Modelo de intervención del binomio médico tratante-enfermera encuestadora para la adherencia al TARV y supresión viral en personas con VIH/sida

Authors

Ventura Puente Sani
Iván Jesús Arias Deronceres
Liam Kadel Dunán Cruz
Lázaro Ibrahim Romero García
Pedro Oropesa Roblejo

Abstract

Introduction: Adherence to antiretroviral therapy (ART) is a multidimensional phenomenon influenced by individual, psychosocial, structural, and healthcare system factors. In Cuba, 96% of those diagnosed with HIV receive ART, and 87.4% have suppressed viral load, highlighting the need for interventions to strengthen adherence, retention, and re-engagement. Objective: To design a clinical-epidemiological intervention model based on the collaborative work of the treating physician and the survey nurse of the STI/HIV/AIDS and Hepatitis Program in Santiago de Cuba. Materials and Methods: A structured review of international recommendations and scientific evidence was conducted. Based on this synthesis, a model was designed using Holistic-Configurational Theory - Variant III, which integrates a cultural dimension and a praxeological dimension, articulated by a systematizing axis, and a baseline level in a dialectical spiral of continuous improvement. Results: The design of a model as a scientific and theoretical contribution, integrating a cultural dimension and a praxeological dimension, articulated by a systematizing axis. This is complemented by a baseline level (Human Activity) that implements the cascading/spiral practice of the dual approach within the community. A survey tool is included to identify barriers and stratify the risk of poor adherence into different categories, triggering differentiated interventions and alert criteria that necessitate continuous medical evaluation to achieve sustained viral suppression and effective patient engagement. Conclusions: The proposed theoretical model transforms adherence into a dialectical process of person-centered care, where the clinical-epidemiological sensitivity of the binomial integrates the understanding of the context with the flexible application of the normative framework.

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