Acesso de usuários do Sistema Único de Saúde à Profilaxia Pós-Exposição ao HIV e o retorno às consultas de acompanhamento no município de Salvador - BA.

Abstract

The Post-Exposure Prophylaxis (PEP) of risk to HIV infection is a technology considered strategic in combined HIV prevention programs in Brazil and worldwide. In addition to the preventive function, it is a method that has the possibility of linking people exposed to HIV to health services. This study aims to analyze the access of SUS users to PEP and the return to follow-up appointments in the city of Salvador - BA. The study population consisted of people who sought PEP in the city, from January to December 2018. Data collection was performed using information from monitoring spreadsheets of emergency care units (UPA) in the city of Salvador and through collection of information from medical records in the specialized care medical service (SEMAE). Descriptive analyzes and a regestion model were used. In descriptive terms, absolute and percentage frequencies were obtained; in the bivariate analysis, using logistic regression, the odds ratio (OR) was obtained, with respective 95% confidence intervals (95%CI), for the outcome prescription of PEP, a significance level of 5% was adopted (p ≤ 0, 05). For statistical analysis, Stata version 12.0 was used. The study was approved by the CAAE Research Ethics Committee: 5525719.6.0000.5030 ensuring the confidentiality and privacy of the participants. Of the 1,525 people who sought PEP in the UPA, 1,273 (83.5%) presented eligibility criteria for PEP and 252 (16.5%) did not. Of this group of eligible people, 1,166 (91.6%) were prescribed antiretrovirals (ARV) and were instructed to follow up with the protocol follow-up appointments, but 107 (8.4%) people, despite having the criteria of inclusion in the PEP, did not receive the prescription of ARVs. Men were the ones who most sought the PEP, totaling 69.2% of the consultations. The predominant age group was 24 to 34 years old and the most frequent exposure was consenting sexual intercourse with 76.3%. Of the total number of people who received the PEP prescription, 226 (19.4%) returned to the first appointment, 115 (9.9%) to the second appointment and 33 (2.8%) to the third appointment to complete the protocol. Most users who attended the first follow-up appointment at SEMAE were: male (64.6%), aged 34 years (37.2%) and with exposure through consenting sexual intercourse (70.4% ). The study reveals that the biggest obstacle to the protocol is the lack of PEP monitoring in the specialized service due to the non-attendance of the user, indicating the need to restructure the PCDT-PEP in the city. It is also extremely important to disseminate this prevention tool to promote more access for people to prophylaxis and health care, ensuring the right of everyone to know and use the set of preventive methods available in the Unified Health System that suit their needs individuals and prevent further HIV infections.