Oliveira Isadora Borges Nolasco
Grupo de Apoio à Prevenção à AIDS da Bahia, Salvador, Brasil.
Cad Saude Publica. 2009;25 Suppl 2:S259-68. doi: 10.1590/s0102-311x2009001400008.
Since 1996, Brazil has implemented internationally acknowledged policies such as universal access to specialized treatment for HIV/AIDS. However, the initiative's impact has been unequal if one compares different population segments and regions of the country. Taking a gender perspective, the current study seeks to evaluate access to a specialized HIV/AIDS service in Salvador, Bahia, identifying facilitating factors and obstacles to access and continuity of care, as experienced by women living with HIV/AIDS. Participant observation and semi-structured and open-ended interviews with 13 women were used. The findings indicate that the organization of routine work in the clinic and the relations between users and the service and the health staff were conditioned by values, concepts, and practices related to gender, class, and appearance. The access to (and continuity of) care in the HIV/AIDS Clinic in Salvador were gender-focused and conditioned on the availability of social and symbolic goods; the clinic showed a limited capacity to adjust to the users' specificities. The findings point to limitations in the operationalization of policies for universal access and reinforce the need for studies that consider the notion of vulnerability and regionalization of the epidemic in Brazil.
自1996年以来，巴西实施了诸如普及艾滋病毒/艾滋病专科治疗等国际公认的政策。然而，如果比较该国不同的人口群体和地区，该倡议的影响并不均衡。从性别角度出发，本研究旨在评估巴伊亚州萨尔瓦多市艾滋病毒/艾滋病专科服务的可及性，确定感染艾滋病毒/艾滋病的女性在获得护理及护理连续性方面的促进因素和障碍。研究采用了参与观察法，并对13名女性进行了半结构化和开放式访谈。研究结果表明，诊所日常工作的组织以及服务使用者与医护人员之间的关系受到与性别、阶级和外貌相关的价值观、观念及行为的制约。萨尔瓦多市艾滋病毒/艾滋病诊所的护理可及性（及连续性）以性别为重点，并取决于社会和象征物品的可得性；该诊所适应使用者特殊性的能力有限。研究结果指出了普及政策实施过程中的局限性，并强化了开展相关研究的必要性，这些研究应考虑巴西的脆弱性概念和艾滋病流行的区域化情况。
