Oportunidades do ambiente domiciliar para o desenvolvimento motor de crianças verticalmente expostas ao HIV

Abstract

Infant motor development can be influenced by biological and environmental factors. The vertical exposure to human immunodeficiency virus (HIV) is among the biological factors. The environmental factors are those provided by the domicile in which the infant is inserted. Thus, considering the home environment of the infant vertically exposed to HIV, the objective was to evaluate the opportunities of the home environment for the motor development of infants vertically exposed to HIV, from 3 to 18 months of age, being followed up at the health service. A cross-sectional study carried out in southern Brazil between December 2015 and September 2017 with 83 family caregivers of these infants, characterizing the socio-demographic and clinical environment of the main caregiver and the exposed infant. The instrument Affordances in the home environment for motor development - Infant Scale was used to measure the quantity and quality of the opportunities of the environment regarding physical space, stimulation variety, toys for fine and gross motor skills and total score. Data insertion in the Epi-info® program and statistical analysis in R, with absolute and relative frequency, correlation of Pearson and Spearman and simple linear regression, with a significance level of 5%. All ethical aspects have been respected. The environment was characterized by houses (94%), with up to two rooms (72.3%) with one to two adults (74.7%) and one to two children (65.1%), from those children (84.3%) do not attend day care centers. Family caregivers are characterized by women (97.6%), living with HIV (95.2%), aged from 27-36 years old (50.6%), with high school education (53.0%) and unemployed (65. 1%). The infants were born full-term (71.1%), with no health problems and with no simblings exposed to HIV (60.2%). The opportunities were classified as moderately sparse for infants with less than one year old (23.11) and over one year old (31.45). The significant variable for the spatial opportunity were income (p = 0.007 and p = 0.011). Variety of stimulation showed positive association with having sibling exposed to HIV (p = 0.006 and p = 0.009) and the greater the age of the caregiver (p = 0.019 and p = 0.049) and the child (p = 0.001 and p = 0.001) greater this opportunity. As the income increases (p = 0.008 and p = 0.005) and the age of the child (p = 0.014 and p = 0.005) increases the opportunity of toys with gross motor skills, whereas fine motor skills toys maintained association only with the infant's age (p = 0.050 eps = 0.032). In the regression, the variables associated with the total score were: age of the caregiver (p = 0.004) and of the child (p = 0.003), schooling (p = 0.000) and having a sibling exposed to HIV (p = 0.026). The sociodemographic and clinical variables of the family caregiver and the infant influenced the opportunities of the home for motor development were classified as moderate. These findings enphasize the need to explore the household according to each family in order to provide opportunities in quality and quantity considered excellent.