ABSTRACT Drawing on ethnographic research conducted from 2011 to 2015 and the authors’ long-term ... more ABSTRACT Drawing on ethnographic research conducted from 2011 to 2015 and the authors’ long-term engagement in diverse aspects of HIV and human rights advocacy in Brazil, this paper explores key elements of the Brazilian sex workers’ movement response to HIV and the broader political factors that profoundly influenced its trajectory. We argue that the movement has constantly challenged representations of prostitution by affirming sex workers’ roles as political actors, not just peer educators, in fighting the HIV epidemic and highlight their development of a sex positive and pleasure centred response that fought stigma on multiple fronts. Moments of tension such as the censorship of an HIV prevention campaign and implementation of ‘test and treat’ projects are analysed, as are the complex questions that Brazil’s 2016 political and economic crisis evokes in terms of how to develop and sustain responses to HIV driven by communities but with material commitment from the State. We conclude with what we see to be the unique, central components of Brazilian sex workers’ approach to HIV prevention and what lessons can be learned from it for broader collective health movements in Latin America and beyond.
Worldwide, HIV prevention is challenged to change because clinical trials show the protective eff... more Worldwide, HIV prevention is challenged to change because clinical trials show the protective effect of technologies such as circumcision, preexposure prophylaxis, and the suppression of viral load through antiretroviral treatment. In the face of demands for their implementation on population levels, the fear of stimulating risk compensation processes and of increasing riskier sexual practices has retarded their integration into prevention programs. In this article, following a narrative review of the literature on risk compensation using the PubMed database, we offer a critical reflection on the theme using a constructionist approach of social psychology integrated to the theoretical framework of vulnerability and human rights. The use of biomedical technologies for prevention does not consistently induce its users to the increase of riskier practices, and variations on the specificity of each method need to be carefully considered. Alternatives to the theories of sociocognitive studies, such as social constructionist approaches developed in the social sciences and humanities fields, indicate more comprehensive interpretations, valuing the notions of agency and rights. The critical analysis suggests priority actions to be taken in the implementation process: development of comprehensive programs, monitoring and fostering dialog on sexuality, and technical information. We highlight the need to implement a human rights-based approach and to prioritize dialog, stressing how complementary these technologies can be to meet different population needs. We conclude by stressing the need to prioritize sociopolitical changes to restore participation, dialog about sexuality, and emphasis on human rights such as core elements of the Brazilian AIDS policy.
This paper describes an alternative approach to undertaking and evaluating sexual health promotio... more This paper describes an alternative approach to undertaking and evaluating sexual health promotion, focusing on the notion of sexual scenes and scenarios and how these can provide a vantage point from which to examine sexual experience. The concept of sexual scenes provides a context within which to analyse many of the behavioural and epidemiological factors associated with sexual practice. In principle, such an approach provides a tool for conscientization, action and the invention of novel group and individual repertoires that may result in individual and social mobilization for health and/or sexual and reproductive rights. Scenes can be elicited through individual interviews, group interviews and discussions, or through staged and dramatized performance and students' writing. Analysing sexual scenes offers an entry point for dialogue in sexual health promotion programming. Evaluation of these programmes can be part of the process of changing sexual scenarios. Change is witnessed not only through individual changes but, especially in impoverished communities, through challenges to dominant local sexual scenarios and engagement with structural concerns.
This article discusses Aids prevention in Brazil in the midst of growing numbers of cases of the ... more This article discusses Aids prevention in Brazil in the midst of growing numbers of cases of the disease among young people. A study was conducted between 2013 and 2017 to explore the sexual behavior of high school students and their opinions regarding sexuality. The findings show that students have adopted the prevention discourse and that religiosity influences beliefs and values relating to sexual initiation, negatively affecting condom use from the onset of sexual activity. To ensure the right to prevention is upheld, it will be necessary to broaden public understanding about how religion as it is actually lived differs from religious politics. The effects of the reversion to moral discourses reminiscent of the military dictatorship and possible discontinuity of successful longstanding prevention programs targeting young people should be monitored. There is an urgent need to understand the dynamic between the old and new discourses that shape sexualization (often via social media) and access to "combination prevention" of Sexually Transmitted Infections (STI)/Aids.
