[Disclosing the virus, hiding the patients: follow-up tests (CD4 and VL) and the physician-patient relationship in the AIDS setting].
The aim of this study is to discuss the meanings associated with the CD4 lymphocyte count and HIV plasma viral load (VL) for patients living with AIDS and the attending physicians, seeking to analyze the impacts of the increasing use of these tests in the treatment setting. A qualitative study was performed in two HIV/AIDS referral centers with participant observation and semi-structured interviews with 27 patients living with AIDS and four physicians. Observation of the medical consultations showed that they are quick, objective, and centered on the CD4 and VL test results, thus reinforcing a hegemonic view of medical knowledge and a biomedical perspective that instrumentalizes their practice. For physicians and patients, the tests tend to reflect the 'truth' on the patient's disease, to the detriment of the patient history and clinical examination, impacting the therapeutic relationship and leading to the physician's lack of attention to the patients' subjectivity. More than ever, there is a need to reclaim good clinical practice and acknowledge the subject's role in medical practice as a healing art.
Guzmán
Julio L D
JL
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil. jguzman@ufba.br
Iriart
Jorge Alberto Bernstein
JA
D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology* / Q000821:virology; D000328:Adult; D018791:CD4 Lymphocyte Count; D030881:Disclosure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D036301:Qualitative Research; D019562:Viral Load; D055815:Young Adult