Soporte social de personas con VIH/SIDA: Modelo de la Determinación Social de la Salud

Santos, Vanessa da Frota; Pedrosa, Samyla Citó; Aquino, Priscila de Souza; Lima, Ivana Cristina Vieira de; Cunha, Gilmara Holanda da; Galvão, Marli Teresinha Gimeniz

doi:10.1590/0034-7167-2017-0346

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Revista Brasileira de Enfermagem

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RESEARCH • Rev. Bras. Enferm. 71 (suppl 1) • 2018 • https://doi.org/10.1590/0034-7167-2017-0346 copiar

Soporte social de personas con VIH/SIDA: Modelo de la Determinación Social de la Salud

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Analizar el soporte social de personas con VIH/SIDA en la perspectiva del Modelo de la Determinación Social de la Salud.

Método:

Estudio transversal realizado en 2015 en un servicio de Infectología. Muestra integrada por 116 personas con VIH/SIDA. Datos recolectados mediante entrevista, utilizándose formulario sociodemográfico y escala de soporte social. Los datos se analizaron por estadística descriptiva. Se realizaron los tests T de Student y Mann-Whitney para verificar la asociación entre el soporte social y los determinantes sociales de salud.

Resultados:

El soporte social total fue satisfactorio, el soporte emocional resultó influido por consumo de tabaco (p=0,0432), y el instrumental, por cantidad de personas en el domicilio (p=0,0003). La principal fuente de apoyo del soporte instrumental y emocional fueron los familiares externos al ámbito doméstico, representando 66,7% y 56,1%, respectivamente.

Conclusión:

Se evidenció que los fumadores presentan menor soporte emocional, y aquellos que viven solos reciben menor soporte instrumental.

Descriptores:
VIH; Síndrome de Inmunodeficiencia Adquirida; Apoyo Social; Determinantes Sociales de la Salud; Salud Pública

Layers of the Social Determinants of Health Model	Total Social Support		Total	p value^* * Chi-square test for independent variables
	Satisfactory	Unsatisfactory	n (%)
	n(%)	n(%)
1. Individual determinants
Sex
Male	35 (30.1)	17 (14.7)	52 (44.8)	0.4800
Female	48 (41.4)	16 (13.8)	64 (55.2)
Age group (in years)
≤ 40	51 (44.0)	18 (15.5)	69 (59.5)	0.6359
> 40	32 (27.5)	15 (12.9)	47 (40.5)
Skin color
Brown	52 (44.8)	16 (13.8)	68 (58.6)	0.2346
Other	31 (26.7)	17 (14.7)	48 (41.4)
2. Proximal determinants
Sexual orientation
Heterosexual	60 (51.7)	25 (21.6)	85 (73.3)	0.8821
Homosexual / Bisexual	23 (19.8)	8 (6.9)	31 (26.7)
Physical exercise
Yes	45 (38.8)	12 (10.3)	57 (49.1)	0.1261
No	38 (32.8)	21 (18.1)	59 (50.9)
Use of alcohol
Yes	41 (35.3)	12 (10.4)	53 (45.7)	0.2869
No	42 (36.2)	21 (18.1)	63 (54.3)
Use of tobacco
Yes	10 (8.6)	11 (9.5)	21 (18.1)	0.0155
No	73 (62.9)	22 (19.0)	95 (81.9)
Use of illicit drugs
Yes	3 (2.6)	3 (2.6)	6 (5.2)	0.4611
No	80 (69.0)	30 (25.8)	110 (94.8)
3. Influence of social networks
Marital Status
Single	32 (27.6)	13 (11.2)	45 (38.8)	0.9749
Married	37 (31.9)	15 (12.9)	52 (44.8)
Other	14 (12.1)	5 (4.3)	19 (16.4)
Children
Yes	34 (29.3)	16 (13.8)	50 (43.1)	0.596
No	49 (42.2)	17 (14.7)	66 (56.9)
Number of people in the household
1	13 (11.2)	8 (6.9)	21 (18.1)	0.414
≥2	70 (60.3)	25 (21.6)	95 (81.9)
Religion
Professes	75 (64.7)	30 (25.9)	105 (90.6)	1.0000
Does not profess	8 (6.8)	3 (2.6)	11 (9.4)
4. Intermediate determinants
Household income (Minimum wage)
< 3	55 (47.4)	22 (19.0)	77 (66.4)	1.0000
≥3	28 (24.1)	11 (9.5)	39 (33.6)
Years of education
≤ 9	29 (25.0)	10 (8.6)	39 (33.6)	0.7955
> 9	54 (46.6)	23 (19.8)	77 (66.4)
Employment status
Active	44 (37.9)	17 (14.7)	61 (52.6)	1.0000
Inactive	39 (33.6)	16 (13.8)	55 (47.4)