Este texto discute o curso da epidemia do HIV/Aids nos últimos anos e a revisão de alguns dos pre... more Este texto discute o curso da epidemia do HIV/Aids nos últimos anos e a revisão de alguns dos pressupostos que informaram as ações de preven ção ao HIV. Refletindo a partir das iniciativas de prevenção ao HIV/ AIDS com grupos de jovens e seus educadores em São Paulo em uma dé cada de trabalho, descreve a superação das noções de "grupo de risco " e alguns indicadores dos sucessos do esforço brasileiro diante dos desafios de uma epidemia que cresce ainda entre os mais jovens. O trabalho inici al com alunos de escolas noturnas inspirou inúmeros programas e têm ajudado a estabelecer parâmetros para ações de prevenção, indicadores do contexto e da vulnerabilidade sociais, além de categorias sócioculturais que informam a vida diária e a atividade sexual dos jovens. A partir de ações interativas que focalizam o sexo e a reprodução, as rela ções de gênero e outros temas associados pelos jovens, os projetos lidam com desinformação, emoções, a violência estrutural e os caminhos para a cidadania plena. Destaca-se a receptividade e a cooperação dos vários grupos de jovens em contextos mais vulneráveis, assim como dos adultos envolvidos com eles: escolares, internos da FEBEM, ou agrupados em di ferentes comunidades e atividades. Descritores: AIDS. Prevenção. Jovens. Vulnerabilidade social.
Desenvolvemos uma revisão crítica da literatura sobre o uso recorrente do teste anti-HIV entre ho... more Desenvolvemos uma revisão crítica da literatura sobre o uso recorrente do teste anti-HIV entre homens que fazem sexo com homens (HSH). Procedemos a uma revisão narrativa da literatura, em que analisamos as diversas concepções sobre testagem frequente ao longo do tempo, suas implicações para os programas de saúde e os principais marcadores sociais que influenciam a incorporação do teste anti-HIV como rotina de cuidado. Embora exista desde os anos 1990, a testagem recorrente entre HSH era frequentemente interpretada como exposição aumentada ao HIV em razão da ausência de uso do preservativo e, consequentemente, uma testagem "desnecessária". A partir dos anos 2000, a testagem periódica passou a ser uma recomendação programática e, sua realização, interpretada como meta a ser atingida. A percepção dos indivíduos sobre o uso que faziam do teste foi raramente considerada para caracterizar este uso como rotina de cuidado. No plano social e cultural, aspectos individuais associados ao teste recente ou de rotina estiveram inscritos em contextos de normas favoráveis ao teste e de menor estigma da AIDS. Diferenças geracionais, de escolarização e relacionadas ao tipo de parceria afetivo-sexual desempenham importantes papéis para o teste. Tais diferenças realçam que a categoria epidemiológica "homens que fazem sexo com homens" abrange diversas relações, identidades e práticas que resultam em usos específicos do teste como estratégia de prevenção. Assim, o diálogo entre programas, profissionais de saúde e as pessoas mais afetadas pela epidemia é central à construção de respostas com efetivo potencial de enfrentamento à epidemia de HIV, e pautadas no respeito aos direitos humanos.
This paper offers a critical overview of social science research presented at the 2014 Internatio... more This paper offers a critical overview of social science research presented at the 2014 International AIDS Conference in Melbourne, Australia. In an era of major biomedical advance, the political nature of HIV remains of fundamental importance. No new development can be rolled out successfully without taking into account its social and political context, and consequences. Four main themes ran throughout the conference track on social and political research, law, policy and human rights: first, the importance of work with socially vulnerable groups, now increasingly referred to as "key populations"; second, continued recognition that actions and programs need to be tailored locally and contextually; third, the need for an urgent response to a rapidly growing epidemic of HIV among young people; and fourth, the negative effects of the growing criminalization of minority sexualities and people living with HIV. Lack of stress on human rights and community participation is resulting in poorer policy globally. A new research agenda is needed to respond to these challenges.
