Luzia Aparecida Oliveira

Limitations of multiprofessional work: a case study of STD/AIDS reference centers

OBJECTIVE To understand the possibilities and limitations of developing coordinated work among professionals of different background in order to promote work collaboration and improve the quality of care of HIV/AIDS patients. METHODS A qualitative study on multiprofessional work was carried out in five STD/AIDS reference centers in the city of São Paulo, Brazil. Semi-structured interviews were applied to 26 professionals from different background, focusing on how they position their practices in a multiprofessional setting. RESULTS Significant differences were observed as to the outreach of multiprofessional work collaboration and possibilities of improving health care are related to the circumstances the multiprofessional work is done. CONCLUSIONS When the multiprofessional team has to deal with predictable circumstances and the planning of long-term care projects where demands are anticipated from situations found in their practices, this creates better working conditions for effective collaboration. This collaboration favors interventions that promote a more productive interaction between the medical treatment and other relevant dimensions of care, such as social, psychological, and emotional needs of the patients.

Motivos e circunstâncias para o aborto induzido entre mulheres vivendo com HIV no Brasil

The impact of HIV/AIDS infection on the decision of women living with HIV/AIDS to interrupt a pregnancy remains an understudied topic. In an effort to understand the influence of HIV/AIDS diagnosis on abortion practices, a qualitative study was carried out in seven Brazilian municipalities with women living with HIV/AIDS who reported inducing an abortion at some point in their lives. This study presents the analysis of interviews with thirty women who became pregnant after diagnosis. The results show that for some women, infection was the primary motive for terminating their pregnancy, while for others, the motives for abortion were predominantly related to life circumstances. The decision to abort due to HIV infection is not the same for all women. It is related to the timing of the diagnosis and other aspects of the womans life during her pregnancy, such as the relationship with her partner, her job and family support. The results suggest the need for more attention from health services to the reproductive decisions of women living with HIV/Aids; the incorporation of men into sexual and reproductive health prevention actions; and a deeper discussion of the illegality of abortion in Brazil and its harmful consequences for women, men, and children.

Conflitos morais e atenção à saúde em Aids: aportes conceituais para uma ética discursiva do cuidado

Este artigo apresenta aspectos teoricos que sustentam uma etica do Cuidado de base discursiva, como utilizado em estudo que examinou os conflitos morais na assistencia as pessoas vivendo com HIV/Aids. Com base na Bioetica deliberativa, define conflito moral como um conflito de deveres. Foram utilizadas a etica do Discurso e as proposicoes do Cuidado, assumindo que o trabalho em saude e eminentemente relacional e comunicacional. Conclui que a etica do Cuidado de base discursiva reconhece a racionalidade nas decisoes que envolvem aspectos morais no cotidiano da assistencia. A busca de solucao dos conflitos, sob essa perspectiva, sugere um processo dialetico em que as razoes para os argumentos sao consideradas. Evidenciar argumentos diversos, incluindo aqueles que sao contraditorios, mas defensaveis, possibilita a tomada de decisoes prudentes.Este artigo apresenta aspectos teoricos que sustentam uma etica do Cuidado de base discursiva, como utilizado em estudo que examinou os conflitos morais na assistencia as pessoas vivendo com HIV/Aids. Com base na Bioetica deliberativa, define conflito moral como um conflito de deveres. Foram utilizadas a etica do Discurso e as proposicoes do Cuidado, assumindo que o trabalho em saude e eminentemente relacional e comunicacional. Conclui que a etica do Cuidado de base discursiva reconhece a racionalidade nas decisoes que envolvem aspectos morais no cotidiano da assistencia. A busca de solucao dos conflitos, sob essa perspectiva, sugere um processo dialetico em que as razoes para os argumentos sao consideradas. Evidenciar argumentos diversos, incluindo aqueles que sao contraditorios, mas defensaveis, possibilita a tomada de decisoes prudentes.

Testagem anti-HIV: indagações sobre a expansão da oferta sob a perspectiva do acesso e da construção da demanda

Reconhecendo a relevância do incremento na oferta de testagem anti-HIV, problematiza-se a concepcao de oferta a luz dos conceitos de acesso e demanda. O mero foco na oferta da testagem mostra-se insuficiente frente a complexidade e dinamicidade do processo, desde a identificacao da sua necessidade ate a realizacao do teste e seus possiveis desdobramentos, incluindo o tratamento. Ademais, o modelo de campanha para incentivo a testagem nao se coaduna com proposicoes que valorizem o protagonismo social dos cidadaos nem atendam as especificidades da disseminacao da epidemia de AIDS. Postula-se a importância de desenvolver estudos que focalizem mais detidamente a demanda por testagem anti-HIV.

