Ansiedade e depressão em pessoas iniciando a terapia antirretroviral na perspectiva de gênero, Belo Horizonte, 2018

Abstract

Introduction: Depression and anxiety are among the most common mental disorders experienced by people living with HIV. It is known that people who experience such suffering are also victims of stigma and prejudice and are often excluded from education, work and other spaces and therefore are led to social isolation. From a gender perspective, even though the HIV epidemic numerically affects more men, social, economic, cultural and biological issues represent an increase in the vulnerability of women, which can be reflected in the difficulty of self-care and autonomy for quality of life. Objective: To assess the symptoms of anxiety and depression in people starting antiretroviral therapy from a gender perspective. Methodology: Sectional analysis that integrated the ECOART project, which is a longitudinal study aimed at studying the effectiveness of antiretroviral therapy (ART) in people living with HIV in Belo Horizonte. ECOART was conducted in three specialized public referral services to HIV. Patients with laboratory evidence of HIV infection up to six months after initiating ART were included in the study. Pearson's chi-square test was used to analyze the differences between gender and the selected variables, with a significance level of 5%. Results: Among 462 patients, 375 (81.2%) were males and 87 (18.8%) were females. Women had a mean age greater than men (39 years), with similarity between the self-declared color (brown = 49%). About 52% of women were single, but 71% of men declared themselves unmarried. Women with children were 80.5% as opposed to 15.1% for men. Men had higher formal schooling (81.7%) with 64.3% reporting some type of employment. The percentage of low formal schooling among women was 62.2%, and only 37.9% reported having a job. Also, only 8.0% of women reported having a private health plan. The use of alcoholic beverages was similar between the sexes, however, the report of illicit drug use in life was higher among men. The non-use of condom in the last sexual intercourse was 42.7% and 16.8% for women and men, respectively. Clinically, both sexes used fixed-dose antiretroviral therapy and declared to experience HIV treatment as easy or very easy, 71.8% among men and 64.2% among women. Regarding the orientation of ART by professionals, 88.8% of men and 55.8% of women understood much of it or everything. The mean of the domains of the quality of life scale, except in the dimension of spirituality, was lower for the female sex. Regarding mental disorders, 30.5% of women and 13.6% of men reported feeling anxiety and depression. Regarding the gender differences among sociodemographic variables, most women were in the range of 51 to 68 years (p = 0.02), had more children (p < 0.001), less jobs (p < 0.001), lower socioeconomic status (p < 0.001), without a private health plan (p < 0.001). Among the behavioral variables and life habits, women smoked less (p = 0.046), used less illicit drugs (p < 0.001) and used less condom (p < 0.001). Among the clinics, women understood less the orientation (p = 0.020), and they also presented lower quality of life according to the domains of the applied scale (p = 0.004), psychological (p = 0.020), independence (p < 0.001), social (p < 0.001), and environmental (p < 0.001). Women experienced more anxiety and depression symptoms (p < 0.001). Conclusion: Strategies should be implemented in HIV referral services to reduce gender differences, especially by offering diagnosis and follow-up of mental disorders for the female sex.