transversal com abordagem quantitativa. A coleta de dados deu-se por meio de entrevista individual realizada no domicílio, a partir de um questionário semiestruturado, após aprovação do Comitê de Ética da Escola de Enfermagem da USP, sob o parecer: 1.667.309. Para a análise dos resultados foi adotado como referencial o conceito de vulnerabilidade. Esta pesquisa foi realizada em oito comunidades quilombolas do alto Trombetas, localizadas no município de Oriximiná, região Oeste do Estado do Pará, com a participação de 139 mulheres. A média de idade foi de 30 anos e as cores autodeclaradas prevalentes foram a negra e a parda. A maioria das mulheres possuía o ensino fundamental completo e intitulou-se casada. Quanto à história pregressa de IST, 56,8% citaram apresentar em algum momento sinais e sintomas de IST, porém, apenas 25,2% informaram sempre fazer uso do preservativo masculino nas relações sexuais e 12,6% do preservativo feminino. Em relação aos motivos para o não uso do preservativo feminino, 52,5% das mulheres justificaram a sua indisponibilidade. Quanto ao conhecimento sobre as IST, 69,1% já haviam recebido algumas informações, verificou-se que pouco mais da metade, 55,4%, respondeu sobre a forma correta de transmissão e que a prevenção é feita através do uso da camisinha (80,6%). Apenas 44,6% das mulheres consideram a existência de risco para contrair uma IST/HIV/aids e que este risco é acentuado pela infidelidade do parceiro (45,2%). Apesar de se considerarem em risco, as mesmas classificam o grau de exposição individual a possível infecção em baixo risco (64,6%) e apenas 8,1% classificam em alto risco. Verificou-se a inexistência de serviços de saúde na comunidade e quanto a atividade de prevenção para as IST/HIV/aids apenas 48,9% das pesquisadas participaram de alguma atividade educativa. Os resultados evidenciam fragilidades de conhecimento, das mulheres frente à prevenção das IST/HIV/aids, potencializado pela ausência de serviços de saúde e ações nas comunidades. Pelo exposto, foi possível identificar que as mulheres quilombolas são vulneráveis nas três dimensões: individual, social e programática para as IST/HIV/aids. Neste contexto é de extrema importância a efetivação dos serviços e ações de saúde nessas localidades, através de políticas públicas responsáveis e comprometidas, com a participação da enfermagem, o principal agente do cuidado comunitário dentro do elo de promoção e prevenção da saúde. / Sexually Transmitted Infections (STIs) still constitute a serious public health problem that increasingly plaguing the female audience, and is accentuated by the individual, social and programmatic vulnerability. Thus, this study aimed to identify and analyze the vulnerabilities of Quilombolas women from the Trombetas River (PA) for STI/ HIV/ AIDS. This is an exploratory, descriptive, prospective, cross-sectional study with a quantitative approach. Data collection was done by means of an individual interview conducted at home, using a semi-structured questionnaire, after approval by the Ethics Committee of the School Nursing of USP, on opinion No. 1.667.309. For the analysis of the results, the vulnerability concept was adopted as reference. This research was carried out in eight quilombola communities of Alto Trombetas, located in the municipality of Oriximiná, western region of the State of Pará, with the participation of 139 women. The mean age was 30 years and the prevalent self-declared colors were black and brown. Most of the women had completed elementary education and titled married. Regarding the previous history of ISTs, 56.8% mentioned that they presented signs and symptoms of STI, but only 25.2% reported using the male condom in sexual intercourse and 12.6% of the female condom. Regarding the reasons for not using the female condom, 52.5% of the women justified their unavailability. As to knowledge about STIs, 69.1% had already received some information, it was found than slightly more than half, 55.4%, answered on the correct form of transmission and that prevention is done through the use of condoms (80.6%). Only 44.6% of women consider the risk of contracting STI /HIV/AIDS and that this risk is accentuated by partner infidelity (45.2%). Although considered at risk, they classify the degree of individual exposure to possible low-risk contamination (64.6%) and only 8.1% rank at high risk. The lack of health services in the community and the prevention activity for STI /HIV/AIDS, only 48.9% of those surveyed participated in some educational activity. The results show weaknesses in women\'s knowledge regarding STI /HIV/AIDS prevention, which is enhanced by the absence of health services and community actions. From the foregoing, it was possible to identify that quilombola women are vulnerable in three dimensions: individual, social and programmatic for STI /HIV/AIDS. In this context, it is extremely important to carry out health services and actions in these localities through responsible and committed public policies, with the participation of nursing, the main agent of community care within the link of promotion and prevention of health.

