RESUMO Parada cardiorrespiratória é a principal
Introduction Before the pandemic context, domestic violence was already considered a violation of human rights with high visibility worldwide. With the COVID-19 pandemic and the adoption of preventive measures such as social distancing and prioritization of care for cases of the disease in health units, there was a lack of care for other health issues, such as assistance to women victims of violence. Objective To analyze how the repercussions of the pandemic context and the measures to combat SARS-CoV-2 affected the follow-up of women victims of sexual violence assisted in a reference service in Northeast Brazil. Methods Qualitative analysis with a descriptive character. A semi-structured interview and simple observation were used. To complement the data, bibliographic and documental research were carried out. Bardin's content analysis was adopted. A convenience sample was used, which resulted in 14 women, and data saturation. As inclusion criteria, they were older than 18 years old, attended by the service between March and November 2020, attended at least one appointment and who freely agreed to participate. Male and under 18 years old patients were excluded. Results In 2020, there was a reduction in appointment bookings (24%) and outpatient visits (27%) compared to the same period in 2019. Regarding the sample, 64.28% were between 19-39 years old, the majority declared themselves brown /black (50%) and being single (71%). About 36% had completed high school, the same percentage that was unemployed. Half (50%) of the interviewees did not receive social or social security benefits and lived in a rented house (50%). Most did not know about the service offered and found out from the referral of friends or a public safety or health agency that they sought as a result of the episode of sexual violence. Regarding the pandemic context and outpatient follow-up, it was noted that many mentioned the decrease in the supply of transport and also made reference to the fear of leaving home and being contaminated. A factor greatly reinforced by the interviewees was the economic risk that the pandemic brought to the routine, whether due to formal unemployment or the impediment to carrying out their autonomous activities. In this context, economic insecurity was cited as one of the recurring reasons for not attending appointments. Questions were also asked about the understanding and evaluation of multidisciplinary care and a positive response was received, validating the intersectoral work developed in the service. Conclusions Violence is a dynamic that is constantly being reformulated, due to the historical context. The decrease in demand and increase in absenteeism were linked to fear of contamination, financial difficulties and lack of knowledge about the service. Actions to improve surveillance and management of sexual violence must be an essential part of the fight against COVID-19. Disclosure No
Introduction There is a need of information about transgender individuals and their health needs. This work has as object of study sexual behaviors and social barriers to access health of transgender men. There is a need for information about transgender men and their health needs. Globally, transgender people face discrimination and social exclusion. Available data indicate numerous healthcare inequities between trans and cisgender (non-trans) people. Objective The aim of this study was to evaluate transgender men at a public university hospital linked to brazilian´s public healthcare, analyzing sexual practices and barriers to access affirmative care. Methods The medical records of seventeen patients (range 18-42 of age) followed between 2016 and 2018, were used to collect data retrospectively and descriptively with quantitative and qualitative approach. Through a structured interview, there was a focus on data concerning difficulties to reach healthcare and medical inequities. Results It was noticed that transgender men face social barriers to health access, such as insistent non-respect of the use of the social name, the lack of knowledge of health demands by health professionals and the barriers imposed by family and/or spouse. The sexual practices performed by these men, who proved to be widely diverse and changing, are mostly penetrative (70,58%), and such practices may be passive and / or active. It was also observed variable sexual orientation among the patients, although most of them (88,23%) maintain a relationship with a cisgender woman. Gynecological follow-up was also the subject of discussion in this study, and despite the fact that 23,52% of patients had gynecological complaints, 29,41% had never done a gynecological consultation, being the resistance to do gynecological exams very commun. Only 28,57% of the patients had not yet started hormone therapy, and they declared that they would like to start this process. The majority of transgender men have also the need of body change. Conclusions Therefore, it is necessary to develop strategies in public and universal health that are effective to provide transgender men with their need to body change or hormone therapy, as well as to guide them to the gynecological examination. Additionally, health care providers need to guarantee proper and free of prejudice assistance. Disclosure No
Introduction In Brazil, situations of discrimination and violence experienced by the LGBTQIA+ community in health care services and educational institutions constitute programmatic vulnerability and have repercussions for their health-disease-care process. In the context of health education, topics related to sexual and gender minorities are not effectively explored, and it is not a mandatory part of the curriculum of medical schools. Objective To analyze the perception of medical students who identify as LGBTQIA+ about homophobia and transphobia. Methods Qualitative cross-sectional study. An online questionnaire was answered anonymously by LGBTQIA+ medical students. They are in the mandatory internship curriculum of Gynecology and Obstetrics in a public maternity school in northeastern Brazil. Responses were categorized, coded, analyzed, and interpreted using Bardin's content analysis method. Results Seven LGBTQIA+ medical students participated. Regarding sexual identity, 3 identified themselves as cisgender women, three as cis men, and one person as "questioning" of these five are homosexual, two bisexual, and one asexual. When asked about the qualification of health service professionals regarding LGBT+ people, six respondents commented on the lack of technical training of the medical team. A student believes that most physicians are knowledgeable about the topic and respect LGBT people. All interviewees have already witnessed, as victims or witnesses, situations of homophobia or transphobia. Three of the participants experienced circumstances that involved professionals providing care to patients. Among the actions mentioned to improve the qualification of professionals in serving the LGBT+ community, most participants suggested training,, and mandatory classes on the subject. Conclusions There was a significant perception of prejudice against the LGBTQIA+ population in transdisciplinary care and medical training. The solutions embrace the inclusion of topics on sexual and gender minorities in the curriculum of medical schools, as well as spaces and welcoming strategies for students who have experienced LGBTphobia. Disclosure No
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