STD/AIDS Prevention and communication processes: a case study in the context of vulnerability

Introduction. The vulnerability in STD/AIDS has proposed not only a new way of dealing with this situation, but also of thinking about sexually transmitted diseases and AIDS prevention strategies. Objective. Since the perception of this vulnerability represents a challenge for prevention practices, strongly based on a verticalization strategy, this paper discusses the experience of a participatory peer education as an STD/AIDS prevention strategy, highlighting the potentialities, possibilities and challenges of dealing with the complexity and dynamism of this reference. Methodology. The experience was taken as a case study and the material produced based on reports received hermeneutic treatment. Results. Tensions were identifi ed in the coordination of the strategy by the governmental institution, as well as 1 Endereço para correspondência: Rua Professor Nehemias Gueiros, 243, apto. 201, Recreio dos Bandeirantes, Rio de Janeiro, RJ, Brasil 22790-030. E-mail: neks@uol.com.br e luzia.ao@uol.com.br Agradecemos o Núcleo de Estudos e Prevenção em Aids (NEPAIDS), por instigar e apoiar refl exões que valorizam a dupla mão entre experiências práticas e produção de conhecimento. Também ressaltamos a cuidadosa e preciosa revisão do texto realizada pelas companheiras Dulce Ferraz e Maria Ines Battistella Nemes. As autoras trabalharam juntas em todas as etapas de elaboração do manuscrito. Silva, N. E. K., Oliveira, L. A. 752 the very idea of “peer” and its identity relations. The dilemmas represented by the wide range of propositions regarding vulnerability were also highlighted. Conclusion. In conclusion, we stress that investment in the communication dimensions of peer prevention, through the enrichment of argumentative repertoires, was fruitful.Introduction. The vulnerability in STD/AIDS has proposed not only a new way of dealing with this situation, but also of thinking about sexually transmitted diseases and AIDS prevention strategies. Objective. Since the perception of this vulnerability represents a challenge for prevention practices, strongly based on a verticalization strategy, this paper discusses the experience of a participatory peer education as an STD/AIDS prevention strategy, highlighting the potentialities, possibilities and challenges of dealing with the complexity and dynamism of this reference. Methodology. The experience was taken as a case study and the material produced based on reports received hermeneutic treatment. Results. Tensions were identifi ed in the coordination of the strategy by the governmental institution, as well as 1 Endereco para correspondencia: Rua Professor Nehemias Gueiros, 243, apto. 201, Recreio dos Bandeirantes, Rio de Janeiro, RJ, Brasil 22790-030. E-mail: neks@uol.com.br e luzia.ao@uol.com.br Agradecemos o Nucleo de Estudos e Prevencao em Aids (NEPAIDS), por instigar e apoiar refl exoes que valorizam a dupla mao entre experiencias praticas e producao de conhecimento. Tambem ressaltamos a cuidadosa e preciosa revisao do texto realizada pelas companheiras Dulce Ferraz e Maria Ines Battistella Nemes. As autoras trabalharam juntas em todas as etapas de elaboracao do manuscrito. Silva, N. E. K., Oliveira, L. A. 752 the very idea of “peer” and its identity relations. The dilemmas represented by the wide range of propositions regarding vulnerability were also highlighted. Conclusion. In conclusion, we stress that investment in the communication dimensions of peer prevention, through the enrichment of argumentative repertoires, was fruitful.

Prevenção às DST/AIDS e processos comunicativos: estudo de caso, a partir do quadro da vulnerabilidade

