BACKGROUND: Tuberculosis is the most common opportunistic infection among HIV-infected patients in Brazil. Brazil's national policy for HIV care recommends screening for latent tuberculosis (TB) and implementing isoniazid preventive therapy (IPT). OBJECTIVES: We compared physician adherence to TB screening and other prevention and care policies among HIV primary care clinics in Rio de Janeiro City. METHODS: Data on performance of CD4 counts, viral load testing, tuberculin skin testing (TST) and IPT were abstracted from patient charts at 29 HIV clinics in Rio de Janeiro as part of the TB/HIV in Rio (THRio) study. Data on use of pneumocystis jiroveci pneumonia (PCP) prophylaxis were also abstracted from a convenience sample of 150 patient charts at 10 HIV clinics. Comparisons were made between rates of adherence to TB guidelines and other HIV care guidelines. RESULTS: Among the subset of 150 patients with confirmed HIV infection in 2003, 96% had at least one reported CD4 counts result; 93% had at least one viral load result reported; and, PCP prophylaxis was prescribed for 97% of patients with CD4 counts < 200 cells/mm³ or when clinically indicated. In contrast, 67 patients (45%) had a TST performed (all eligible); and only 11% (17) of eligible patients started IPT. Among 12,027 THRio cohort participants between 2003 and 2005, the mean number of CD4 counts and viral load counts was 2.5 and 1.9, respectively, per patient per year. In contrast, 49% of 8,703 eligible patients in THRio had a TST ever performed and only 53% of eligible patients started IPT. CONCLUSION: Physicians are substantially more compliant with HIV monitoring and PCP prophylaxis than with TB prophylaxis guidelines. Efforts to improve TB control in HIV patients are badly needed.

O presente artigo visa contribuir para reflexão acerca das alternativas de capacitação e qualificação de docentes atuantes no ensino técnico, com base na experiência do Programa de Aperfeiçoamento do Ensino Técnico (PAETEC), desenvolvido pela Escola Politécnica de Saúde Joaquim Venâncio (EPSJV/FIOCRUZ). O PAETEC busca a renovação das práticas de aperfeiçoamento profissional, no próprio local de trabalho, de forma a possibilitar maior interação entre processos educacionais e atividade de pesquisa. Para tanto, utiliza como estratégia uma metodologia integradora que permite ao professor refletir sobre sua própria prática, transformando-a em objeto de investigação

Based on the experience of a teacher training program entitled Program for Continuing Education of Polytechnic Faculty (PAETEC) developed by the Escola Politécnica de Saúde Joaquim Venâncio (EPSJV/FIOCRUZ), this article is intended to contribute to the discussion of alternatives for continuing vocational teacher education programs. In the search for new on-the-job teacher training models fostering interaction between the educational process and research activity, the experience employs a strategy based on the construction of an integrated methodology allowing teachers to reflect on their own practices and turn them into the object of their research.

O presente artigo visa contribuir para reflexão acerca das alternativas de capacitação e qualificação de docentes atuantes no ensino técnico, com base na experiência do Programa de Aperfeiçoamento do Ensino Técnico (PAETEC), desenvolvido pela Escola Politécnica de Saúde Joaquim Venâncio (EPSJV/FIOCRUZ). O PAETEC busca a renovação das práticas de aperfeiçoamento profissional, no próprio local de trabalho, de forma a possibilitar maior interação entre processos educacionais e atividade de pesquisa. Para tanto, utiliza como estratégia uma metodologia integradora que permite ao professor refletir sobre sua própria prática, transformando-a em objeto de investigação

Based on the experience of a teacher training program entitled Program for Continuing Education of Polytechnic Faculty (PAETEC) developed by the Escola Politécnica de Saúde Joaquim Venâncio (EPSJV/FIOCRUZ), this article is intended to contribute to the discussion of alternatives for continuing vocational teacher education programs. In the search for new on-the-job teacher training models fostering interaction between the educational process and research activity, the experience employs a strategy based on the construction of an integrated methodology allowing teachers to reflect on their own practices and turn them into the object of their research.