Avaliação de oportunidades do domicílio para o desenvolvimento motor na experiência da família de lactentes expostos ao HIV

Abstract

The child vertically exposed to the human immunodeficiency virus (HIV) demands in addition to usual care those for the prevention of vertical transmission, which are provided by the family in the home environment, in order to provide a healthy development. Objective: to evaluate whether interdependent levels of the environment interfere in the opportunities of the home for the motor development of infants vertically exposed to HIV, in the family experience. Method: cross-sectional study conducted with 168 relatives of exposed children, aged three to 18 months, under follow-up at health services in the municipalities of Santa Maria, Novo Hamburgo, Cachoeirinha, Sapucaia do Sul, Viamão, Erechim, Santa Cruz and Passo Fundo, State of Rio Grande do Sul, Brazil. Date collection by telephone contact between December 2015 and August 2020 using a sociodemographic and clinical characterization instrument of family members and children and the environment; scale of assessment of the capacity to care for children exposed to HIV; satisfaction scale with social support; opportunities in the home environment for motor development - baby scale; inventory of protective factors of the family; and food-short-version insecurity. The ethical aspects of research with human beings were respected. Results: family members characterized by mothers (95.2%), with high school education (23.1%), income of up to two years (48.8%) and no employment relationship (60.8%). Infants were born at term (70.1%), without health problems (86.2%), with an infectious disease consultation before the first month (62.2%), with up to four consultations in the last year (49.7%). The environment was characterized by houses (94.5%), with up to two children (69.5%) and up to two adults (74.4%). The total opportunities of the home environment were classified as moderately adequate (37.4%), excellent stimulation variety (35.4%), moderately adequate physical space (44.5%), thick motricity toys (38.0%) and fine motricity toys (38.7%) classified as less than adequate. From the regression model there was a significant association for schooling (p < 0.005), income (p < 0.013) and food security (p < 0.032) with the outcome less than adequate or moderately adequate for household opportunities. Conclusion: lower school, financial and food safety conditions imply environmental vulnerabilities for motor development, which can be enhanced, when considering the clinical fragility of this infant, with a serological condition still undefined, and demand for usual care and for prevention of vertical transmission performed by the family member. The findings of this study reinforce the need to promote child motor development according to the sociodemographic conditions of each family, using the one available at home.