Objectives: To describe sexual risk for HIV infection among adult night school students in São Pa... more Objectives: To describe sexual risk for HIV infection among adult night school students in São Paulo, Brazil, and to evaluate the effect of an HIV/AIDS prevention workshop to reduce sexual risk. Subjects and methods: A longitudinal study was conducted among four demographically similar public night schools in the inner city of São Paulo. Schools were randomized into intervention and control conditions. Of 394 young adults who took part in the baseline survey, 304 (77%) completed a postintervention questionnaire. Interventions: In a workshop consisting of four sessions of 3 h each, the students discussed AIDS symbolism, the impact of AIDS on their lives, risk perception, the way in which sexual norms shape knowledge and attitudes, AIDS-related knowledge, reproduction and sexual pleasure, and condom use negotiation. We fostered community-building through AIDS training courses for teachers in the schools, peer support programs and public events. Results: At baseline, 87% had been sexually active at some time and 76% had had sex in the past 6 months. Among those who reported vaginal intercourse and/or anal intercourse, condom use was low. The workshops were positively process-evaluated and supported by the community, the students, their teachers and their parents. We obtained statistically significant effects from the workshops for females only, who reported improved communication with partners about sex and AIDS and less unprotected sex with non-monogamous partners after the intervention. Conclusion: These data show that the sexual risk of HIV infection can be lowered when Brazilian disenfranchized communities support AIDS prevention workshops. Even more impressive results may be achieved if the need to address socioeconomic obstacles and gendered sexual roles is emphasized through further long-term community development programs.
The Brazilian National AIDS Program is widely recognized as the leading example of an integrated ... more The Brazilian National AIDS Program is widely recognized as the leading example of an integrated HIV/AIDS prevention, care, and treatment program in a developing country. We critically analyze the Brazilian experience, distinguishing those elements that are unique to Brazil from the programmatic and policy decisions that can aid the development of similar programs in other low- and middle-income and developing countries.Among the critical issues that are discussed are human rights and solidarity, the interface of politics and public health, sexuality and culture, the integration of prevention and treatment, the transition from an epidemic rooted among men who have sex with men to one that increasingly affects women, and special prevention and treatment programs for injection drug users.
Fragments of a "pandemic life" collected in prevention projects in outer city and school peripher... more Fragments of a "pandemic life" collected in prevention projects in outer city and school peripherical territories in São Paulo introduces this article. The impact of the loss of close people to COVID-19, the spread of false information about prevention and care, and the disorganization of daily life emerged from our sustained interaction with young people. Inequality and unemployment were growing before the pandemic, as was the number of mental health events. By co-producing and promoting integrality in prevention with young people, we have followed the social and community response to the syndemic in the context of online schools and school life under the impact of a decade of attacks on sex education. Sexuality, the theme that gave rise to most prevention projects, was challenging to address. Differently from the AIDS responses, community-territorial identities mobilized "untested feasibilities" for this social and health emergency by associating "resistance" to governmental negligence, violation, and the attack on human rights. Globally, this attack questions human rights universality and indivisibility, using sexuality to reinterpret its emancipatory sense of solidarity in difference. The notion of "psychosocial suffering" allows to deal with the excess of individualization and medicalization of suffering experiences structured by inequalities in this long-lasting context.
Fragments of a "pandemic life" collected in prevention projects in outer city and school peripher... more Fragments of a "pandemic life" collected in prevention projects in outer city and school peripherical territories in São Paulo introduces this article. The impact of the loss of close people to COVID-19, the spread of false information about prevention and care, and the disorganization of daily life emerged from our sustained interaction with young people. Inequality and unemployment were growing before the pandemic, as was the number of mental health events. By co-producing and promoting integrality in prevention with young people, we have followed the social and community response to the syndemic in the context of online schools and school life under the impact of a decade of attacks on sex education. Sexuality, the theme that gave rise to most prevention projects, was challenging to address. Differently from the AIDS responses, community-territorial identities mobilized "untested feasibilities" for this social and health emergency by associating "resistance" to governmental negligence, violation, and the attack on human rights. Globally, this attack questions human rights universality and indivisibility, using sexuality to reinterpret its emancipatory sense of solidarity in difference. The notion of "psychosocial suffering" allows to deal with the excess of individualization and medicalization of suffering experiences structured by inequalities in this long-lasting context.
O direito à prevenção da Aids revisitado em tempos de retrocesso 1/6 réplica Agradecemos os comen... more O direito à prevenção da Aids revisitado em tempos de retrocesso 1/6 réplica Agradecemos os comentários generosos e instigantes de Fernando Seffner; César Abadia-Barrero e Héctor Ruiz-Sánchez; Mônica Franch e Felipe Rios; Cláudia Cárdenas e Ivia Maksud sobre o artigo, que convergem na avaliação sobre o retrocesso nas políticas que, por duas décadas, ampliaram nas escolas o direito à prevenção das IST/Aids baseada em saberes técnico-científicos. Ao responder, ampliaremos a discussão dos resultados mirando os caminhos de menor resistência que o contexto oferece para sustentar o direito à prevenção.
