José Ricardo Ayres

A sexualidade de adolescentes vivendo com HIV: direitos e desafios para o cuidado

Sexuality and reproductive healthcare represent relevant issues for comprehensive care of HIV-positive adolescents. However, public policies and health services give this issue insufficient attention. The scope of this article is to assess how HIV-positive young people and teenagers cope with their sexuality, dating and the urge to have children and start a family. In a qualitative study, in-depth interviews were staged with 21 HIV-positive (contracted by vertical, sexual or intravenous transmission) teenagers and 13 caregivers of children and youths living in Sao Paulo and Santos. The interviews revealed the different ways teenagers cope with their sexuality and with the anxiety of HIV disclosure in this context. Lack of information about HIV prevention, lack of support and skills to cope with their sexuality were revealed in the reports. Furthermore, stigma and discrimination were the most frequently reported difficulties. The main challenges to be faced in Brazil in regard to this issue are discussed, especially the need to consider HIV-positive youth as entitled to sexual rights. Recommendations are also made for incorporating the issue into a humanized and comprehensive care approach for HIV-positive children and young people.

Significados e sentidos das práticas de saúde: a ontologia fundamental e a reconstrução do cuidado em saúde

O cuidado em saude tem sido um tema abordado atualmente por autores da Saude Coletiva. Essas praticas e estudos refletem dois modos aparentemente antagonicos de se conceber o cuidado, ora baseado na instrumentalidade, com enfase nos procedimentos e nas intervencoes tecnicas, ora com foco na relacao de encontro entre profissionais e usuarios dos servicos de saude. A partir de uma leitura critica desse conjunto de estudos, procura-se nao opor os dois grupos identificados, mas articula-los em sua complementaridade por meio da ontologia fundamental de Martin Heidegger. Em Ser e Tempo, Heidegger desconstroi a ontologia tradicional para reconstruir uma nova ontologia que busque os fundamentos da existencia humana. Um retorno aos fundamentos mostra-se essencial para uma reconstrucao das praticas de saude e do cuidado.Healthcare is a topic currently being dealt with by authors within the field of public health. These practices and studies reflect two ways of conceiving of care that are apparently antagonistic. They are sometimes based on instrumentality, with emphasis on procedures and technical interventions, and sometimes with a focusing on the relationship between healthcare professionals and healthcare service users. Based on critical reading of this collection of studies, the aim of the present study was, rather than contrasting the two groups identified, to link them in their complementarity through using Martin Heideggers fundamental ontology. In Being and Time, Heidegger deconstructs the traditional ontology, to reconstruct a new ontology that seeks the fundamentals of human existence. Returning to these fundamentals can be seen to be essential for reconstructing healthcare and its practices.

Significados y sentidos de las prácticas de salud: la ontología fundamental y la reconstrucción del cuidado en salud

O cuidado em saude tem sido um tema abordado atualmente por autores da Saude Coletiva. Essas praticas e estudos refletem dois modos aparentemente antagonicos de se conceber o cuidado, ora baseado na instrumentalidade, com enfase nos procedimentos e nas intervencoes tecnicas, ora com foco na relacao de encontro entre profissionais e usuarios dos servicos de saude. A partir de uma leitura critica desse conjunto de estudos, procura-se nao opor os dois grupos identificados, mas articula-los em sua complementaridade por meio da ontologia fundamental de Martin Heidegger. Em Ser e Tempo, Heidegger desconstroi a ontologia tradicional para reconstruir uma nova ontologia que busque os fundamentos da existencia humana. Um retorno aos fundamentos mostra-se essencial para uma reconstrucao das praticas de saude e do cuidado.Healthcare is a topic currently being dealt with by authors within the field of public health. These practices and studies reflect two ways of conceiving of care that are apparently antagonistic. They are sometimes based on instrumentality, with emphasis on procedures and technical interventions, and sometimes with a focusing on the relationship between healthcare professionals and healthcare service users. Based on critical reading of this collection of studies, the aim of the present study was, rather than contrasting the two groups identified, to link them in their complementarity through using Martin Heideggers fundamental ontology. In Being and Time, Heidegger deconstructs the traditional ontology, to reconstruct a new ontology that seeks the fundamentals of human existence. Returning to these fundamentals can be seen to be essential for reconstructing healthcare and its practices.

Comensalia y cuidado: chicas-jóvenes-mujeres huérfanas en el contexto del VIH/Sida

“Monopoly of the kitchen” is historically and culturally attributed to women and mothers. To care for their families, they select and buy food, and cook and serve it. They sustain commensality. In contexts of HIV/AIDS, when mothers die, the daughters become responsible for such care. What do the girls think of the caregiver’s role that they prematurely have to face? What do their brothers think about this? Semi-structured interviews were conducted with 14 young orphans. The data were analyzed as proposed by Mills (2009). The young women did not show any dissatisfaction with the new tasks that they were doing, but deplored the fact that this impeded them from studying and having a life beyond the home. Their brothers viewed dealing with the kitchen as women’s business and rarely collaborated. These young women need care directed towards the vulnerable situation in which they live. Public health policies could seek macrostructures that would act on this demand.

Meanings and senses of healthcare practices: fundamental ontology and the reconstruction of healthcare

O cuidado em saude tem sido um tema abordado atualmente por autores da Saude Coletiva. Essas praticas e estudos refletem dois modos aparentemente antagonicos de se conceber o cuidado, ora baseado na instrumentalidade, com enfase nos procedimentos e nas intervencoes tecnicas, ora com foco na relacao de encontro entre profissionais e usuarios dos servicos de saude. A partir de uma leitura critica desse conjunto de estudos, procura-se nao opor os dois grupos identificados, mas articula-los em sua complementaridade por meio da ontologia fundamental de Martin Heidegger. Em Ser e Tempo, Heidegger desconstroi a ontologia tradicional para reconstruir uma nova ontologia que busque os fundamentos da existencia humana. Um retorno aos fundamentos mostra-se essencial para uma reconstrucao das praticas de saude e do cuidado.Healthcare is a topic currently being dealt with by authors within the field of public health. These practices and studies reflect two ways of conceiving of care that are apparently antagonistic. They are sometimes based on instrumentality, with emphasis on procedures and technical interventions, and sometimes with a focusing on the relationship between healthcare professionals and healthcare service users. Based on critical reading of this collection of studies, the aim of the present study was, rather than contrasting the two groups identified, to link them in their complementarity through using Martin Heideggers fundamental ontology. In Being and Time, Heidegger deconstructs the traditional ontology, to reconstruct a new ontology that seeks the fundamentals of human existence. Returning to these fundamentals can be seen to be essential for reconstructing healthcare and its practices.

Commensality and care: orphan girls and young women in the context of HIV/Aids

“Monopoly of the kitchen” is historically and culturally attributed to women and mothers. To care for their families, they select and buy food, and cook and serve it. They sustain commensality. In contexts of HIV/AIDS, when mothers die, the daughters become responsible for such care. What do the girls think of the caregiver’s role that they prematurely have to face? What do their brothers think about this? Semi-structured interviews were conducted with 14 young orphans. The data were analyzed as proposed by Mills (2009). The young women did not show any dissatisfaction with the new tasks that they were doing, but deplored the fact that this impeded them from studying and having a life beyond the home. Their brothers viewed dealing with the kitchen as women’s business and rarely collaborated. These young women need care directed towards the vulnerable situation in which they live. Public health policies could seek macrostructures that would act on this demand.