Perceptions of sex workers about the care received in the health care context

Authors

  • Beatriz Guerta Pastori aUniversidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brasil.
  • Andrei Biliato Colmanetti cDepartamento de Saúde Coletiva da Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brasil.
  • Cláudia de Azevedo Aguiar UFTM Universidade Federal do Triângulo Mineiro

DOI:

https://doi.org/10.36311/jhgd.v32.10856

Keywords:

Sex Workers, Delivery of Health Care, Unified Health System, Collective Subject Discourse

Abstract

Introduction: sex workers are configured as a historically marginalized group for deviate of the moral and social behavior pattern dictated by conservative dogmas on which Brazil was built. Such exclusion is also expressed in public health policies, where the group is mentioned only in actions and programs aimed at sexually transmitted infections (STIs), which violates basic principles proposed by SUS (Brazilian Unified Health System). This paper aims to analyze the care received in the context of health care from the perspective of sex workers.

Methods: this is a descriptive and exploratory study, with a qualitative approach, that have as referential of analysis the Collective Subject Discourse (CSD), built from a half-structured interview realized with the group in question and a socioeconomic questionnaire. The DSC is a method that assemble opinions and individual expressions in a unique testimony, written in first person singular, that gives voice to this collectivity. The collect was helped by community health agents of Family Health Unit that includes the brothel’s territory.

Results and Discussion: were interviewed 22 sex workers, being 19 cis woman and 3 trans woman, most of whom in a situation of social vulnerability – brown or black, little schooling and low rent. The speeches identified the existence of health care that does not meet the specific demands of this population, in addition to the presence of fragmented care and focused on sexual and gynecological health. The trans or cis interviewed, moreover, strong resistance to gender identity and respect for the social name by the team. In addition, there were expressions of fear in revealing the profession during medical appointment, due to the stigma and preconception that fell on them. Even so, these professionals understand that their health needs are met in SUS, which connotes a resigned view of the gaps in the care network, requiring specific health actions, programs and policies for this population.

Final Considerations: the sex workers are a society’s cutout that suffer daily with stigma on their pattern of sexual behavior, living an important condition of social vulnerability. This reflects on fear to seek medical services and to reveal their profession, resulting in gaps on the access and right to health in this population. It is necessary, therefore, creation of health programs and policies specifics and requalification of the health teams for the management of this patients. 

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References

Leitão EF, Costa LLS, Brêda MZB, Albuquerque MC dos S de, Jorge JS. A prática cotidiana de saúde das profissionais do sexo. Revista Brasileira em Promoção da Saúde 2012; 25: 295–304. https://doi.org/10.5020/18061230.2012.2259

Moraes MLC de, Costa PB, Aquino PDS, Pinheiro AKB. Educação em saúde com prostitutas de Fortaleza: relato de experiência. Rev Eletr Enf 2008; 10. https://doi.org/10.5216/ree.v10.46823

Aquino P de S, Ximenes LB, Pinheiro AKB. Políticas públicas de saúde voltadas à atenção à prostituta: breve resgate histórico. Enfermagem em Foco 2010; 1. https://doi.org/10.21675/2357-707X.2010.v1.n1.4

Centro de Documentação do Ministério da Saúde. Assistência integral à saúde da mulher: bases de ação programática. Brasília: Ministério da Saúde; 1984.

Brasil, editor. Política nacional de atenção integral à saúde da mulher: princípios e diretrizes. 1a. ed., 2a. reimp. Brasília, DF: Editora MS; 2011

Villela WV, Monteiro S. Gênero, estigma e saúde: reflexões a partir da prostituição, do aborto e do HIV/aids entre mulheres. Epidemiol Serv Saúde 2015; 24: 531–40. https://doi.org/10.5123/S1679-49742015000300019

Sousa FR de. Educação Popular em Saúde e participação de prostitutas: contribuições para a gestão participativa do SUS. Interface (Botucatu) 2014; 18: 1568–1568. https://doi.org/10.1590/1807-57622013.0406

Szwarcwald C. Taxas de prevalência de HIV e sífilis e conhecimento, atitudes e práticas de risco relacionadas às infecções sexualmente transmissíveis no grupo das mulheres profissionais do sexo: relatório de pesquisa. Brasília: Ministério da Saúde; 2010.

Lefèvre F, Lefèvre AMC. O discurso do sujeito coletivo: um novo enfoque em pesquisa qualitativa; desdobramentos 2003.