Layers of the Social Determinants of Health Model	Types of Social Support
	Instrumental			Emotional
	Mean	SD	p value	Mean	SD	p value
1. Individual determinants
Sex
Male	3.7	0.8	0.3638^† † Student's t test;	4.0	0.8	0.4330^‡ ‡ Mann-Whitney test;
Female	3.6	0.8	0.3638^† † Student's t test;	3.8	0.9	0.4330^‡ ‡ Mann-Whitney test;
Age group (in years)
≤ 40	3.7	0.7	0.5875^‡ ‡ Mann-Whitney test;	3.9	0.9	0.7818^‡ ‡ Mann-Whitney test;
> 40	3.7	1.0		3.9	0.9	0.7818^‡ ‡ Mann-Whitney test;
Skin color
Brown	3.8	0.8	0.1377^‡ ‡ Mann-Whitney test;	3.9	0.9	0.5005^‡ ‡ Mann-Whitney test;
Other	3.6	0.7		3.8	0.9
2 Proximal determinants
Sexual orientation
Heterosexual	3.7	0.8	0.827^‡ ‡ Mann-Whitney test;	3.8	0.9	0.1991^‡ ‡ Mann-Whitney test;
Homosexual / Bisexual	3.7	0.8		4.1	0.7
Physical exercise
Yes	3.8	0.7	0.1782^‡ ‡ Mann-Whitney test;	4.0	0.9	0.2522^‡ ‡ Mann-Whitney test;
No	3.5	0.9		3.8	0.9
Use of alcohol
Yes	3.7	0.7	0.8744^‡ ‡ Mann-Whitney test;	4.0	0.7	0.6792^‡ ‡ Mann-Whitney test;
No	3.6	0.8		3.8	1.0
Use of tobacco
Yes	3.3	1.0	0.0576^‡ ‡ Mann-Whitney test;	3.6	0.8	0.0432^‡ ‡ Mann-Whitney test;
No	3.7	0.7		4.0	0.8
Use of illicit drugs
Yes	3.0	1.0	0.1248^‡ ‡ Mann-Whitney test;	3.5	0.9	0.3332^‡ ‡ Mann-Whitney test;
No	3.7	0.8		3.9	0.9
3. Influence of social networks
Marital Status
Single	3.7	0.8	0.5722^‡ ‡ Mann-Whitney test;	4.0	0.8	0.3463^‡ ‡ Mann-Whitney test;
Married	3.7	0.8		3.8	0.9
Children
Yes	3.6	0.8	0.4495^‡ ‡ Mann-Whitney test;	4.0	0.9	0.5064^‡ ‡ Mann-Whitney test;
No	3.7	0.8		3.8	0.8
Number of people in the household
1	3.1	0.6	0.0003^‡ ‡ Mann-Whitney test;	4.0	0.8	0.5877^‡ ‡ Mann-Whitney test;
≥2	3.8	0.8		3.9	0.9
Religion
Professes	3.7	0.8	0.8135^‡ ‡ Mann-Whitney test;	3.9	0.9	0.3477^‡ ‡ Mann-Whitney test;
Does not profess	3.7	0.8		4.1	0.7
4. Intermediate determinants
Household income (Minimum wage)^§ § At the time of the study, the minimum wage was BRL 788, equivalent to USD 251.77.
< 3	3.6	0.8	0.4161^‡ ‡ Mann-Whitney test;	3.9	0.8	0.5882^‡ ‡ Mann-Whitney test;
≥3	3.8	0.8		3.9	0.9
Years of education
≤ 9	3.7	0.9	0.9398^† † Student's t test;	3.8	0.9	0.3168^‡ ‡ Mann-Whitney test;
> 9	3.7	0.8		3.9	0.9
Employment status
Active	3.8	0.8	0.1605^† † Student's t test;	4.0	0.9	0.2802^‡ ‡ Mann-Whitney test;
Inactive	3.6	0.8		3.8	0.8

Source of support	Social support
Source of support	Instrumentaln (%)	Emotionaln (%)
Spouse/partner	53 (46.5)	57 (50.0)
Relative living in the same household	46 (40.6)	44 (38.6)
Relative not living in the same household	76 (66.7)	64 (56.1)
Friend(s)	35(30.7)	63 (55.3)
Boss/co-worker	2 (1.8)	4 (3.5)
Neighbor(s)	5 (4.4)	4 (3.5)
Health professionals	10 (8.8)	19 (16.7)
Other	3 (2.6)	3 (2.6)

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[1] CORRESPONDING AUTHOR: Vanessa da Frota Santos E-mail: doutorandavanessasantos@outlook.com