Desde a sua descoberta, no início da década de 80, o HIV/aids, constituiu-se como uma doença que ultrapassa os limites da dimensão biomédica, apresentando diversos desafios à sociedade. No Brasil, estima-se que aproximadamente 734 mil pessoas vivem com HIV/aids. Foram desenvolvidas diferentes classes de drogas antirretrovirais para seu tratamento; as quais são eficazes para o controle parcial da replicação viral. Sem a descoberta da cura, é imprescindível que as pessoas vivendo com HIV/aids sigam as recomendações da equipe de saúde, aderindo ao tratamento proposto; aumentando sua qualidade de vida, bem como contribuindo para a diminuição da transmissão do vírus. Durante o tratamento, algumas dificuldades podem surgir, determinando momentos de maior ou menor adesão ao mesmo e os profissionais de saúde, dentre eles, os farmacêuticos, devem estar atentos a estes momentos. Este estudo transversal teve como objetivo analisar a retirada do TARV nos últimos 24 meses e investigar os possíveis fatores que levam a retirada desta medicação de forma irregular na Unidade Especial de Tratamento de Doenças Infecciosas (UETDI) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo. Participaram 250 pessoas que vivem com HIV/aids que retiram a medicação na Farmácia do local do estudo. Os participantes foram separados em dois grupos: Grupo em Atraso e Grupo Controle segundo seus históricos de dispensação da TARV nos vinte e quatro meses anteriores a realização das entrevistas. Predominaram participantes do sexo masculino (57,6%), com mais de 40 anos (76%), brancos (51,6%), com baixa escolaridade (48,4%), sem parceiro fixo (52,4%), residentes em Ribeirão Preto (63,6%). Todas as variáveis foram relacionadas em um estudo univariado e aquelas com um valor de \"p\" igual ou menor que 0,2 foram selecionadas para análise multivariada. As associações entre variáveis selecionadas e a retirada irregular comparada com a retirada regular, foi estimada pela estimativa com intervalo de confiança de 95%. As variáveis que mostraram associação com a retirada da TARV em atraso foram: fazer uso de outro medicamento além da TARV, apresentar resultado de exame de carga viral como detectável, ter, no início do período analisado, contagem de linfócitos T CD4 menor que 200 células /mm3 e ter baixa adesão como resultado do Teste de Morisky- Green / Since its discovery in the early 80s, HIV / AIDS was established as a disease that pushes the boundaries of biomedical dimension, presenting many challenges to the society. In Brazil, there are almost 734,000 people carrying HIV / AIDS. Different classes of antiretroviral drugs were developed for their treatment, which are effective in partial control of viral replication. Yet incurable disease it is essential that people living with HIV / AIDS follow the recommendations of the health care agents, adhering to the proposed treatment, increasing their quality of life, and contributing to the reduction of transmission of the virus. During treatment, some difficulties may arise, determining moments of greater or lesser adherence, and pharmacists among other health professionals, should be aware of these moments. This cross-sectional study aimed to analyze the withdrawal of ART in the last 24 months, and investigate the possible factors that lead the medication withdrawal erratically on Special Treatment of Infectious Diseases Unit (UETDI) of the Clinics Hospital - School of Medicine of Ribeirao Preto, University of São Paulo. Two hundred and fifty people living with HIV / AIDS got medication in the study site pharmacy. Participants were divided into two groups: Group Control and Group Delay, according to their historical dispensing of ART in twenty-four months prior to the interviews; predominant male participants (57.6%) with more than 40 years (76%), white (51.6%), with low education (48.4%), with no steady partner (52.4%), residents in Ribeirão Preto (63.6%). All variables related in a univariate analysis, and those with a value of \"p\" equal to or smaller than 0.2 were selected for multivariate analysis. The associations between selected variables, and the irregular removal compared to regular withdrawal were estimated with 95% confidence interval. The variables that were associated with the withdrawal of ART arrears, and making use of another drug in addition to HAART, presented results of viral load test as detectable, having the beginning of period analyzed, CD4 lymphocyte count less than 200 cells / mm3, and have low compliance as a result of Morisky- Green test.