Introduction. The vulnerability in STD/AIDS has proposed not only a new way of dealing with this situation, but also of thinking about sexually transmitted diseases and AIDS prevention strategies. Objective. Since the perception of this vulnerability represents a challenge for prevention practices, strongly based on a verticalization strategy, this paper discusses the experience of a participatory peer education as an STD/AIDS prevention strategy, highlighting the potentialities, possibilities and challenges of dealing with the complexity and dynamism of this reference. Methodology. The experience was taken as a case study and the material produced based on reports received hermeneutic treatment. Results. Tensions were identifi ed in the coordination of the strategy by the governmental institution, as well as 1 Endereço para correspondência: Rua Professor Nehemias Gueiros, 243, apto. 201, Recreio dos Bandeirantes, Rio de Janeiro, RJ, Brasil 22790-030. E-mail: neks@uol.com.br e luzia.ao@uol.com.br Agradecemos o Núcleo de Estudos e Prevenção em Aids (NEPAIDS), por instigar e apoiar refl exões que valorizam a dupla mão entre experiências práticas e produção de conhecimento. Também ressaltamos a cuidadosa e preciosa revisão do texto realizada pelas companheiras Dulce Ferraz e Maria Ines Battistella Nemes. As autoras trabalharam juntas em todas as etapas de elaboração do manuscrito. Silva, N. E. K., Oliveira, L. A. 752 the very idea of “peer” and its identity relations. The dilemmas represented by the wide range of propositions regarding vulnerability were also highlighted. Conclusion. In conclusion, we stress that investment in the communication dimensions of peer prevention, through the enrichment of argumentative repertoires, was fruitful.Introduction. The vulnerability in STD/AIDS has proposed not only a new way of dealing with this situation, but also of thinking about sexually transmitted diseases and AIDS prevention strategies. Objective. Since the perception of this vulnerability represents a challenge for prevention practices, strongly based on a verticalization strategy, this paper discusses the experience of a participatory peer education as an STD/AIDS prevention strategy, highlighting the potentialities, possibilities and challenges of dealing with the complexity and dynamism of this reference. Methodology. The experience was taken as a case study and the material produced based on reports received hermeneutic treatment. Results. Tensions were identifi ed in the coordination of the strategy by the governmental institution, as well as 1 Endereco para correspondencia: Rua Professor Nehemias Gueiros, 243, apto. 201, Recreio dos Bandeirantes, Rio de Janeiro, RJ, Brasil 22790-030. E-mail: neks@uol.com.br e luzia.ao@uol.com.br Agradecemos o Nucleo de Estudos e Prevencao em Aids (NEPAIDS), por instigar e apoiar refl exoes que valorizam a dupla mao entre experiencias praticas e producao de conhecimento. Tambem ressaltamos a cuidadosa e preciosa revisao do texto realizada pelas companheiras Dulce Ferraz e Maria Ines Battistella Nemes. As autoras trabalharam juntas em todas as etapas de elaboracao do manuscrito. Silva, N. E. K., Oliveira, L. A. 752 the very idea of “peer” and its identity relations. The dilemmas represented by the wide range of propositions regarding vulnerability were also highlighted. Conclusion. In conclusion, we stress that investment in the communication dimensions of peer prevention, through the enrichment of argumentative repertoires, was fruitful.

Prevención a las DST/Sida y procesos comunicativos: estudio de caso, a partir del cuadro de la vulnerabilidad

Introduction. The vulnerability in STD/AIDS has proposed not only a new way of dealing with this situation, but also of thinking about sexually transmitted diseases and AIDS prevention strategies. Objective. Since the perception of this vulnerability represents a challenge for prevention practices, strongly based on a verticalization strategy, this paper discusses the experience of a participatory peer education as an STD/AIDS prevention strategy, highlighting the potentialities, possibilities and challenges of dealing with the complexity and dynamism of this reference. Methodology. The experience was taken as a case study and the material produced based on reports received hermeneutic treatment. Results. Tensions were identifi ed in the coordination of the strategy by the governmental institution, as well as 1 Endereço para correspondência: Rua Professor Nehemias Gueiros, 243, apto. 201, Recreio dos Bandeirantes, Rio de Janeiro, RJ, Brasil 22790-030. E-mail: neks@uol.com.br e luzia.ao@uol.com.br Agradecemos o Núcleo de Estudos e Prevenção em Aids (NEPAIDS), por instigar e apoiar refl exões que valorizam a dupla mão entre experiências práticas e produção de conhecimento. Também ressaltamos a cuidadosa e preciosa revisão do texto realizada pelas companheiras Dulce Ferraz e Maria Ines Battistella Nemes. As autoras trabalharam juntas em todas as etapas de elaboração do manuscrito. Silva, N. E. K., Oliveira, L. A. 752 the very idea of “peer” and its identity relations. The dilemmas represented by the wide range of propositions regarding vulnerability were also highlighted. Conclusion. In conclusion, we stress that investment in the communication dimensions of peer prevention, through the enrichment of argumentative repertoires, was fruitful.Introduction. The vulnerability in STD/AIDS has proposed not only a new way of dealing with this situation, but also of thinking about sexually transmitted diseases and AIDS prevention strategies. Objective. Since the perception of this vulnerability represents a challenge for prevention practices, strongly based on a verticalization strategy, this paper discusses the experience of a participatory peer education as an STD/AIDS prevention strategy, highlighting the potentialities, possibilities and challenges of dealing with the complexity and dynamism of this reference. Methodology. The experience was taken as a case study and the material produced based on reports received hermeneutic treatment. Results. Tensions were identifi ed in the coordination of the strategy by the governmental institution, as well as 1 Endereco para correspondencia: Rua Professor Nehemias Gueiros, 243, apto. 201, Recreio dos Bandeirantes, Rio de Janeiro, RJ, Brasil 22790-030. E-mail: neks@uol.com.br e luzia.ao@uol.com.br Agradecemos o Nucleo de Estudos e Prevencao em Aids (NEPAIDS), por instigar e apoiar refl exoes que valorizam a dupla mao entre experiencias praticas e producao de conhecimento. Tambem ressaltamos a cuidadosa e preciosa revisao do texto realizada pelas companheiras Dulce Ferraz e Maria Ines Battistella Nemes. As autoras trabalharam juntas em todas as etapas de elaboracao do manuscrito. Silva, N. E. K., Oliveira, L. A. 752 the very idea of “peer” and its identity relations. The dilemmas represented by the wide range of propositions regarding vulnerability were also highlighted. Conclusion. In conclusion, we stress that investment in the communication dimensions of peer prevention, through the enrichment of argumentative repertoires, was fruitful.