Lefevre F, Lefevre AMC. Discourse of the collective subject: social representations and communication interventions. Texto Contexto - Enferm 2014; 23: 502–7. https://doi.org/10.1590/0104-07072014000000014

Lima FS da S, Merchán-Hamann E, Urdaneta M, Damacena GN, Szwarcwald CL. Fatores associados à violência contra mulheres profissionais do sexo de dez cidades brasileiras. Cad Saúde Pública 2017; 33. https://doi.org/10.1590/0102-311X00157815

Hankel J, Dewey S, Martinez N. Women Exiting Street-Based Sex Work: Correlations between Ethno-Racial Identity, Number of Children, and Violent Experiences. Journal of Evidence-Informed Social Work 2016; 13: 412–24. https://doi.org/10.1080/23761407.2015.1086718

Clarke RJ, Clarke EA, Roe-Sepowitz D, Fey R. Age at Entry into Prostitution: Relationship to Drug Use, Race, Suicide, Education Level, Childhood Abuse, and Family Experiences. Journal of Human Behavior in the Social Environment 2012; 22: 270–89. https://doi.org/10.1080/10911359.2012.655583

Juliano D. El trabajo sexual en la mira: polémicas y estereotipos. Cad Pagu 2005: 79–106. https://doi.org/10.1590/S0104-83332005000200004

Santos OP dos, Ramalho RC, Oliveira CFD, Lima RCD, Arantes AA, Filho IM de M. Perfil sociodemográfico e avaliação do conhecimento das profissionais do sexo acerca das ISTs em um município na região metropolitana de Goiânia. Revista de Iniciação Científica e Extensão 2019; 2: 81–8.

Figueiredo R, Peixoto M. Profissionais do sexo e vulnerabilidade. BIS, Bol Inst Saúde (Impr) 2010: 196–201.

Cruz NL da, Ferreira CL, Martins E, Souza M. O cuidado com a saúde das mulheres profissionais do sexo: uma revisão narrativa. Disciplinarum Scientia | Saúde 2016; 17: 339–52.

Platt L, Grenfell P, Meiksin R, Elmes J, Sherman SG, Sanders T, etal.. Associations between sex work laws and sex workers’ health: A systematic review and meta-analysis of quantitative and qualitative studies. PLoS Med 2018; 15: e1002680. https://doi.org/10.1371/journal.pmed.1002680.

Brito-Silva K, Bezerra AFB, Tanaka OY. Direito à saúde e integralidade: uma discussão sobre os desafios e caminhos para sua efetivação. Interface (Botucatu) 2012; 16: 249–60. https://doi.org/10.1590/S1414-32832012005000014

Paiva LL de, Araújo JL de, Nascimento EGC do, Alchieri JC. A vivência das profissionais do sexo. Saúde debate 2013; 37: 467–76.

Silva RS. O entendimento do direito à saúde: uma abordagem dos usuários do SUS no Distrito Federal. Cad Ibero Am Direito Sanit 2015; 4: 56–74. https://doi.org/10.17566/ciads.v4i3.156.

Benoit C, Jansson SM, Smith M, Flagg J. Prostitution Stigma and Its Effect on the Working Conditions, Personal Lives, and Health of Sex Workers. The Journal of Sex Research 2018; 55: 457–71. https://doi.org/10.1080/00224499.2017.1393652

Bungay V, Kolar K, Thindal S, Remple VP, Johnston CL, Ogilvie G. Community-Based HIV and STI Prevention in Women Working in Indoor Sex Markets. Health Promotion Practice 2013; 14: 247–55. https://doi.org/10.1177/1524839912447189

Ministério da Saúde (Brasil). Política Nacional de Saúde Integral de Lésbicas, Gays, Bissexuais, Travestis e Transexuais – LGBT. Brasília: Ministério da Saúde, 2013.

Ferreira B de O, Nascimento EF do, Pedrosa JI dos S, Monte LMI do. Vivências de travestis no acesso ao SUS. Physis 2017; 27: 1023–38. https://doi.org/10.1590/S0103-73312017000400009

Muller MI, Knauth DR. Desigualdades no SUS: o caso do atendimento às travestis é ’babado’! Cad EBAPEBR 2008; 6: 01–14. https://doi.org/10.1590/S1679-39512008000200002

Paim JS, Silva LMV da. Universalidade, integralidade, equidade e SUS. BIS - Bol Inst Saúde 2010.

Published

2022-06-23

Issue

Section

ORIGINAL ARTICLES