Wilza Vieira Villela

Sobre a experiência sexual dos jovens

The rise in teenage pregnancy and young peoples vulnerability to HIV have been a serious problem. This paper is intended to confront this statement based on its structural concepts (adolescence, youth, teenage pregnancy, and vulnerability) and by a non-exhaustive review of the relevant literature. The current paper discusses the ideas of youth and adolescence to approach the sexuality of young people and adolescents from the perspective of inequalities between different social groups and their access to health and resources for the prevention of diseases like HIV/AIDS as well as contraception. There are multiple paths leading young people to having unprotected sexual relations, and the numbers that surface on pregnancy, STDs, and HIV infection are doubtless lower than the real figures. The data presented herein indicate that the safe-sex approach is still necessary among youth, requiring efforts to produce creative strategies that make sense in different socio-cultural contexts in which young people experience sex.

Contexts of HIV vulnerability among Brazilian women

This article aims to identify contexts of vulnerability related to HIV among Brazilian women. From November 2003 to December 2004, a cross-sectional study was conducted in 13 municipalities in the five Brazilian regions. The study included 1,777 women with a positive HIV diagnosis and 2,045 women attending public health care services. There were no significant differences between the two groups concerning number of sexual partners. However, HIV-positive women had a history of earlier sexual initiation and lower frequency of condom use. Higher proportions of HIV-positive women had used drugs, had a history of previous STDs, and had been victims of sexual violence some time in their life. The findings suggest the importance of considering strategies for HIV prevention focused on womens empowerment as a whole, and not focused only on their individual behaviors.

Conquistas e desafios no atendimento das mulheres que sofreram violência sexual

This article analyzes treatment for female victims of sexual violence, with a focus on partnerships between government and the organized womens movement. The central references are the specific literature and testimony by key social actors who have participated in this process. The results show that despite the real and symbolic importance of care for rape victims, the government and the womens movement have not succeeded in guaranteeing the expansion of these services or adequately linking the discussion of sexual violence to womens right to abortion under any circumstances. It is thus necessary to step up the measures on this agenda.

Key aspects of sexual behavior and safer sex practice among men from the city of São Paulo.

Heterosexual relations currently constitute the predominant route of HIV transmission to women in Brazil. Few studies have approached male sexual behavior taking women into account. This study included 597 men ages 21 to 50 in São Paulo city and explored several aspects pertaining to safer sex, such as sexual partners, knowledge of sexually transmitted diseases (STDs)/AIDS, risk perception, and protective practices aimed at AIDS prevention. The results showed that, similar to other countries, the proportion of men who have sex with men is low (5%), that younger men adopt more protective behavior than older men regarding multiple partners and condom use, that knowledge of AIDS is widespread (but that there is still a lack of knowledge concerning STDs in general), and that although risk perception increases protective behavior, presumption of the partners behavior influences this perception, placing men and women in a vulnerable situation.

Ambiguidades e contradições no atendimento de mulheres que sofrem violência

Este artigo discute o atendimento a mulheres em situacoes de violencia por servicos de saude e de seguranca publica. Tem como pressuposto que as atuais politicas de enfrentamento da violencia contra as mulheres preveem acoes dessas duas instituicoes. Baseia-se na analise de tres elementos que compoem a pratica: o espaco fisico, o fluxo dos servicos e a percepcao dos profissionais em relacao as usuarias. Seus dados foram obtidos em estudo qualitativo realizado em unidades basicas de saude, servicos de emergencia de hospitais publicos, delegacias especializadas no atendimento a mulheres e distritos policiais de uma regiao da cidade de Sao Paulo. A coleta de dados incluiu observacao nao participante e entrevistas com profissionais. Os resultados apontam que o atendimento as mulheres que sofrem violencia e marcado por ambiguidades e contradicoes; os espacos e fluxos de trabalho sao pouco adequados a tarefa tao sensivel e a percepcao dos profissionais e permeada por estereotipos de genero. Isso sugere que o enfrentamento da violencia contra as mulheres exige a reconfiguracao das praticas de trabalho, com educacao permanente para os profissionais e mudancas nos processos de trabalho.

