Reaching truckers in Brazil with non-stigmatizing and effective HIV/STI services

Research with mobile populations has demonstrated that men in the mobile workforce tend to be exposed to greater HIV risk, and have higher sexually transmitted infection (STI) and HIV prevalence, than those in less mobile or non-mobile professions. At the request of the Brazilian Ministry of Health and with support from USAID/Brazil, the Population Council conducted an assessment in Brazilian border areas to determine which populations were most in need of HIV prevention activities. The research revealed the presence of an extremely mobile, international truck driver community with little to no access to HIV prevention, testing, and treatment services. The intervention strategy of placing a health unit inside the customs station and offering HIV/STI-related services with other services to meet the general health needs of truckers was successful for reaching truckers, was acceptable and well received, and promoted some important HIV-related behavior change

Assessment of risk factors for HIV infection in female sex workers and men who have sex with men in Ciudad del Este, Paraguay

Research conducted by the Population Council/Brazil, supported by the USAID-funded Horizons Project, documents findings from a study in Paraguay among men who have sex with men and female sex workers to estimate HIV and syphilis prevalence; examine knowledge, attitudes, and risk behaviors related to HIV and STIs; and describe the contextual and behavioral factors influencing HIV and STI transmission. Findings provide guidance to the development of HIV and STI prevention and care interventions and further operations research to test strategies and interventions to reduce the spread of HIV and STIs in these groups

“Alunos são todos iguais, não têm sexo:” análise das práticas de educação sexual e o enfrentamento à homofobia nas escolas

By analyzing the public policies which aim at combating homophobia implemented in Brazil over the past 15 years and the researches on this subject, we can come to the conclusion that there is awareness that homophobia is an important and priority problem in Brazil. Studies also indicated that, although there is consensus that the fight against homophobia should start from the childhood, little is known about the state of homophobia in the school community and very little about why this problem persists in schools. A descriptive and exploratory study was carried out, by using qualitative approach and content analysis, aiming to describe the homophobia situation in the school community in 11 Brazilian state capitals. We used: in-depth interviews with education secretaries who work for the states and for the cities; directors and education coordinators; focus groups with teachers and students; informal interviews with administrative staff; and observation of the school environment. While legislation related to sex education should be a cross-cutting theme and include aspects of gender and sexual diversity, it is noted a great distance from what really happens. This survey corroborates with national data and several surveys that were done at local levels, in several Brazilian cities. The authorities’ discourse concluded that public sex education policies that consider sexual diversity exist, but when in practice, it happens in a spontaneously form and focuses only on the biological aspects of pregnancy and STI / HIV-AIDS prevention. The data here displayed has a strong presence of homophobic prejudice and the school’s unpreparedness to deal with sexual diversity. This configuration is problematic when it comes to dealing with the sexuality, since it is an isolation from the larger dimensions of life and prevents its motivating force from participating in other school practices.A análise das políticas públicas de enfrentamento à homofobia implementadas no Brasil nos últimos 15 anos e as pesquisas realizadas sobre o tema indicam que há consciência de que a homofobia no país é um problema importante e prioritário. Os estudos também indicam que, embora haja consenso de que o enfrentamento da homofobia deveria começar desde a infância, pouco se sabe sobre a situação da homofobia na comunidade escolar e muito pouco sobre as causas que a mantém nas escolas. Realizou-se um estudo descritivo e exploratório de abordagem qualitativa, com análise de conteúdo, com o objetivo de descrever a situação da homofobia na comunidade escolar em 11 capitais brasileiras. Utilizaram-se: entrevistas em profundidade com secretários/as estaduais e municipais de educação, diretor/a e coordenador/a de ensino; grupos focais com professores/as e estudantes; entrevistas informais com pessoal administrativo; e observação do ambiente escolar. Embora a legislação aponte que a educação sexual deve ser um tema transversal e incluir aspectos de gênero e diversidade sexual, constatou-se uma grande distância ao que realmente acontece. A pesquisa corrobora com dados nacionais pesquisas que foram feitas em âmbitos locais em diversas cidades brasileiras. O discurso de autoridades foi de que existem políticas públicas de educação sexual que consideram a diversidade sexual, mas na prática, quando ocorre, esta se da de forma espontânea e enfoca somente os aspectos biológicos de prevenção da gravidez e das ITS/HIV-Aids. Os dados mostraram a forte presença de preconceito homofóbico e o despreparo da escola para lidar com a diversidade sexual. Esta configuração é problemática para o tratamento da sexualidade, pois a isola das demais dimensões da vida e impede que sua força motivadora participe das demais práticas escolares

Uma reflexão sobre o empoderamento da mulher a partir da experiência de um retiro de meditação budista

A pandemia de COVID-19 afetou profundamente o cotidiano, pois seu enfrentamento impôs severas medidas de isolamento e distanciamento social. As pessoas foram confinadas nas residências e apenas profissionais de serviços essenciais mantiveram o trabalho externo. O trabalho e a educação adaptaram-se à forma remota. O trabalho feminino, já caracterizado pela dupla jornada, viu-se ampliado, os casos de violência doméstica e mortes maternas  se elevaram. Neste cenário, a espiritualidade emergiu como forma de assegurar estabilidade mental, e a meditação apresentou-se como ferramenta de saúde mental e de empoderamento feminino. Para este trabalho realizou-se pesquisa bibliográfica e documental, e sobre a meditação e seu potencial de empoderamento, analisou-se o retiro virtual realizado pela Associação Buddha-Dharma entre janeiro e março de 2021