O objetivo do artigo é discutir a territorialização das culturas sexuais homoeróticas em São Paul... more O objetivo do artigo é discutir a territorialização das culturas sexuais homoeróticas em São Paulo, suas redes sociométricas e seu acesso à prevenção. Foi realizado um mapeamento etnográfi co de 58 bares e boates em dois bairros (Centro e Jardins) inclusivos da sociabilidade homossexual em São Paulo e 500 homens responderam a um questionário sobre prevenção da aids e suas práticas sexuais. O estudo identifi cou diferentes subculturas homoeróticas. No Centro, com bares mais antigos e tradicionais, era maior a presença de travestis e garotos de programa e de imagens identitárias mais referidas à divisão tradicional de papéis de gênero (feminino/masculino). No Jardins, onde os bares eram mais requintados, prevaleciam imagens baseadas na identidade gay. Os questionários indicaram que 52% dos homens mantinham relações sexuais sem proteção com parceiros fi xos e 42% com parceiros casuais. Diferenças signifi cativas foram observadas no Centro: os homens expressaram menor percepção do risco de se infectar e menor confi ança na prevenção; usavam menos frequentemente o preservativo que HSH no bairro dos Jardins e os motivos mais alegados eram "estar apaixonado" e a "existência de medicamentos para tratar a aids"; no Centro era maior a proporção de homens menos escolarizados, negros e pobres. Concluiu-se que nestes dois territórios formavam-se diferentes redes sociométricas expressando subculturas homoeróticas e contextos sociais-programáticos produtores de distintas vulnerabilidades ao HIV que, por sua vez, exigiriam abordagens específi cas para a prevenção entre HSH que as frequentam.
ABSTRACT Drawing on ethnographic research conducted from 2011 to 2015 and the authors’ long-term ... more ABSTRACT Drawing on ethnographic research conducted from 2011 to 2015 and the authors’ long-term engagement in diverse aspects of HIV and human rights advocacy in Brazil, this paper explores key elements of the Brazilian sex workers’ movement response to HIV and the broader political factors that profoundly influenced its trajectory. We argue that the movement has constantly challenged representations of prostitution by affirming sex workers’ roles as political actors, not just peer educators, in fighting the HIV epidemic and highlight their development of a sex positive and pleasure centred response that fought stigma on multiple fronts. Moments of tension such as the censorship of an HIV prevention campaign and implementation of ‘test and treat’ projects are analysed, as are the complex questions that Brazil’s 2016 political and economic crisis evokes in terms of how to develop and sustain responses to HIV driven by communities but with material commitment from the State. We conclude with what we see to be the unique, central components of Brazilian sex workers’ approach to HIV prevention and what lessons can be learned from it for broader collective health movements in Latin America and beyond.
Worldwide, HIV prevention is challenged to change because clinical trials show the protective eff... more Worldwide, HIV prevention is challenged to change because clinical trials show the protective effect of technologies such as circumcision, preexposure prophylaxis, and the suppression of viral load through antiretroviral treatment. In the face of demands for their implementation on population levels, the fear of stimulating risk compensation processes and of increasing riskier sexual practices has retarded their integration into prevention programs. In this article, following a narrative review of the literature on risk compensation using the PubMed database, we offer a critical reflection on the theme using a constructionist approach of social psychology integrated to the theoretical framework of vulnerability and human rights. The use of biomedical technologies for prevention does not consistently induce its users to the increase of riskier practices, and variations on the specificity of each method need to be carefully considered. Alternatives to the theories of sociocognitive studies, such as social constructionist approaches developed in the social sciences and humanities fields, indicate more comprehensive interpretations, valuing the notions of agency and rights. The critical analysis suggests priority actions to be taken in the implementation process: development of comprehensive programs, monitoring and fostering dialog on sexuality, and technical information. We highlight the need to implement a human rights-based approach and to prioritize dialog, stressing how complementary these technologies can be to meet different population needs. We conclude by stressing the need to prioritize sociopolitical changes to restore participation, dialog about sexuality, and emphasis on human rights such as core elements of the Brazilian AIDS policy.
