Jeane Freitas de Oliveira

Integralidade do cuidado à saúde da mulher: limites da prática profissional

Abstract Resumen The current policy of full attention to women’s health proposesthe incorporation of the principle of integrality and the size ofgender in professional practices. This qualitative study wastherefore aimed at encouraging reflection and discussion amonga multiprofessional team about women’s health care practicesand identifying those aspects that might weaken or strengthenthe integrality perspective. It was carried out in a primary healthunit in Salvador (Bahia, Brazil), in 2005 and 2006, having assubjects women’s health care practitioners from differenteducational backgrounds who took part in three reflectionworkshops. Data were analyzed by means of discourse analysistechniques assuming gender and integrality as the theoreticalframework. The multiprofessional team was shown to recognizethe fact that their female clientele face situations of class andgender inequalities as well as unequal and authoritarianrelationships at the health unit. Integrality was absent from theprofessional practices under study, a fact also recognized by thehealth care team who, although being able to identify theweaknesses, is unable to mobilize its potential for collectiveorganization in order to effect change.Keywords: Women’s health. P rimary health care. Public PoliciesResumen The current policy of full attention to women’s health proposes the incorporation of the principle of integrality and the size of gender in professional practices. This qualitative study was therefore aimed at encouraging reflection and discussion among a multiprofessional team about women’s health care practices and identifying those aspects that might weaken or strengthen the integrality perspective. It was carried out in a primary health unit in Salvador (Bahia, Brazil), in 2005 and 2006, having as subjects women’s health care practitioners from different educational backgrounds who took part in three reflection workshops. Data were analyzed by means of discourse analysis techniques assuming gender and integrality as the theoretical framework. The multiprofessional team was shown to recognize the fact that their female clientele face situations of class and gender inequalities as well as unequal and authoritarian relationships at the health unit. Integrality was absent from the professional practices under study, a fact also recognized by the health care team who, although being able to identify the weaknesses, is unable to mobilize its potential for collective organization in order to effect change.

VULNERABILIDADE DE MULHERES USUÁRIAS DE DROGAS AO HIV/AIDS EM UMA PERSPECTIVA DE GÊNERO

Este artigo discute a vulnerabilidade de mulheres usuarias de drogas a infeccao pelo HIV/AIDS. Trata de estudo qualitativo cujos dados foram apreendidos pela observacao de campo e entrevista com dezoito mulheres, durante atividades de extensao direcionadas a pessoas usuarias de drogas. A analise apontou condutas relacionadas as praticas sexuais e ao uso de drogas, interligadas e norteadas por construcoes socio-culturais que ampliam a vulnerabilidade das usuarias a infeccao pelo HIV. Independente do tipo de droga, modalidade e rede de uso, o consumo de drogas por mulheres e sua convivencia com pessoas usuarias de drogas, em relacionamentos sexuais e afetivos, constituem situacoes de vulnerabilidade a infeccao pelo HIV, com grau diferenciado nos niveis individual e social. Essas situacoes estao permeadas por relacoes desiguais de genero e poder e apontam para necessidade de estudos e de intervencao numa abordagem de genero contemplando pessoas usuarias de drogas, em particular as do sexo feminino.

Vulnerabilidade de mulheres em união heterossexual estável à infecção pelo HIV/Aids: estudo de representações sociais

Se discuten representaciones sociales de mujeres en union heterosexual estable, respecto de vulnerabilidad a infeccion por VIH/SIDA. Datos generados a partir de asociacion libre de palabras, constituyendose en muestra de investigacion fundamentada en Teoria de las Representaciones Sociales, desarrollada con mujeres seronegativas para VIH, de capital e interior de Bahia. El analisis factorial de correspondencia revelo significatividad para: procedencia, escolaridad y tiempo de union. La aceptacion de la traicion surgio como factor de vulnerabilidad para participantes con 1-5 anos de union estable del interior. Las mujeres de capital con 6-10 anos de union representan a la monogamia como forma de prevencion. Mujeres con mayor tiempo de union y escolaridad basica se auto-representan como invulnerables, al contrario de aquellas con 1-5 anos de union y escolarizacion media. Los resultados sugieren aumentar acciones para desnaturalizar coerciones socioculturales que engendran representaciones y favorecen la exposicion de la mujer en union estable al SIDA.This article discusses the social representations of women living in common-law marriage in terms of their vulnerability to becoming infected with HIV/AIDS. Data were obtained through the free association of words, and consisted of an excerpt of a study founded on the Social Representations Theory developed with HIV-negative women living in the state capital and cities in the interior of Bahia. The correspondence factor analysis showed significance for the variables: origin, education level and time spent in common-law marriage. Their acceptance of marital affairs emerged as a vulnerability factor for respondents with one to five years spent in common-law marriage, living in cities in the interior. Women from the capital, with 6-10 years spent in common-law marriage, reported monogamy as a form of prevention. Women with a longer common-law marriage who had completed only a primary education reported feeling invulnerable, which was the opposite of those with one to five years in common-law marriage with a secondary education. Results show there is a need for more interventions aiming to denaturalize the socio-cultural coercions that generate representations and make women in common-law marriages more vulnerable to AIDS.

