O serviço de Atenção Básica como o "terreiro" da casa: lugar, gênero e sexualidade nas práticas de saúde em HIV/aids em um contexto interiorano

Abstract

INTRODUCTION: The emergence of a new disease in the early 1980s, identified by the acronym Aids (Acquired Immunodeficiency Syndrome), has brought about significant changes in many fields beyond health, mainly by combining sexual behavior and disease, giving greater visibility to issues related to sexuality , considering the sexual route, one of the main forms of transmission. The spread of HIV infection (the human immunodeficiency virus), the cause of AIDS, in Brazil manifested itself as an epidemic with multiple dimensions resulting from the deep social inequalities of the country with significant changes in its epidemiological profile. Among these is the internalization, with the geographical diffusion of the disease from the great urban centers to the municipalities of the interior of the country. Considering the historical aspects and the experience as a nurse of a Family Health Center, in the hinterland of the Brazilian Northeast, this study arose from concerns about how health practices related to HIV/AIDS reproduced, in this service, the marginalization and invisibility of the people living with this condition. OBJECTIVE: To understand the place of HIV/AIDS in health practices in the daily life of a Family Health Center (FHC) in the Brazilian Northeast. METHODOLOGY: This is an ethnography, whose fieldwork carried out between July and November of 2018 in a FHC of the municipality of Caicó/RN. The participants involved were the professionals that make up the two family health teams of the FHC. Participant observation, semi-structured interviews, and sociodemographic questionnaire were used. Data were analyzed using the thematic coding technique. RESULTS: The analysis pointed to the invisibility and social erasure of people living with HIV/AIDS (PLHA) in the territory of this service, being associated with: prejudice; the absence of private spaces between professionals and these people; and the continuing education of professionals to deal with the HIV/AIDS condition. Another result was the evidence of the social markers of difference: sexuality, gender, and the context of the place of study as potentiators of issues that reinforce and shape local prejudice and stigma. And, lastly, the difficulty of professionals with work directed at both PLHA and HIV/AIDS in general, possibly being the result of moral values, associated with the absence of permanent education and a municipal health program focused on these issues. CONCLUSION: The approach to the theme provided an overview of an important issue on HIV/AIDS, signaling a fragility of a Primary Care specific health unit to incorporate into its services interventions that address PLHA and the multiple dimensions of HIV/AIDS. Developing the research made possible changes in my view as a professional before limited and restricted to official protocols and manuals. The study becomes a fuel for the path of professional transformation that I have not yet fully attained, but which has already been aware that there is a long way ahead, besides, it has provided instruments that allow me to be a multiplier agent. Finally, it contributes to the discussion of the topic and the current political scenario associated with public health.