This paper describes an alternative approach to undertaking and evaluating sexual health promotio... more This paper describes an alternative approach to undertaking and evaluating sexual health promotion, focusing on the notion of sexual scenes and scenarios and how these can provide a vantage point from which to examine sexual experience. The concept of sexual scenes provides a context within which to analyse many of the behavioural and epidemiological factors associated with sexual practice. In principle, such an approach provides a tool for conscientization, action and the invention of novel group and individual repertoires that may result in individual and social mobilization for health and/or sexual and reproductive rights. Scenes can be elicited through individual interviews, group interviews and discussions, or through staged and dramatized performance and students' writing. Analysing sexual scenes offers an entry point for dialogue in sexual health promotion programming. Evaluation of these programmes can be part of the process of changing sexual scenarios. Change is witnessed not only through individual changes but, especially in impoverished communities, through challenges to dominant local sexual scenarios and engagement with structural concerns.
This article discusses Aids prevention in Brazil in the midst of growing numbers of cases of the ... more This article discusses Aids prevention in Brazil in the midst of growing numbers of cases of the disease among young people. A study was conducted between 2013 and 2017 to explore the sexual behavior of high school students and their opinions regarding sexuality. The findings show that students have adopted the prevention discourse and that religiosity influences beliefs and values relating to sexual initiation, negatively affecting condom use from the onset of sexual activity. To ensure the right to prevention is upheld, it will be necessary to broaden public understanding about how religion as it is actually lived differs from religious politics. The effects of the reversion to moral discourses reminiscent of the military dictatorship and possible discontinuity of successful longstanding prevention programs targeting young people should be monitored. There is an urgent need to understand the dynamic between the old and new discourses that shape sexualization (often via social media) and access to "combination prevention" of Sexually Transmitted Infections (STI)/Aids.
Este texto discute o curso da epidemia do HIV/Aids nos últimos anos e a revisão de alguns dos pre... more Este texto discute o curso da epidemia do HIV/Aids nos últimos anos e a revisão de alguns dos pressupostos que informaram as ações de preven ção ao HIV. Refletindo a partir das iniciativas de prevenção ao HIV/ AIDS com grupos de jovens e seus educadores em São Paulo em uma dé cada de trabalho, descreve a superação das noções de "grupo de risco " e alguns indicadores dos sucessos do esforço brasileiro diante dos desafios de uma epidemia que cresce ainda entre os mais jovens. O trabalho inici al com alunos de escolas noturnas inspirou inúmeros programas e têm ajudado a estabelecer parâmetros para ações de prevenção, indicadores do contexto e da vulnerabilidade sociais, além de categorias sócioculturais que informam a vida diária e a atividade sexual dos jovens. A partir de ações interativas que focalizam o sexo e a reprodução, as rela ções de gênero e outros temas associados pelos jovens, os projetos lidam com desinformação, emoções, a violência estrutural e os caminhos para a cidadania plena. Destaca-se a receptividade e a cooperação dos vários grupos de jovens em contextos mais vulneráveis, assim como dos adultos envolvidos com eles: escolares, internos da FEBEM, ou agrupados em di ferentes comunidades e atividades. Descritores: AIDS. Prevenção. Jovens. Vulnerabilidade social.
Desenvolvemos uma revisão crítica da literatura sobre o uso recorrente do teste anti-HIV entre ho... more Desenvolvemos uma revisão crítica da literatura sobre o uso recorrente do teste anti-HIV entre homens que fazem sexo com homens (HSH). Procedemos a uma revisão narrativa da literatura, em que analisamos as diversas concepções sobre testagem frequente ao longo do tempo, suas implicações para os programas de saúde e os principais marcadores sociais que influenciam a incorporação do teste anti-HIV como rotina de cuidado. Embora exista desde os anos 1990, a testagem recorrente entre HSH era frequentemente interpretada como exposição aumentada ao HIV em razão da ausência de uso do preservativo e, consequentemente, uma testagem "desnecessária". A partir dos anos 2000, a testagem periódica passou a ser uma recomendação programática e, sua realização, interpretada como meta a ser atingida. A percepção dos indivíduos sobre o uso que faziam do teste foi raramente considerada para caracterizar este uso como rotina de cuidado. No plano social e cultural, aspectos individuais associados ao teste recente ou de rotina estiveram inscritos em contextos de normas favoráveis ao teste e de menor estigma da AIDS. Diferenças geracionais, de escolarização e relacionadas ao tipo de parceria afetivo-sexual desempenham importantes papéis para o teste. Tais diferenças realçam que a categoria epidemiológica "homens que fazem sexo com homens" abrange diversas relações, identidades e práticas que resultam em usos específicos do teste como estratégia de prevenção. Assim, o diálogo entre programas, profissionais de saúde e as pessoas mais afetadas pela epidemia é central à construção de respostas com efetivo potencial de enfrentamento à epidemia de HIV, e pautadas no respeito aos direitos humanos.