As doenças de veiculação hídrica são causadas, principalmente, por micro-organismos patogênicos de origem entérica. A partir da década de 1980, as enfermidades causadas por protozoários parasitas emergiram e reemergiram e se tornaram um problema de saúde pública com relevância na atualidade, especialmente para grupos populacionais mais vulneráveis, como pessoas que vivem com HIV/aids. Este trabalho teve por objetivo avaliar a prevalência de parasitas emergentes e reemergentes em crianças que vivem com HIV/aids atendidas no HCFMRP-USP e os condicionantes socioambientais envolvidos. Foram coletadas 47 amostras de fezes de 17 crianças de quatro a 13 anos que vivem com HIV/aids atendidas no HCFMRP- USP, no período de março a setembro de 2013. Do total, 52,9% das crianças eram do sexo feminino e 47,1% do sexo masculino, sendo que 52.9% eram pardas, 35,3% brancas e 11,8% negras. A análise de coccídeos intestinais oportunistas, como Cryptosporidium spp., Cyclospora spp. e Cystoisospora spp. foi realizada pelo método de Ziehl Nielsen Modificado, enquanto que para a pesquisa de cistos de Giardia spp. e outros parasitas foi utilizado o método de sedimentação espontânea por meio do Kit Coproplus®. As presenças dos parasitas Giardia spp e Cryptosporidium spp. foram confirmadas por meio de ensaios imunoenzimáticos para detecção de antígenos (métodos de Elisa). Foi ainda aplicado um questionário referente às questões socioambientais, hábitos comportamentais e hábitos de higiene pessoal e alimentar adotados pelas crianças participantes do estudo e algumas informações adicionais foram coletadas dos prontuários. Os resultados obtidos revelaram uma alta frequência de parasitas em crianças que vivem com HIV/aids atendidas no HCFMRP- USP (76,5%), sendo representados por agentes patogênicos: Giardia spp. (35,3%), Cryptosporidium spp. (23,5%), Cyclospora spp. (5,9%); e agente comensal: Entamoeba coli (47,1%). Apesar de se tratar de protozoários de veiculação hídrica, considera-se que a água utilizada pelas crianças não seja a principal via de transmissão desses parasitas, tendo em vista as evidencias que existem da boa qualidade da água que abastece a região, procedente do Aquífero Guarani. Dessa forma, considera-se que as características socioambientais, os hábitos de higiene pessoal e alimentar adotados pelas crianças bem como o contato com outras pessoas e/ou animais podem ter contribuído para o quadro de enteroparasitoses. A alta prevalência de parasitas encontrada no presente estudo nos remete a grandes preocupações em termos de saúde pública, uma vez que, o quadro clínico para Giardia spp., Cryptosporidium spp, Cyclospora spp. pode evoluir para uma morbidade grave quando há uma supressão do sistema imunológico do indivíduo. Dessa forma, conclui-se que alguns aspectos são imprescindíveis para uma melhoria da qualidade de vida das crianças que vivem com HIV/aids, dentre os que se destacam: o diagnóstico precoce para enteroparasitas, a implementação da análise coprológica de protozoários emergentes e reemergentes na rotina da atenção desses pacientes, o uso correto da terapia antirretroviral, bem como o monitoramento das características imunológicas / The waterborne diseases are caused mainly by pathogenic microorganisms enteric origin. From the 1980s, the diseases caused by protozoan parasites emerged and re-emerged and have become a public health problem of relevance today, especially for the most vulnerable population groups such as people living with HIV/aids. This study objetived to assess the prevalence of emerging and re-emerging parasites in children living with HIV/aids followed at HCFMRP-USP and socioenvironmental constraints involved. Were collected 47 stool samples from 17 children aged four to 13 years living with HIV/aids followed at HCFMRP- USP, in the period from March to September 2013. Of the total, 52.9% of children were female and 47.1% male, and that 52.9% were brown, 35.3% white and 11.8% black. The analysis of intestinal coccidia opportunistic as Cryptosporidium spp. Cyclospora spp. and Cystoisospora spp. was performed by the modified Ziehl Nielsen method, while for the research of Giardia spp. and other parasites was used by spontaneous sedimentation method by means of Kit Coproplus®. The presence of Giardia spp and Cryptosporidium spp. were confirmed by enzyme immunoassays for the detection of antigens (ELISA methods). Was still applied a questionnaire relating to socioenvironmental issues, behavioral habits and personal hygiene habits and food adopted by the children participating in the study and some additional information was collected from medical records of children. The results revealed a high frequency of parasites in children living with HIV/aids followed at HCFMRP-USP (76.5%), being represented by pathogens: Giardia spp. (35.3%), Cryptosporidium spp. (23.5%), Cyclospora spp. (5.9%), and commensal agent: Entamoeba coli (47.1%). Although it being waterborne protozoa, is considered that the water used by children is not the main route of transmission of these parasites, in view of the evidence that there are good-quality water that supplies the region, coming from the Guarani Aquifer. Thus, it is considered that the socioenvironmental characteristics, personal hygiene and food adopted by children as well as contact with other people and / or animals may have contributed to the enteroparasitosis frame. The high prevalence of parasites found in this study leads us to great concern in terms of public health, since the clinical picture for Giardia spp., Cryptosporidium spp. e Cyclospora spp. may progress to severe morbidity when there is a suppression of the immune system of the individual. Thus, it is concluded that some aspects are essential to improving the quality of life for children living with HIV/aids, among which stand out: early diagnosis for intestinal parasites, the implementation of coprologic analysis of emerging and reemerging protozoan in routine care of these patients, the correct use of antiretroviral therapy, as well as monitoring of the immunological characteristics