Risco nutricional, insegurança alimentar e qualidade de vida em pessoas vivendo com HIV/AIDS no Estado da Paraíba

Abstract

The acquired immunodeficiency syndrome is caused by the human immunodeficiency virus that is transmitted, mainly by the sexual and parenteral route, being responsible for the reduction of CD4 + T lymphocytes in infected individuals, consequently, favoring the reduction of immunity and propensity for serious opportunistic diseases, such as risk of weight loss. Nutritional risk assessment is a method used to predict weight loss in individuals with loss of appetite, chewing and insufficient swallowing, which are responsible for promoting malnutrition in frail individuals. Food insecurity may contribute to nutritional risk and these factors occur when there is insufficient quality and quantity of food for a healthy lifestyle which may lead to a lower quality of life. Considering that quality of life is a broad concept related to satisfaction in living, social welfare, safety and personal dignity, the impacts arising from HIV infection, food insecurity and nutritional risk can aggravate the quality of the affected individuals. In this context, the main objective is to evaluate nutritional risk and its relationships with food insecurity and the quality of life of people living with HIV / AIDS in the state of Paraíba. Cross-sectional study related to the project "Evaluation of Food Insecurity and Quality of Life in People Living with HIV / AIDS" involving 479 people with HIV / AIDS treated at a reference service in the State of Paraíba - Brazil. Data were collected through interviews using a structured form containing sociodemographic variables of habit of life, nutritional status and clinical condition; in addition to the simplified nutritional appetite questionnaire, which is the short version of the Council of Nutrition Appetite Questionnaire. This questionnaire is an option for evaluating simple nutritional risk and for faster application than the other instruments. The Brazilian version proved to be clear and valid for use. The questionnaire was chosen as an instrument to evaluate the nutritional risk, more specifically the appetite, because there are no specific instruments for this purpose for people living with HIV / AIDS. As well as the Brazilian scale of food insecurity and the World Health Organization Quality of Life - HIV Bref. The Chi-square test was used to evaluate the association between categorical variables and nutritional risk and, when positive, were included in the Poisson multiple regression model with robust variance. The study participants had a mean age of 44 years and were mostly low socioeconomic status, low school level and no occupation. These variables were significantly associated with nutritional risk. Food insecurity showed a dose response effect, the more severe the nutritional risk was, and when inserted in the regression model adjusted for food insecurity presented a prevalence ratio of 1.05 increasing nutritional risk by 5%. Nutritional risk was more frequent in individuals with poorer quality of life in all domains, being more prevalent in the physical, environmental and psychological domains. People living with HIV / AIDS have a high prevalence of nutritional risk, which seriously affects biological and social vulnerability, and actions are needed to strengthen social support, self-care and self-assessment. The care network is the first step in reducing nutritional risk, contributing to lower morbidity and mortality of these people.