Representações sociais de Agentes Comunitários de Saúde acerca do consumo de drogas

This paper discusses on the social representations of community health agents (CHAs) about drug use as part of a qualitative, ethnographic study with data collected by means of a set of research techniques among health professionals including 22 CHAs in a basic health unit in Salvador, Bahia (Brazil) from January, 2006 to January, 2007. The Theory of Social Representations was adopted as the theoretical framework whereas gender was the chosen analytical category. CHAs were found to recognize the womens proximity and participation in the drug phenomenon in the community where they live and act, although they take no professional measures towards such an issue. Their social representations were shown to reproduce stereotypes and prejudices towards drug users and drug use, especially gender- and social class-related, while highlighting the invisibility of drug use as a health problem for the population under study.This paper discusses on the social representations of community health agents (CHAs) about drug use as part of a qualitative, ethnographic study with data collected by means of a set of research techniques among health professionals including 22 CHAs in a basic health unit in Salvador, Bahia (Brazil) from January, 2006 to January, 2007. The Theory of Social Representations was adopted as the theoretical framework whereas gender was the chosen analytical category. CHAs were found to recognize the womens proximity and participation in the drug phenomenon in the community where they live and act, although they take no professional measures towards such an issue. Their social representations were shown to reproduce stereotypes and prejudices towards drug users and drug use, especially gender- and social class-related, while highlighting the invisibility of drug use as a health problem for the population under study.

Representações sociais de profissionais de saúde sobre o consumo de drogas: um olhar numa perspectiva de gênero

Estudo de carater qualitativo, desenvolvido com objetivo de apreender as representacoes sociais de profissionais de saude sobre o consumo de drogas, numa perspectiva de genero. Os dados foram coletados de marco a julho de 2004, atraves da observacao participante, em uma unidade de saude especializada na assistencia a pessoas usuarias de drogas em Salvador-Bahia; e de entrevista semi-estruturada com 19 profissionais que atuam na referida unidade. Os dados foram submetidos a tecnica de analise de conteudo tematica, sendo identificadas duas categorias: o consumo de drogas como uma forma de enfrentar a vida; o ocultamento das mulheres usuarias. O contexto de atuacao dos profissionais revelou diferentes realidades em relacao as mulheres que consomem drogas, que vao de encontro as representacoes dos profissionais sobre este grupo populacional. Ressaltamos a influencia do contexto na elaboracao das representacoes sociais. Visando uma assistencia humanizada e equânime, sugerimos ampliacao da abordagem de genero para os entrevistados e a inclusao de outros profissionais em estudos como este.

A interferência do contexto assistencial na visibilidade do consumo de drogas por mulheres

Considerando a crescente demanda por assistencia a drogadicao feminina e sua internacionalmente reconhecida especificidade, este estudo qualitativo, realizado em Salvador-Ba, no periodo de outubro/2003 a setembro/2004, com profissionais de saude, propoe investigar se o contexto assistencial em que eles se encontram interfere na visibilidade do consumo feminino de drogas. Atraves da observacao participante e da analise de conteudo de entrevistas com dezenove profissionais, revelaram-se situacoes especificas quanto a visibilidade de mulheres usuarias de acordo com o local de atendimento (“instituicao” versus “rua”). Diferencas na percepcao da demanda, tipo de droga utilizado, idade, papeis sociais desempenhados e influencia do parceiro para inicio e manutencao do consumo de drogas demonstraram que o contexto assistencial influencia na representacao daqueles profissionais sobre as usuarias de drogas, o que pode interferir nas estrategias assistenciais implementadas. Recomenda-se a articulacao entre os dois contextos assistenciais na unidade estudada e desta com outros servicos de saude.

