Aspectos psicossociais na adesão ao tratamento de pessoas com HIV/AIDS: o uso do genograma para o conhecimento da rede familiar

Abstract

Combined therapy represented a great advance in the control of HumanImmunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/aids), changing the epidemiological profile of the disease. However, adhesion to anti-retroviral therapy (ARVT) is one of the greatest challenges to epidemic control. Many aspects related to the complexity of life of infected people are barriers to the complete adhesion to the therapy, especially those aspects that interfere in social relations, inthe interaction with the partner, with family and in the social support the patient receives. The goal of this study was to understand the dynamic of the familys social network of people living with HIV/aids and its influence on ARVT. To reach this goal, the qualitative methodology based on the interaction theories of Goffman (1999) and Petitat (1998) was used. Individual interviews were done with 26 subjects under ARVT in Belo Horizonte, Brazil. The analysis was based on the structural narrativeanalysis. The results were organized in four thematic categories: 1) Structuring the family's network throuout life; 2) Revealing serumpositivity to the family; 3) Family interactions after seropositivity; 4) Social support. Data interpretation revealed that subjects non-adherent to the ARVT had the familys network weakened, with conflictual interactions and distance from people who might give any support. Those patients did not have any social support to count on, or only had it when their health was worse. The subjects classified as adherent had a more structured familys socialnetwork. The secret regarding the disease is constantly present in the life of infected people, due to fear of the stigma and prejudice related to the disease. Revealing seropositivity, when it happens, is done to few people of the social circle, in order to guarantee the maintenance of the secret regarding the diagnosis. Health services are strategical places to the implementation of instruments and of new practices of assistance to the person who lives with HIV/aids, promoting the inclusion and strengthening of familys network during the treatment.