Las dinámicas basadas en el consumo de medicamentos antirretrovirales en entornos carcelarios, CRS Turi

Abstract

This study explores adherence to antiretrovirals in prison contexts during January 2019 to February 2020 in the CRS Turi located in the southern zone of Ecuador, from the consumption of medicines based on a triangulation of information from ethnographic data, participant observation and medical reports of biochemical tests of viral load. Adherence to antiretroviral treatment depends on the relationship between the drug and the actors within and outside the prison walls. On the other hand, official statistical data show success at the viral load level, although their superficiality does not represent the reality of the disease. Consequently, the viral load does not show a comprehensive health approach or the multi-actor dynamics in relation to the characteristics of the environment. Timely diagnosis, health education, assertive doctor-patient communication, prescription, follow-up and delivery of the drug to the patient play a preponderant role. However, the dynamics of the prison context modify the health care processes to the detriment of the prison population. Three approaches were used: a) to analyze the epidemiological data of people with HIV in prison; b) to describe the transit of antiretroviral medication in relation to adherence in prison; and c) to interpret the processes of health, disease and care in HIV-positive people.