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      Intervenções psicológicas para crianças que vivem ou convivem com HIV/Aids Translated title: Psychological interventions to children infected and affected by HIV/Aids Translated title: Intervenciones psicológicas para los niños que viven o conviven con el VIH/SIDA

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          Abstract

          Com o avanço no tratamento antirretroviral, a infecção pelo HIV/Aids em crianças passou de um quadro agudo para uma doença crônica, tendo implicações médicas, psicológicas e sociais. Aspectos da convivência com o HIV/Aids, como revelação do diagnóstico, adesão ao tratamento e enfrentamento de diversos lutos, são especialmente desafiadores entre as crianças. Assim, este estudo buscou identificar, na literatura, intervenções psicológicas desenvolvidas nos últimos anos para crianças que vivem ou convivem com o HIV/Aids. Foram revisadas as bases de dados Medline, PsycInfo, Indexpsi, PEPSIC, SciELO e LILACS, encontrando-se 17 estudos sobre o tema. Foram descritos objetivos, público-alvo, país de origem, contextualização teórica, técnicas utilizadas e resultados dessas intervenções. A revisão apontou que são raros estudos descrevendo intervenções psicológicas para essas crianças. Além disso, muitos dos estudos encontrados não apresentaram uma clara descrição do método utilizado e avaliação de seus resultados, o que prejudica a utilização dessas intervenções em outros contextos.

          Translated abstract

          Due to the recent progress with antiretroviral treatment, HIV/Aids infection has changed from an acute clinical status to a chronic illness with medical, psychological and social implications. Typical aspects of living with HIV/Aids, such as diagnostic disclosure, treatment adherence and the coping with several mournings, are particularly challenging among children. Therefore, this study aimed to identify psychological interventions that have been developed in the past years with children infected or affected by HIV/Aids. Medline/Pubmed, PsycInfo, Indexpsi, PEPSIC, SciELO and LILACS databases were reviewed, where 17 studies about the related subject were found. Objectives, target population, theoretical conceptualization, used techniques and results of these interventions have been described. The review indicates that studies describing psychological interventions for these children are rare. Moreover, many of these studies did not present a clear description of the methods used and the evaluation of the results, limiting the use of these interventions in other contexts.

          Translated abstract

          Con los avances en la terapia antirretroviral, la infección por VIH/SIDA en los niños cambió de enfermedad aguda a enfermedad crónica, con implicaciones médicas, psicológicas y sociales. Aspectos de la convivencia con el VIH/SIDA, como la revelación del diagnóstico, la adherencia al tratamiento y afrontamiento a las pérdidas, son especialmente difíciles para los niños. Por eso, este estudio buscó identificar en la literatura intervenciones psicológicas desarrolladas en los últimos años para niños que conviven con el VIH/SIDA. Fueron revisados el Medline, PsycInfo, Indexpsi, PEPSIC, SciELO y LILACS, en donde se encontraron 17 estudios sobre el tema. Se describen los objetivos, público objetivo, país de origen, el contexto teórico, técnicas utilizadas y los resultados de esas intervenciones. La revisión apuntó que son raros los estudios que describen las intervenciones psicológicas para esos niños. Además, muchos de los estudios encontrados no presentan claramente el método usado y la evaluación de sus resultados, lo que perjudica el uso de esas intervenciones en otros contextos.

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          Most cited references55

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          Strategies for promoting adherence to antiretroviral therapy: a review of the literature.

          The success of antiretroviral therapy (ART) for HIV infection, though widespread and resounding, has been limited by inadequate adherence to its unforgiving regimens, especially over the long term. This article summarizes the literature on behavioral interventions to promote ART adherence and highlights some of the most recent and innovative research on patient education and case management, modified directly observed therapy, contingency management, interventions emphasizing social support, and novel technologies to promote awareness. Research in the area of adherence in pediatric HIV infection and in resource-constrained international settings also is considered. Although adherence interventions have been successful in experimental trials, they may not be feasible or adaptable given the constraints of real-world clinics and community-based settings. Implementation and dissemination of adherence interventions needs increased attention as ART adherence research moves beyond its first decade. We conclude with suggestions for incorporating research findings into clinical practice.
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            Adherence to antiretroviral therapy for pediatric HIV infection: a qualitative systematic review with recommendations for research and clinical management.

            Although nonadherence to prescribed therapies is widespread, it is particularly problematic with highly active antiretroviral therapy for HIV infection. This review of >50 studies in the area of pediatric HIV infection revealed varying methods for assessing antiretroviral adherence with a wide range of estimates of adherence. Correlates of adherence could be grouped as those relating to the medication, the patient, and the caregiver/family, with many conflicting findings and a lack of theory guiding the research. Only 8 studies, mainly small feasibility or pilot investigations, evaluated highly active antiretroviral therapy adherence interventions in pediatric populations. We conclude with specific recommendations for assessment and clinical management of adherence and discuss directions for future research in this area.
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              Experiences of stigma and access to HAART in children and adolescents living with HIV/AIDS in Brazil.

              This study describes and conceptualizes the experiences of stigma in a group of children living with HIV in São Paulo, Brazil, and evaluates the impact of access to highly active antiretroviral therapy (HAART) over the social course of AIDS and over the children's experiences of stigma. Through ethnographic research in São Paulo from 1999 to 2001, the life trajectories of 50 children ages 1-15 living with or affected by HIV were studied. Data were collected via participant observation and semi-structured informal interviews and analyzed using social theories on illness experience and social inequality. Our results demonstrate that AIDS-related stigma occurs within complex discrimination processes that change as children reach adolescence. We found that structural violence in the forms of poverty, racism, and inequalities in social status, gender, and age fuels children's experiences of stigma. We also describe how access to HAART changes the lived experience of children, reduces stigma, and brings new challenges in AIDS care such as adolescents' sexuality and treatment adherence. Based on these results, we propose structural violence as the framework to study stigma and argue that interventions to reduce stigma that solely target the perception and attitudes toward people living with HIV are limited. In contrast universal access to HAART in Brazil is a powerful intervention that reduces stigma, in that it transforms AIDS from a debilitating and fatal disease to a chronic and manageable one, belongs to a broader mechanism to assure citizens' rights, and reduces social inequalities in access to health care.
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                Author and article information

                Journal
                pusf
                Psico-USF
                Psico-USF
                Universidade de São Francisco, Programa de Pós-Graduação Stricto Sensu em Psicologia (Campinas, SP, Brazil )
                1413-8271
                2175-3563
                April 2013
                : 18
                : 1
                : 65-76
                Affiliations
                [01] Porto Alegre orgnameUniversidade Federal do Rio Grande do Sul Brasil
                Article
                S1413-82712013000100008 S1413-8271(13)01800100008
                10.1590/S1413-82712013000100008
                b1349f44-4353-4826-9ca3-2468a4bca20e

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 11 January 2012
                : 05 March 2013
                : 26 February 2013
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 31, Pages: 12
                Product

                SciELO Brazil

                Categories
                Artigos

                VIH,AIDS,Crianças,HIV,Intervenciones psicológicas,Children,SIDA,Psychological interventions,Intervenções psicológicas,Niños

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