Especificidades de usuários(as) de drogas visando uma assistência baseada na heterogeneidade

O artigo enfoca a heterogeneidade de grupos e de pessoas usuarias de drogas, com enfase nas especificidades de mulheres. Trata-se de revisao da literatura sobre o fenomeno das drogas e saude, a partir de textos selecionados que utilizam a variavel empirica sexo. Foram identificadas diferencas no consumo de drogas entre homens e mulheres e especificidades entre mulheres tanto em relacao a aspectos epidemiologicos quanto aos determinantes socio-culturais do fenomeno. Identificou-se que a taxa de consumo, tipo da droga, idade, mortalidade e comorbidade foram aspectos responsaveis pelas principais diferencas de genero. Especificamente em grupos de mulheres, foram identificadas diferencas relacionadas ao tipo de droga versus idade e procura por tratamento versus tipo de atividade desenvolvida pela unidade de saude. Os dados demonstram que a assistencia as pessoas usuarias de drogas deve contemplar especificidades individuais e de grupos.

Discriminação racial no cuidado em saúde reprodutiva na percepção de mulheres

Racial discrimination can influence the functioning of the health services and the relationships between health professionals and service users, and may be reproduced imperceptibly, through how the people in the vicinity are treated. This study aimed to describe womens perception about racial discrimination in health care practices in reproductive health. It is an exploratory-descriptive study, with a qualitative approach. The information was collected in a Primary Health Care Center in Salvador, Bahia, Brazil in 2010, through semi-structured interviews held with 25 women. The technique of thematic analysis was used for analyzing the discourses. The analysis revealed situations of discrimination experienced or witnessed by the women in the reproductive health services and recognition of discrimination related to race/color and to social class. Despite there being perception of racial discrimination, the women had difficulty in recognizing that they suffered such practices, evidencing the naturalization of racial inequalities in reproductive health care. DESCRIPTORS: Perception. Reproductive health. Nursing. Race and health.

Vulnerability of women in common-law marriage to becoming infected with HIV/AIDS: a study of social representations

Se discuten representaciones sociales de mujeres en union heterosexual estable, respecto de vulnerabilidad a infeccion por VIH/SIDA. Datos generados a partir de asociacion libre de palabras, constituyendose en muestra de investigacion fundamentada en Teoria de las Representaciones Sociales, desarrollada con mujeres seronegativas para VIH, de capital e interior de Bahia. El analisis factorial de correspondencia revelo significatividad para: procedencia, escolaridad y tiempo de union. La aceptacion de la traicion surgio como factor de vulnerabilidad para participantes con 1-5 anos de union estable del interior. Las mujeres de capital con 6-10 anos de union representan a la monogamia como forma de prevencion. Mujeres con mayor tiempo de union y escolaridad basica se auto-representan como invulnerables, al contrario de aquellas con 1-5 anos de union y escolarizacion media. Los resultados sugieren aumentar acciones para desnaturalizar coerciones socioculturales que engendran representaciones y favorecen la exposicion de la mujer en union estable al SIDA.This article discusses the social representations of women living in common-law marriage in terms of their vulnerability to becoming infected with HIV/AIDS. Data were obtained through the free association of words, and consisted of an excerpt of a study founded on the Social Representations Theory developed with HIV-negative women living in the state capital and cities in the interior of Bahia. The correspondence factor analysis showed significance for the variables: origin, education level and time spent in common-law marriage. Their acceptance of marital affairs emerged as a vulnerability factor for respondents with one to five years spent in common-law marriage, living in cities in the interior. Women from the capital, with 6-10 years spent in common-law marriage, reported monogamy as a form of prevention. Women with a longer common-law marriage who had completed only a primary education reported feeling invulnerable, which was the opposite of those with one to five years in common-law marriage with a secondary education. Results show there is a need for more interventions aiming to denaturalize the socio-cultural coercions that generate representations and make women in common-law marriages more vulnerable to AIDS.

The interference of the care context with the visibility of the drug consumption by women.

Considerando a crescente demanda por assistencia a drogadicao feminina e sua internacionalmente reconhecida especificidade, este estudo qualitativo, realizado em Salvador-Ba, no periodo de outubro/2003 a setembro/2004, com profissionais de saude, propoe investigar se o contexto assistencial em que eles se encontram interfere na visibilidade do consumo feminino de drogas. Atraves da observacao participante e da analise de conteudo de entrevistas com dezenove profissionais, revelaram-se situacoes especificas quanto a visibilidade de mulheres usuarias de acordo com o local de atendimento (“instituicao” versus “rua”). Diferencas na percepcao da demanda, tipo de droga utilizado, idade, papeis sociais desempenhados e influencia do parceiro para inicio e manutencao do consumo de drogas demonstraram que o contexto assistencial influencia na representacao daqueles profissionais sobre as usuarias de drogas, o que pode interferir nas estrategias assistenciais implementadas. Recomenda-se a articulacao entre os dois contextos assistenciais na unidade estudada e desta com outros servicos de saude.