The secret about seropositivity in the context of the lives
of people followed at a reference service on HIV/AIDS in Belo Horizonte, Brazil
W.J. Santos1, F.M.C. Silva1, E.F. Drumond2, A.S. Gomes1, M.I.F. Freitas1
1Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, Brazil, 2Secretaria Municipal de Saúde de Belo Horizonte, Belo Horizonte, Brazil
Background: Psychosocial aspects in reference to working relations, relationships with partners, family, and friends influence adherence to antiretroviral therapy (ART). In Brazil, the family is the basis for the care of chronically ill patients. People living with HIV/AIDS likewise appeal to relatives in situations of need. Some keep the diagnosis secret, thus restricting relationships support, which can lead to lower treatment adherence. This study is part of a research on ART adherence in a reference HIV/AIDS outpatient clinic.
Objective: To analyze the insertion of the secret about seropositivity in the treatment of people infected with HIV.
Methods: Qualitative research carried out at a public health service in Belo Horizonte, Brazil, with 24 in-depth interviews of people aged over 18y, in ART for at least a year, who gave their free informed consent. Topics included sharing of information on seropositivity, and ways of hiding it. Interviews were recorded, transcribed and analyzed by means of Structural Analysis of Narrative.
Results: Some interviewees chose a family member considered “trustworthy”, a friend or someone distant to share the diagnosis, in search of support. Some told no one, desiring to avoid suffering and for fear of discrimination. Talking is considered difficult and there are things left unsaid in order not to “open the wound”. Exchanges are restricted to the objectivity of the treatment. Those who keep the secret also fail to take part in support groups, talking only to healthcare professionals. The social networks are practically nonexistent for the non-adherent and slightly less fragile for the adherent.
Conclusions: The secret expressed a strong feeling of insecurity. Solitude and shallow communication are the basis for interactions, pointing to the need of measures by health services and the State in order to involve other characters besides relatives and to provide places for effective psychosocial support.
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