This paper offers a critical overview of social science research presented at the 2014 Internatio... more This paper offers a critical overview of social science research presented at the 2014 International AIDS Conference in Melbourne, Australia. In an era of major biomedical advance, the political nature of HIV remains of fundamental importance. No new development can be rolled out successfully without taking into account its social and political context, and consequences. Four main themes ran throughout the conference track on social and political research, law, policy and human rights: first, the importance of work with socially vulnerable groups, now increasingly referred to as "key populations"; second, continued recognition that actions and programs need to be tailored locally and contextually; third, the need for an urgent response to a rapidly growing epidemic of HIV among young people; and fourth, the negative effects of the growing criminalization of minority sexualities and people living with HIV. Lack of stress on human rights and community participation is resulting in poorer policy globally. A new research agenda is needed to respond to these challenges.
Objectives: To describe sexual risk for HIV infection among adult night school students in São Pa... more Objectives: To describe sexual risk for HIV infection among adult night school students in São Paulo, Brazil, and to evaluate the effect of an HIV/AIDS prevention workshop to reduce sexual risk. Subjects and methods: A longitudinal study was conducted among four demographically similar public night schools in the inner city of São Paulo. Schools were randomized into intervention and control conditions. Of 394 young adults who took part in the baseline survey, 304 (77%) completed a postintervention questionnaire. Interventions: In a workshop consisting of four sessions of 3 h each, the students discussed AIDS symbolism, the impact of AIDS on their lives, risk perception, the way in which sexual norms shape knowledge and attitudes, AIDS-related knowledge, reproduction and sexual pleasure, and condom use negotiation. We fostered community-building through AIDS training courses for teachers in the schools, peer support programs and public events. Results: At baseline, 87% had been sexually active at some time and 76% had had sex in the past 6 months. Among those who reported vaginal intercourse and/or anal intercourse, condom use was low. The workshops were positively process-evaluated and supported by the community, the students, their teachers and their parents. We obtained statistically significant effects from the workshops for females only, who reported improved communication with partners about sex and AIDS and less unprotected sex with non-monogamous partners after the intervention. Conclusion: These data show that the sexual risk of HIV infection can be lowered when Brazilian disenfranchized communities support AIDS prevention workshops. Even more impressive results may be achieved if the need to address socioeconomic obstacles and gendered sexual roles is emphasized through further long-term community development programs.
The Brazilian National AIDS Program is widely recognized as the leading example of an integrated ... more The Brazilian National AIDS Program is widely recognized as the leading example of an integrated HIV/AIDS prevention, care, and treatment program in a developing country. We critically analyze the Brazilian experience, distinguishing those elements that are unique to Brazil from the programmatic and policy decisions that can aid the development of similar programs in other low- and middle-income and developing countries.Among the critical issues that are discussed are human rights and solidarity, the interface of politics and public health, sexuality and culture, the integration of prevention and treatment, the transition from an epidemic rooted among men who have sex with men to one that increasingly affects women, and special prevention and treatment programs for injection drug users.
Fragments of a "pandemic life" collected in prevention projects in outer city and school peripher... more Fragments of a "pandemic life" collected in prevention projects in outer city and school peripherical territories in São Paulo introduces this article. The impact of the loss of close people to COVID-19, the spread of false information about prevention and care, and the disorganization of daily life emerged from our sustained interaction with young people. Inequality and unemployment were growing before the pandemic, as was the number of mental health events. By co-producing and promoting integrality in prevention with young people, we have followed the social and community response to the syndemic in the context of online schools and school life under the impact of a decade of attacks on sex education. Sexuality, the theme that gave rise to most prevention projects, was challenging to address. Differently from the AIDS responses, community-territorial identities mobilized "untested feasibilities" for this social and health emergency by associating "resistance" to governmental negligence, violation, and the attack on human rights. Globally, this attack questions human rights universality and indivisibility, using sexuality to reinterpret its emancipatory sense of solidarity in difference. The notion of "psychosocial suffering" allows to deal with the excess of individualization and medicalization of suffering experiences structured by inequalities in this long-lasting context.