Discrimination, stigma, and AIDS: a review of academic literature produced in Brazil (2005-2010)

Given the implications of stigma for HIV/AIDS prevention and control of the epidemic, as emphasized by UNAIDS, this study analyzes the Brazilian academic production on health, AIDS, stigma, and discrimination, available in the SciELO database from 2005 to 2010. Brazilian research on the theme is modest as compared to the international literature, but the studies follow the same trend of focusing on individual experiences of discrimination as opposed to analysis of stigma and discrimination as social processes associated with power relations and domination (macro-social structures) and the characteristics of individuals and social groups that shape social interactions. The current study seeks to analyze the reasons for the scarcity of studies on the social perspective towards stigma and discrimination in the field of public health and the implications for the development of proposals to deal with HIV/AIDS-related discrimination.Frente as implicacoes do estigma para a prevencao e o controle da epidemia de HIV/AIDS, destacada pela UNAIDS, este trabalho analisa a producao academica nacional sobre saude, AIDS, estigma e discriminacao, disponivel no SciELO, de 2005 a 2010. Constatou-se que a literatura sobre o tema nao e expressiva, quando comparada a literatura internacional; no entanto, os trabalhos seguem a mesma tendencia de privilegiar as experiencias individuais de discriminacao, em detrimento da analise do estigma e da discriminacao como processos sociais, associados as relacoes de poder e dominacao (estruturas macrossociais), assim como as caracteristicas dos individuos e grupos sociais que conformam as interacoes sociais. O trabalho busca analisar as razoes para a escassez de estudos sobre a perspectiva social do estigma e da discriminacao no campo da saude publica, e suas implicacoes para o desenvolvimento de propostas de enfrentamento da discriminacao associada ao HIV/AIDS.

Induced abortion in women of reproductive age living with and without HIV/Aids in Brazil

This study aimed to identify and compare the characteristics of women living (WLHA) and not living with HIV/AIDS (WNLHA) regarding the report of lifetime induced abortion. Data from 1,777 MVHA and 2,045 MNVHA were collected between November 2003 and December 2004 during a cross-sectional study carried out in 13 municipalities of Brazil. After adjustment for confounding variables, 13.3% of MVHA versus 11.0% of MNVHA reported induced abortion in their lifetime (p>0.05). In multivariate analysis, independent correlates of lifetime induced abortion for both groups were: age, with older women reporting greater proportions of reporting induced abortion, living in the North region of Brazil, age at sexual debut (up to 17 years old), having three or more lifetime sexual partners, having ever used drugs and self-reporting occurrence of sexually transmitted diseases. The results suggest that, in general, the characteristics of women who reported induced abortion in both groups were similar, and that the contexts associated to HIV infection and to reproductive practices and decisions among women might share similarities.

Beyond stereotypes of Brazilian male sexuality: Qualitative and quantitative findings from São Paulo, Brazil

This study examined aspects of male sexuality in São Paulo using both qualitative and quantitative methods. It commences with an outline of some key tenets of emerging perspectives on male sexuality in Brazil and contemporary issues such as sexual orientation, first intercourse, perception of male sexual nature, sexual philosophies (with particular reference to gender and the double standard) and number of sexual partners. The findings show evidence for some aspects of traditional stereotypes, but also evidence of more gender-liberal and sexually monogamous traits among many men in São Paulo. Care needs to be taken against over-generalization regarding male sexuality in Brazil.

A configuração da rede social de mulheres em situação de violência doméstica

This article presents the configuration of the social network of women living in domestic violence situations in a city in the metropolitan region of São Paulo, Brazil. Interviews were conducted with 9 women and 8 professionals, in addition to observation in three institutions which constitute the network for protection of women. The analysis was underpinned by the theoretical assumptions of social networks. Results show that violence inflicted upon women by their partners make them unable to establish and maintain social bonds, and thus face isolation and ostracism. Professionals and institutions can play a vital role for getting women out of the cycle of violence provided that care networks and services are well organized. Further studies of social networks, focusing on the nature of the links and exchanges among actors may contribute to acquiring knowledge about the relationship dynamics in situation of violence.

A incorporação de novos temas e saberes nos estudos em saúde coletiva: o caso do uso da categoria gênero

This article aims to reflect how gender as a category has been incorporated into academic public health studies. The discussion is based on some characteristics of the public health area, such as: interdisciplinary approach, commitment to the demands of society; dialogue with health professionals and connection with health policies implemented in the country. With this in mind, a review of articles from the SciELO database was made referring to gender and health as descriptors. The articles were classified in terms of their focal theme, methods, groups studied and use of gender category. The results reveal some heterogeneity in the use of the category in the studies selected that eventually could be explained by the particularities of the area. Based on this discussion, this article intends to foster a reflection on the ways to improve a gender approach in public health studies so as to overcome the existing differences between knowledge accrued in various fields.