Mapping the implementation of the rapid HIV test in the Family Health Strategy: the nurses' perspective

Silva, Ilisdayne Thallita Soares da; Valença, Cecília Nogueira; Silva, Richardson Augusto Rosendo da

doi:10.1590/2177-9465-EAN-2017-0019

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RESEARCH • Esc. Anna Nery 21 (04) • 2017 • https://doi.org/10.1590/2177-9465-EAN-2017-0019 copy

Mapping the implementation of the rapid HIV test in the Family Health Strategy: the nurses' perspective^* * Section of the master's thesis "Mapping the implementation of rapid HIV testing in the Family Health Strategy", defended and approved in the Graduate Program in Nursing of the Federal University of Rio Grande do Norte in 2016 by the first author with tutoring by the last author. The second author contributed intellectually only with the elaboration of this publication.

Mapeo de la aplicación de la prueba rápida del anti-VIH en la Estrategia Salud de la Familia: perspectiva de enfermeros

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To analyze the implementation of the rapid HIV test in the Family Health Strategy (FHS) from the perspective of nurses.

Method:

A qualitative study was performed with 13 FHS nurses between March and June 2015 using a semi-structured interview. The data were analyzed by symbolic cartography and Bardin's thematic analysis.

Results:

The nurses projected to the center of the map: lack of test kits, insufficient time for training, speed of the test result and excessive activities. In the periphery, they placed aspects related to the physical space, the lack of participation of other professionals in the training, the ease of performing the test and breaking the news of positive HIV diagnoses.

Conclusion and implications for practice:

An adequate supply of test kits, tests more widely available to the entire population and training of other members of the FHS team are required. This study supports improvements in the nursing practice of rapid HIV testing.

Keywords:
Nursing; HIV; Family Health Strategy

Scale	Symbolization (Voices of the respondents)
M1	I do not have a room to perform the test.I do not have the storage space. I get the test kits from only one lab at a time. It is rare to see tests from different laboratories at the same time. The correct would be this. At the moment, I work with only one kind of test. So, if there is a positive result, I repeat with the same test. I have no choice (I10).
M2	I have no problems with the room. I have privacy. I stay in the room alone with the patient.The tests are stored in the pharmacy refrigerator. In the refrigerator that only has insulin. The biggest problem in the structure is the lack of tests. We sent worksheets to management every month, but I have not received any tests for five months (I8).
Projection
Center	Periphery
Two few rapid HIV test kits	A room to perform the test and storage space for the test

Scale	Symbolization (Voices of the respondents)
M3	I thought the time of training was too short. It should have been longer. A lack of attention paid to the counseling part of training. On how to talk to the patient with positive or negative test results. There was also a lack of discussion about patient referral in the case of a positive result. I do not know the procedure that should be followed; I do not know where to send the patient (I2).
M4	The training was satisfactory about testing, about the technique itself. But, related to counseling, it was not enough. I was the only one from my municipality to participate in the training. I think they should have sent other professionals to participate such as the social worker and the psychologist to give support (I5).
Projection
Center	Periphery
Insufficient time for training	Lack of participation of other types of professionals in the training

Scale	Symbolization (Voices of the respondents)
M5	Not every municipality provides a laboratory to perform the HIV test. We, for example, send them to another city and there is a demand from other municipalities in that city. When will the exam [results] arrive? The simplicity is this: you identify something in time.This enables early interventions. That's the purpose of quick tests. Otherwise, it would not be a rapid test (I6).
M6	The simplicity is that there is no more rejection among the patients. When I offer, they already ask me: what day can I do it? So this I think is important because I have 22 years of experience and I've never seen this before. Today they no longer have any resistance to take the test (I11).
Projection
Center	Periphery
Fast exam results	Easy to perform the test Less refusal by the patient to take the test

Scale	Symbolization (Voices of the respondents)
M8	The difficulty is that the nurse is alone to perform the test. There is a high demand for few professionals. In addition, the number of tests is limited. It is not possible to contemplate a larger number of vulnerable patients (I13).
M9	The difficulty is the short time we have because of the other activities carried out in the FHS. Therefore, here in the municipality, we just test pregnant women. They asked us to tell the public that the unit has a quick test, but we do not because we do not have time to do it. It's too much, the demand is great. In addition, the number of tests is small (I4).
M2	The difficulty I think is telling the patient that he has HIV. Most people think it's the end. That there's no way (E8).
Projection
Center	Periphery
Too few tests to operationalize the testing process Too many activities	Breaking the news of HIV positive test results

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[1] Corresponding author: Cecília Nogueira Valença. E-mail: cecilia_valenca@yahoo.com.br