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巴西长途卡车司机对艾滋病毒/艾滋病的认知及易感性

Meanings and vulnerability to HIV/AIDS among long-distance truck drivers in Brazil.

作者信息

Magno Laio, Castellanos Marcelo Eduardo Pfeiffer

机构信息

Departamento de Ciências da Vida. Universidade do Estado da Bahia. Salvador, BA, Brasil.

Instituto de Saúde Coletiva. Universidade Federal da Bahia. Salvador, BA, Brasil.

出版信息

Rev Saude Publica. 2016 Dec 22;50:76. doi: 10.1590/S1518-8787.2016050006185.

Abstract

OBJECTIVE

To understand the meanings assigned by long-distance truck drivers to HIV/AIDS and its transmission and prevention, bearing in mind different contexts of vulnerability.

METHODS

Qualitative research with 22 truck drivers. Semi-structured interviews and participant observation were conducted in highways of the state of Bahia in 2013. We selected male truck drivers, with one year or more of work experience in long-distance routes. We carried out the thematic analysis of the interviews, to identify different contexts of vulnerability.

RESULTS

The results showed that the insertion of truck drivers in contexts of high social vulnerability (poor working conditions, violence on the roads, and use of alcohol and other drugs) along with the advances in access and effectiveness of treatment for AIDS promote a reduced perception of the risk and severity of this disease. In addition, the notion of "risk group" and the symbolic division between "home space" (protected) and "street space" (unprotected) intensified a restricted and specific use of condoms, guided by the opposition between "woman of the street" (unknown women, prostitutes, among others) and "woman of the house" (wives, girlfriends).

CONCLUSIONS

The meanings assigned by truckers to AIDS incorporated elements of recent transformations of the expanded social context, such as the development of health technologies (especially anti-retroviral drugs) and the guarantee of free access to treatment in the Brazilian public health system; but also incorporated old elements of social vulnerability context - such as the poor working conditions on Brazilian highways.

OBJETIVO

Compreender os significados atribuídos pelos caminhoneiros de rota longa ao HIV/aids e à sua transmissão e prevenção, tendo em vista diferentes contextos de vulnerabilidade.

MÉTODOS: Pesquisa qualitativa com 22 caminhoneiros. Foram realizadas entrevistas semi-estruturadas e observação participante em rodovias do estado da Bahia em 2013. Foram selecionados caminhoneiros do sexo masculino, com um ano ou mais de experiência de trabalho em rotas de longa distância. Realizou-se análise temática das entrevistas, orientada para identificação de diferentes contextos de vulnerabilidade.

RESULTADOS

Os resultados mostraram que a inserção dos caminhoneiros em contextos de alta vulnerabilidade social (más condições de trabalho, violência nas estradas e uso de álcool e outras drogas) e os avanços no acesso e efetividade do tratamento para aids favorecem a minimização da percepção de risco e gravidade dessa doença. Além disso, a noção de "grupo de risco" e a divisão simbólica entre "espaço da casa" (protegido) e "espaço da rua" (desprotegido) intensificaram um uso restrito e específico do preservativo, orientado pela oposição entre "mulher do mundo" (desconhecidas, prostitutas, entre outros) e "mulher de casa" (esposas, namoradas).

CONCLUSÕES: Os significados atribuídos pelos caminhoneiros à aids incorporaram elementos de transformações recentes do contexto social ampliado, como o desenvolvimento de tecnologias em saúde (com destaque para os antirretrovirais) e a garantia de acesso gratuito ao tratamento no sistema público de saúde no Brasil; mas também incorporaram antigos elementos do contexto de vulnerabilidade social - a exemplo das más condições de trabalho nas estradas brasileiras.

摘要

目的

考虑到不同的脆弱性背景,了解长途卡车司机赋予艾滋病毒/艾滋病及其传播与预防的意义。

方法

对22名卡车司机进行定性研究。2013年在巴伊亚州的高速公路上进行了半结构化访谈和参与观察。我们选择了有一年或一年以上长途路线工作经验的男性卡车司机。我们对访谈进行了主题分析,以确定不同的脆弱性背景。

结果

结果表明,卡车司机处于高度社会脆弱性背景(恶劣的工作条件、道路暴力以及酒精和其他药物的使用),同时艾滋病治疗的可及性和有效性取得进展,这使得他们对该疾病的风险和严重性的认知降低。此外,“风险群体”的概念以及“家庭空间”(受保护)和“街道空间”(无保护)之间的象征性划分,强化了避孕套的有限且特定的使用,这种使用以“街头女性”(陌生女性、妓女等)和“家庭女性”(妻子、女友)之间的对立为导向。

结论

卡车司机赋予艾滋病的意义纳入了广泛社会背景近期转变的要素,如卫生技术的发展(特别是抗逆转录病毒药物)以及巴西公共卫生系统中免费治疗的保障;但也纳入了社会脆弱性背景的旧有要素,例如巴西高速公路上恶劣的工作条件。

目标

鉴于不同的脆弱性背景,理解长途卡车司机赋予艾滋病毒/艾滋病及其传播与预防的意义。

方法

对22名卡车司机进行定性研究。2013年在巴伊亚州的公路上进行了半结构化访谈和参与观察。选取了有一年或一年以上长途路线工作经验的男性卡车司机。对访谈进行了主题分析,旨在识别不同的脆弱性背景。

结果

结果显示,卡车司机身处高度社会脆弱性背景(工作条件差、道路暴力以及酒精和其他药物的使用),且艾滋病治疗的可及性和有效性有所进步,这有利于降低对该疾病风险和严重性的认知。此外,“风险群体”的概念以及“家庭空间”(受保护)与“街道空间”(无保护)之间的象征性划分,强化了避孕套的有限且特定的使用,其导向是“社会女性”(陌生女性、妓女等)与“家庭女性”(妻子、女友)之间的对立。

结论

卡车司机赋予艾滋病的意义包含了广泛社会背景近期变革的要素,如卫生技术的发展(尤其是抗逆转录病毒药物)以及巴西公共卫生系统中免费治疗的保障;但也包含了社会脆弱性背景的旧有要素,例如巴西公路上恶劣的工作条件。

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