“We live on the tightrope”: the experience of health professionals working with HIV/AIDS in a remote area of Northeast Brazil

Thais Raquel Pires Tavares Lucas Pereira de Melo About the authors


This ethnographic study aimed to understand the experience of health professionals working in a Specialized Service for HIV/AIDS Care in a remote area of Northeast Brazil. Data collection used participant observation and a semi-structured interview with seven professionals in the health care team. The thematic coding technique yielded three categories: “I didn’t even know what it was”: aspects of becoming a specialist in HIV/AIDS; “They’re all out there, kind of hidden”: strategies for dealing with the (in)visibility of serological status; and “We live on the tightrope”: experiences in the work process. The study’s most relevant aspect was the service’s institutional invisibility as a result of the current configuration of the AIDS structure in Brazil. The results revealed several difficulties that are typical of services located in remote areas, especially the health professionals’ lack of experience, aggravated by the lack of continuing education, unmet infrastructure needs, the position of HIV/AIDS care on the local political agenda, and the physician-centered organization of the work process. The study also highlighted the interlocutors’ agency in the production of strategies to deal with these difficulties. The study further emphasized the local dimension as a social marker of difference that modeled the interlocutors’ experiences, where the health policy’s guidelines and principles are performed by health professionals, administrators, and users, comprising diverse material forms.

HIV; Acquired Immunodeficiency Syndrome; Health Personnel; Rural Health Services

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