Fragments of a "pandemic life" collected in prevention projects in outer city and school peripher... more Fragments of a "pandemic life" collected in prevention projects in outer city and school peripherical territories in São Paulo introduces this article. The impact of the loss of close people to COVID-19, the spread of false information about prevention and care, and the disorganization of daily life emerged from our sustained interaction with young people. Inequality and unemployment were growing before the pandemic, as was the number of mental health events. By co-producing and promoting integrality in prevention with young people, we have followed the social and community response to the syndemic in the context of online schools and school life under the impact of a decade of attacks on sex education. Sexuality, the theme that gave rise to most prevention projects, was challenging to address. Differently from the AIDS responses, community-territorial identities mobilized "untested feasibilities" for this social and health emergency by associating "resistance" to governmental negligence, violation, and the attack on human rights. Globally, this attack questions human rights universality and indivisibility, using sexuality to reinterpret its emancipatory sense of solidarity in difference. The notion of "psychosocial suffering" allows to deal with the excess of individualization and medicalization of suffering experiences structured by inequalities in this long-lasting context.
O direito à prevenção da Aids revisitado em tempos de retrocesso 1/6 réplica Agradecemos os comen... more O direito à prevenção da Aids revisitado em tempos de retrocesso 1/6 réplica Agradecemos os comentários generosos e instigantes de Fernando Seffner; César Abadia-Barrero e Héctor Ruiz-Sánchez; Mônica Franch e Felipe Rios; Cláudia Cárdenas e Ivia Maksud sobre o artigo, que convergem na avaliação sobre o retrocesso nas políticas que, por duas décadas, ampliaram nas escolas o direito à prevenção das IST/Aids baseada em saberes técnico-científicos. Ao responder, ampliaremos a discussão dos resultados mirando os caminhos de menor resistência que o contexto oferece para sustentar o direito à prevenção.
O objetivo do artigo é discutir a territorialização das culturas sexuais homoeróticas em São Paul... more O objetivo do artigo é discutir a territorialização das culturas sexuais homoeróticas em São Paulo, suas redes sociométricas e seu acesso à prevenção. Foi realizado um mapeamento etnográfi co de 58 bares e boates em dois bairros (Centro e Jardins) inclusivos da sociabilidade homossexual em São Paulo e 500 homens responderam a um questionário sobre prevenção da aids e suas práticas sexuais. O estudo identifi cou diferentes subculturas homoeróticas. No Centro, com bares mais antigos e tradicionais, era maior a presença de travestis e garotos de programa e de imagens identitárias mais referidas à divisão tradicional de papéis de gênero (feminino/masculino). No Jardins, onde os bares eram mais requintados, prevaleciam imagens baseadas na identidade gay. Os questionários indicaram que 52% dos homens mantinham relações sexuais sem proteção com parceiros fi xos e 42% com parceiros casuais. Diferenças signifi cativas foram observadas no Centro: os homens expressaram menor percepção do risco de se infectar e menor confi ança na prevenção; usavam menos frequentemente o preservativo que HSH no bairro dos Jardins e os motivos mais alegados eram "estar apaixonado" e a "existência de medicamentos para tratar a aids"; no Centro era maior a proporção de homens menos escolarizados, negros e pobres. Concluiu-se que nestes dois territórios formavam-se diferentes redes sociométricas expressando subculturas homoeróticas e contextos sociais-programáticos produtores de distintas vulnerabilidades ao HIV que, por sua vez, exigiriam abordagens específi cas para a prevenção entre HSH que as frequentam.
Sustaining a Rights-Based Response to HIV in Brazil
In this chapter, we look to the three preside... more Sustaining a Rights-Based Response to HIV in Brazil In this chapter, we look to the three presidential administrations that most affected Brazil’s national response over the past decade: Fernando Henrique Cardoso (1994–2002), Luiz Ignacio da Silva Lula Inácio (popularly referred to as ‘Lula’) (2003–2010) and Dilma Rousseff (2011–2016), to discuss why and how the approach appears to have weakened over time and raise larger questions about the challenges of sustaining a rights-based response. We focus specifically on the 2010–2016 time-period, highlighting the major changes in Brazil’s political land- scape and how these changes have affected HIV prevention actions. A brief case study of the female sex worker movement illustrates how broader political changes affected one of the population groups that has been central to Brazil’s response to HIV since the beginning. We conclude by offering thoughts on how to strengthen future actions to address HIV in Brazil by reinvigorating a rights-based agenda and creating a more strategic partnership between government and civil society.