Moral conflicts and AIDS healthcare: conceptual contributions to a discourse ethics of care

Este artigo apresenta aspectos teoricos que sustentam uma etica do Cuidado de base discursiva, como utilizado em estudo que examinou os conflitos morais na assistencia as pessoas vivendo com HIV/Aids. Com base na Bioetica deliberativa, define conflito moral como um conflito de deveres. Foram utilizadas a etica do Discurso e as proposicoes do Cuidado, assumindo que o trabalho em saude e eminentemente relacional e comunicacional. Conclui que a etica do Cuidado de base discursiva reconhece a racionalidade nas decisoes que envolvem aspectos morais no cotidiano da assistencia. A busca de solucao dos conflitos, sob essa perspectiva, sugere um processo dialetico em que as razoes para os argumentos sao consideradas. Evidenciar argumentos diversos, incluindo aqueles que sao contraditorios, mas defensaveis, possibilita a tomada de decisoes prudentes.Este artigo apresenta aspectos teoricos que sustentam uma etica do Cuidado de base discursiva, como utilizado em estudo que examinou os conflitos morais na assistencia as pessoas vivendo com HIV/Aids. Com base na Bioetica deliberativa, define conflito moral como um conflito de deveres. Foram utilizadas a etica do Discurso e as proposicoes do Cuidado, assumindo que o trabalho em saude e eminentemente relacional e comunicacional. Conclui que a etica do Cuidado de base discursiva reconhece a racionalidade nas decisoes que envolvem aspectos morais no cotidiano da assistencia. A busca de solucao dos conflitos, sob essa perspectiva, sugere um processo dialetico em que as razoes para os argumentos sao consideradas. Evidenciar argumentos diversos, incluindo aqueles que sao contraditorios, mas defensaveis, possibilita a tomada de decisoes prudentes.

Conflitos morales y atención a la salud en el sida: aportes conceptuales para una ética discursiva del cuidado

Este artigo apresenta aspectos teoricos que sustentam uma etica do Cuidado de base discursiva, como utilizado em estudo que examinou os conflitos morais na assistencia as pessoas vivendo com HIV/Aids. Com base na Bioetica deliberativa, define conflito moral como um conflito de deveres. Foram utilizadas a etica do Discurso e as proposicoes do Cuidado, assumindo que o trabalho em saude e eminentemente relacional e comunicacional. Conclui que a etica do Cuidado de base discursiva reconhece a racionalidade nas decisoes que envolvem aspectos morais no cotidiano da assistencia. A busca de solucao dos conflitos, sob essa perspectiva, sugere um processo dialetico em que as razoes para os argumentos sao consideradas. Evidenciar argumentos diversos, incluindo aqueles que sao contraditorios, mas defensaveis, possibilita a tomada de decisoes prudentes.Este artigo apresenta aspectos teoricos que sustentam uma etica do Cuidado de base discursiva, como utilizado em estudo que examinou os conflitos morais na assistencia as pessoas vivendo com HIV/Aids. Com base na Bioetica deliberativa, define conflito moral como um conflito de deveres. Foram utilizadas a etica do Discurso e as proposicoes do Cuidado, assumindo que o trabalho em saude e eminentemente relacional e comunicacional. Conclui que a etica do Cuidado de base discursiva reconhece a racionalidade nas decisoes que envolvem aspectos morais no cotidiano da assistencia. A busca de solucao dos conflitos, sob essa perspectiva, sugere um processo dialetico em que as razoes para os argumentos sao consideradas. Evidenciar argumentos diversos, incluindo aqueles que sao contraditorios, mas defensaveis, possibilita a tomada de decisoes prudentes.