Reaching truckers in Brazil with non-stigmatizing and effective HIV/STI services

A study conducted by the Population Council in 2001 found that truckers crossing Brazil’s southern border had easy access to commercial sex and extremely limited access to health services, condoms, HIV testing and counseling, and HIV/STI prevention messages. In response, the Population Council’s Horizons Program conducted an intervention study from 2002 to 2005. The study examined the feasibility, acceptability, and impact of providing a range of health services to truckers at a health post inside a customs station, where truckers wait anywhere from one day to a week for documents and cargo to clear customs. As noted in this brief, truckers responded positively to HIV-related services offered together with other health services, such as blood pressure and glucose screening. Truckers passing through the intervention site reported greater uptake of HIV counseling and testing, as well as increased condom use and partner communication compared to truckers surveyed at the comparison site. These data suggest that the strategy was successful in reducing HIV risk among truckers

Assessment of risk factors for HIV infection among men who have sex with men in the metropolitan area of Campinas City, Brazil, using respondent-driven sampling

The Population Council, in collaboration with the Brazil Ministry of Health, the Municipal Program of STD/AIDS of Campinas, and the US Centers for Disease Control and Prevention/Global AIDS Program/Brazil, conducted a study to characterize the sociodemographic, behavioral, and environmental factors associated with subgroups of MSM who are most at risk for HIV infection. This research is the first Brazilian study to provide population-based estimates for HIV, syphilis, and HIV-related risk behaviors using an innovative sampling technique to reach members of the target population. Our data suggest the importance for HIV prevention programs to address not only sexual risk reduction, but also other social and cultural factors such as their vulnerability to homophobic violence, social construction of sexual identity, and social norms regarding sexuality and condom use within their social networks. The findings from this study clearly indicate the importance of the population of MSM in the HIV epidemic and the need for targeted interventions, particularly for the risky sub-populations in Campinas

Chaos, co-existence, and the potential for collective action: HIV-related vulnerability in Brazil\u27s international borders

In a country where quality HIV/AIDS prevention and care has been foremost on the national agenda, Brazil\u27s extensive and diverse borders are one of the last unstudied potential hotbeds of HIV vulnerability. We carried out a rapid assessment of HIV-related services and the social context of HIV/AIDS at the Brazilian borders including current governmental and community response. The assessment was implemented in six frontier municipalities using the WHO\u27s strategic approach methodology, which combines existing epidemiologic data with field-based qualitative data collection techniques, including observation of service delivery points and in-depth interviews and focus groups with local leaders, providers, and community members, in order to recommend context-specific HIV prevention strategies. This paper focuses on the qualitative findings regarding the role of the social context in shaping HIV vulnerability at the Brazilian borders. We documented a profound lack of governmental structure and response to HIV/AIDS at the borders as well as a notable absence of social cohesion and mobilization among the diverse population groups and communities situated at the borders with regard to HIV/AIDS. The weak governmental and community response is situated within a larger socio-political context of economic inequity and social division, which must be addressed if an effective response to HIV can be developed at Brazil\u27s international borders. Possibilities for encouraging a collective response among the diverse border populations are explored

Chaos, co-existence, and the potential for collective action: HIV-related vulnerability in Brazil's international borders

In a country where quality HIV/AIDS prevention and care has been foremost on the national agenda, Brazil's extensive and diverse borders are one of the last unstudied potential hotbeds of HIV vulnerability. We carried out a rapid assessment of HIV-related services and the social context of HIV/AIDS at the Brazilian borders including current governmental and community response. The assessment was implemented in six frontier municipalities using the WHO's strategic approach methodology, which combines existing epidemiologic data with field-based qualitative data collection techniques, including observation of service delivery points and in-depth interviews and focus groups with local leaders, providers, and community members, in order to recommend context-specific HIV prevention strategies. This paper focuses on the qualitative findings regarding the role of the social context in shaping HIV vulnerability at the Brazilian borders. We documented a profound lack of governmental structure and response to HIV/AIDS at the borders as well as a notable absence of social cohesion and mobilization among the diverse population groups and communities situated at the borders with regard to HIV/AIDS. The weak governmental and community response is situated within a larger socio-political context of economic inequity and social division, which must be addressed if an effective response to HIV can be developed at Brazil's international borders. Possibilities for encouraging a collective response among the diverse border populations are explored.Brazil HIV/AIDS National borders Collective efficacy Governance Collective action

Sexual risk behaviours and HIV seroprevalence among male sex workers who have sex with men and non-sex workers in Campinas, Brazil

Objectives: To compare population-based prevalence estimates of sexual risk behaviours and HIV seroprevalence of male sex workers who have sex with men (MSM) and those not engaged in sex work in Campinas, Brazil. Methods: MSM (n = 658) were recruited for a crosssectional study through respondent-driven sampling. Audio-assisted computer self-interview was used to collect information on sexual behaviours and HIV testing (optional) was performed. Population-based prevalence estimates with 95% Cl of characteristics and behaviours of MSM sex workers and non-sex workers are reported. Results: One-quarter reported ever receiving payment for sex and 14.8% (95% Cl 11.1 to 19.0) had been paid in the previous 2 months; most exclusively with men. MSM sex workers were significantly more likely than non-sex workers to report being transgendered (40.5% vs 8.1%), to practise unprotected receptive (22.4% vs 4.6%) and insertive (20.5% vs 5.0%) anal intercourse with ≥2 male partners and to have unprotected vaginal sex with women (22.7% vs 5.6%). MSM sex workers experienced significantly greater rates of psychological abuse (80.9% vs 58.4%) and physical abuse (48.2% vs 15.2%). Conclusions: MSM sex workers have higher sexual risk behaviours as well as social vulnerabilities than the general population of MSM. HIV/sexually transmitted infection prevention efforts should be targeted to this riskier subgroup. Programmes should be transgender sensitive, should recognise that MSM sex workers have sex with men and women and address other factors that influence risk, such as homophobic abuse