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vol.25 suppl.2Unintended consequences: evaluating the impact of HIV and AIDS on sexuality research and policy debatesContraception and family planning services as viewed by users of three clinics in the Unified National Health System, Rio de Janeiro State, Brazil author indexsubject indexarticles search
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Cadernos de Saúde Pública

Print version ISSN 0102-311XOn-line version ISSN 1678-4464

Abstract

OLIVEIRA, Isadora Borges Nolasco. Universal access? Obstacles to access, continuity of treatment, and gender issues at a specialized HIV/AIDS clinic in Salvador, Bahia State, Brazil. Cad. Saúde Pública [online]. 2009, vol.25, suppl.2, pp.s259-s268. ISSN 0102-311X.  http://dx.doi.org/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.

Keywords : Acquired Immunodeficiency Syndrome; Health Services Accessibility; Continuity of Patient Care.

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