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<p>Comprehensive care approaches the patient in an integrated way, on the three health care levels, through long-term care and counting with specialized support. In the case of chronic diseases, the establishment of a dialogue and individualized treatment plans are fundamental for a better adherence to treatment. The objective of the present study discussing the case of a HIV positive adolescent, who did not adhere to treatment, is to propose interventions that can serve as examples in the conduct of similar case. The primary care team selected a complex case, in which the mother and her adolescent son, both HIV infected, had not adhered adequately to treatment. Household visits were made in order to understand their familiar and social context and to initiate possible interven-tions, and contact was established between the different care levels. This resulted in a better articulation between the different services and helped identifying the needs of this family. A patient must be addressed not only considering the biological aspect but also his social and cultural environment to be able to offer individualized care and a better quality of life.</p> <p>A cl&iacute;nica ampliada visa &agrave; abordagem integral do paciente, baseando-se na intersetorialidade, no acompanhamento longitudinal e no apoio matricial. No caso de doen&ccedil;as cr&ocirc;nicas, &eacute; fundamental a forma&ccedil;&atilde;o de v&iacute;nculo e constru&ccedil;&atilde;o do projeto terap&ecirc;utico singular, possibilitando maior ades&atilde;o ao tratamento. O objetivo do presente estudo &eacute;, por meio da discuss&atilde;o do caso cl&iacute;nico de um adolescente HIV positivo n&atilde;o-aderente ao tratamento, propor interven&ccedil;&otilde;es que possam ser usadas como exemplo na condu&ccedil;&atilde;o de casos semelhantes. A equipe da UBS selecionou um caso complexo em que m&atilde;e e filho adolescente, HIV positivos, n&atilde;o aderiram de forma adequada ao tratamento. A fim de entender seu contexto familiar e social, e iniciar poss&iacute;veis interven&ccedil;&otilde;es, foram realizadas visitas domiciliares e comunica&ccedil;&atilde;o entre os diversos n&iacute;veis de atendimento, o que propiciou a articula&ccedil;&atilde;o entre os servi&ccedil;os e melhor identifica&ccedil;&atilde;o das demandas familiares. Na abordagem do paciente, deve-se considerar tanto seu aspecto biol&oacute;gico quanto seu contexto sociocultural, a fim de possibilitar um atendimento individualizado, de forma a oferecer melhor qualidade de vida e maior ades&atilde;o ao tratamento.</p>

Intervenção na adesão ao tratamento de doenças crônicas tendo como modelo um paciente adolescente HIV positivo