organizadores A psicologia social nasce, no final do século XIX, a partir da constatação e con... more organizadores A psicologia social nasce, no final do século XIX, a partir da constatação e concei-tualização de processos psíquicos específicos às situações sociais. Processos de natureza psicológica que, contudo, não podem ser descritos como mera somató-ria da psicologia dos indivíduos. Por outro lado, tais processos tampouco podem prescindir dos indivíduos e de sua participação psicológica. Assim, a questão da precedência e da origem primeira entre esses dois âmbitos parece incontornável. Para além da tensão entre sua correção gramatical e seu uso no discurso, o hífen vale como uma metáfora gráfica de uma questão epistemológica de grande valor em psicologia social. Sua presença entre o " psico " e o " social " implicitamente assume que a articulação entre esses dois campos heterogêneos da experiência é posterior a sua existência. Sua ausência aponta para um quiasma entre os campos, sugerindo um elo anterior e irredutível a eles. Este livro, oriundo de um simpósio dos docentes do Programa em Psicologia Social do Instituto de Psicolo-gia da Universidade de São Paulo (IP-USP), dedica-se a essa questão e se propõe a apresentar diferentes teorias sobre a questão do hífen em psicologia social.
Tá difícil de engolir? Experiências de adesão ao tratamento anti-retroviral em São Paulo, 2000
. Com os avanços conquistados nesses anos de epidemia emergiu a questão da adesão;
. Construindo ... more . Com os avanços conquistados nesses anos de epidemia emergiu a questão da adesão; . Construindo a aderência: “a primeira tomada a gente nunca esquece”; . O preconceito e o isolamento ainda causam mais mal que o vírus HIV – em especial aos usuários de álcool e drogas; . Informação e efeitos colaterais: a importância da equipe multidisciplinar; . Respostas que cuidador e paciente devem construir juntos; . Dicas práticas sugeridas por entrevistados; . Dicas dos laboratórios e serviços 0800; . As crenças de cada um e o nível educacional; . Fazendo uma tabela; . Adequando a linguagem e avaliando a aderência em uma equipe multidisciplinar; . Avaliação de aderência: perguntas úteis e pouco úteis; . Tratamento crônico e avaliação permanente da adesão; . A adesão ao serviço: pobreza, visitas domiciliares e o vínculo; . Estimulando a participação das crianças – apoiando os cuidadores; . A adesão é resultado do processo de lidar com dificuldades de várias ordens e a diversidade dos portadores é um desafio constante.
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Papers by Vera Paiva
In this chapter, we look to the three presidential administrations that most affected Brazil’s national response over the past decade: Fernando Henrique Cardoso (1994–2002), Luiz Ignacio da Silva Lula Inácio (popularly referred to as ‘Lula’) (2003–2010) and Dilma Rousseff (2011–2016), to discuss why and how the approach appears to have weakened over time and raise larger questions about the challenges of sustaining a rights-based response. We focus specifically on the 2010–2016 time-period, highlighting the major changes in Brazil’s political land- scape and how these changes have affected HIV prevention actions. A brief case study of the female sex worker movement illustrates how broader political changes affected one of the population groups that has been central to Brazil’s response to HIV since the beginning. We conclude by offering thoughts on how to strengthen future actions to address HIV in Brazil by reinvigorating a rights-based agenda and creating a more strategic partnership between government and civil society.
. Construindo a aderência: “a primeira tomada a gente nunca esquece”;
. O preconceito e o isolamento ainda causam mais mal que o vírus HIV – em especial aos usuários de álcool e drogas;
. Informação e efeitos colaterais: a importância da equipe multidisciplinar;
. Respostas que cuidador e paciente devem construir juntos;
. Dicas práticas sugeridas por entrevistados;
. Dicas dos laboratórios e serviços 0800;
. As crenças de cada um e o nível educacional;
. Fazendo uma tabela;
. Adequando a linguagem e avaliando a aderência em uma equipe multidisciplinar;
. Avaliação de aderência: perguntas úteis e pouco úteis;
. Tratamento crônico e avaliação permanente da adesão;
. A adesão ao serviço: pobreza, visitas domiciliares e o vínculo;
. Estimulando a participação das crianças – apoiando os cuidadores;
. A adesão é resultado do processo de lidar com dificuldades de várias ordens e a diversidade dos portadores é um desafio constante.