Formação, práticas e trajetórias de aconselhadores de centros de testagem anti-HIV do Rio de Janeiro, Brasil

Abstract

Perante a importância do aconselhamento na testagem anti-HIV, analisamos as diretrizes institucionais, as competências privilegiadas no treinamento profissional e os saberes/práticas de aconselhadores. Trata-se de estudo qualitativo centrado na análise documental, observação e entrevista com aconselhadores de Centros de Testagem e Aconselhamento (CTA) do estado do Rio de Janeiro. A análise foi orientada pela teoria de Pierre Bourdieu. Foi evidenciado que o habitus profissional dos aconselhadores resulta da articulação dos treinamentos, da graduação e de experiências e interesses pessoais. A operacionalização de competências, como a escuta ativa, é limitada pela rotina dos serviços e escassez de espaços de reflexão. Para incrementar a prática do aconselhamento, é importante desenvolver competências no treinamento, manter a educação continuada e fazer adequações na rotina do serviço. Tais ajustes podem fortalecer a passagem das diretrizes à ação e o aprimoramento da organização e gestão dos CTA.

Counseling practices in Sexually Transmitted Infections/AIDS: the female health professionals’ perspective

“…Emphasis is placed on the relationship, the development of light technologies, as a link between the subjects, and centrality to HIV testing is guaranteed (4,6) and its application to as many people as possible. There is, in this context, an overlapping of the biomedical paradigm on psychosocial practices, allied to the transformations of the productive process in the area of Health, where hard technologies are prioritized, in this case, HIV testing technologies (3) .…”

“…According to the theoretical framework and clinical management, the process of listening assumes different positions in counseling in an attempt to help the subject in their conflict situations (22) . However, the official technical recommendations for the practice of counseling propose the active listening of the feelings, attitudes and values of the subjects related to the diagnosis of STD and HIV (3) . It is highlighted that the posture, the bond and the type of relationship established between user-counselor and its articulation with prevention practices influence behavior changes and adherence to STD treatment by the patients (23) .…”

“…It is recommended that care in these health facilities follow the following flow: a) initially, each volunteer to the test should be guided at the embracement about the tests offered, receive a password, and be registered; b) after this, the user should be submitted to pre-test counseling, individual or collective, and should discuss issues related to the voluntary nature of testing, as well as confidentiality, possible emotional reactions triggered at this stage, notions about immunological window and safer sexual practices; c) if the person agrees to perform the tests, will be sent to perform the test, which takes on average 30 minutes, between the execution and its result; d) the post-test counseling is performed, with the recommendation that the result should be delivered by the same counselor of the pre-test, because it prioritizes the initial link established with the user (2) . Four decades ago, there was the international recommendation on the provision of counseling and voluntary testing as a means to respond effectively and effectively to the HIV/AIDS epidemic (3)(4) .…”

Movimento social de mulheres com HIV/AIDS: uma experiência entre cidadãs “posithivas” do Rio de Janeiro, Brasil

“…According to their account, after confirming thatthey were infected, they did not receive support, listening or focus on the conditions of vulnerability to AIDS. It should be noted that post-diagnosis advice is part of the national guidelines, but its implementation remains a challenge 29 .…”

A educação para o enfrentamento da epidemia do HIV

“…Considering the context of the Rapid Test (RT) decentralization and the expansion of access to treatment, some qualitative research is taking place in Brazil to evaluate the way this process is developing. In Rio de Janeiro, the research involving the training course and practice of counselors in RT showed that it is essential to promote dialogues regarding the recommendations of the guidelines, relating to local knowledge, the team's interdisciplinary way of acting and the point of view of the user 5 .…”