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      Posições sexuais, estilos corporais e risco para o HIV entre homens que fazem sexo com homens no Recife (Brasil) Translated title: Sexual positions, body styles and HIV risk among men who have sex with men in Recife (Brazil)

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          Abstract

          Resumo O artigo apresenta resultados de pesquisa etnográfica na comunidade gay do Recife (PE), realizada por meio de observação participante e entrevistas. Objetiva compreender condutas sexuais de risco de homens que fazem sexo com homens (HSH) ao HIV, focando os sentidos das posições sexuais no intercurso anal — receptivo (IAR) e insertivo (IAI). Praticantes de IAR desprotegido são sujeitos a maior risco de infecção que praticantes de IAI. Os que praticam ambos, IAR e IAI, são elos amplificadores (maiores chances de receber e passar o vírus) nas cadeias de transmissão. O texto aborda as categorias êmicas, relacionadas com as identidades de gênero — pintosa (gay feminino), boy (gay masculino) e cafuçu (HSH e com mulheres, não gay, masculino, classe popular) — e com as identidades sexuais — ativo (IAI), passivo (IAR) e versátil (IAI e IAR) —, nos modos como significam as posições sexuais e produzem atração sexual. Os homens masculinos são os sexualmente desejados. Boys tendem a se relacionar com boys, e pintosas, com cafuçus. Há expressivo número de versáteis, o que amplia o risco coletivo dentro da comunidade gay. Por meio das relações entre pintosas e cafuçus, pode existir um caminho propício para o vírus circular mais entre a comunidade gay e a sociedade mais ampla.

          Translated abstract

          Abstract The article presents the results of an ethnographic study of the gay community in Recife (PE), conducted via participant observation and interviews. It seeks to understand sexual risk conduct among men who have sex with men (MSM) and HIV, focusing on the significance of sexual positions during anal-receptive intercourse (ARI) and anal-insertive intercourse (AII). Those who practice unprotected ARI are subject to a greater risk of infection than those who practice AII. Those who practice both, ARI and AII, are amplifiers (greater chances of receiving and passing on the virus) in the transmission chains. The text addresses the emic categories related with gender identities – pintosa (female gay), boy (male gay), and cafuçu (MSM and with women, non-gay, male, lower social class) – and with gender identities – active (AII), passive (ARI), and versatile (AII and ARI) – in the ways they result in sexual positions and produce sexual attraction. Masculine men are the most sexually desirable. Boys tend to relate with boys, and pintosas with cafuçus. There is a significant number of versatiles, which increases the collective risk within the gay community. By means of the relations between pintosas and cafuçus, there is increased danger for the virus to circulate more among the gay community and society in general.

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          Most cited references 19

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          Diferença, diversidade, diferenciação

           Avtar Brah (2006)
          A primeira parte do texto trata das várias noções de "diferença" que surgiram na recente controvérsia sobre a categoria "negro" (black) como sinal comum para a experiência de grupos africanos-caribenhos e do sul da Ásia na Grã-Bretanha do pós-guerra. O objetivo é assinalar como "negro" operou como sinal contingente em diferentes circunstâncias políticas. A segunda seção considera as maneiras como questões de "diferença" foram enquadradas na teoria e na prática feministas durante as décadas de 1970 e 1980, tendo como foco principal o debate britânico. A autora conclui com um breve exame de algumas categorias conceituais usadas na teorização da "diferença", sugerindo um novo quadro para análise.
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            A critical analysis of the Brazilian response to HIV/AIDS: lessons learned for controlling and mitigating the epidemic in developing countries.

            The Brazilian National AIDS Program is widely recognized as the leading example of an integrated HIV/AIDS prevention, care, and treatment program in a developing country. We critically analyze the Brazilian experience, distinguishing those elements that are unique to Brazil from the programmatic and policy decisions that can aid the development of similar programs in other low- and middle-income and developing countries.Among the critical issues that are discussed are human rights and solidarity, the interface of politics and public health, sexuality and culture, the integration of prevention and treatment, the transition from an epidemic rooted among men who have sex with men to one that increasingly affects women, and special prevention and treatment programs for injection drug users.
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              HIV among MSM in a large middle-income country.

              To conduct the first national biological and behavioral surveillance survey for HIV among MSM in Brazil. A cross-sectional surveillance study utilizing Respondent Driven Sampling (RDS) in 10 cities, following formative research. Planned sample: 350 MSM reporting sex with another man in the last 12 months, at least 18 years of age, and residing in the city of the study. Conventional RDS recruitment. Results were calculated for each city using RDSAT 5.6. For the national estimate, a new individual weight using a novel method was calculated. The 10 cities were aggregated, treated as strata and analyzed using STATA11.0. Self-reported HIV status and logistic regression was used to impute missing values for serostatus, an important issue for RDSAT. A total of 3859 MSM were interviewed. Sample was diverse, most self-identified as mulatto or black, were social class C or below, and had relatively low levels of education. More than 80% reported more than one partner in the last 6 months. Only 49% had ever tested for HIV. HIV prevalence among MSM ranged from 5.2 to 23.7% in the 10 cities (3.7-16.5% without imputation) and was 14.2% for all cities combined with imputation. The overall prevalence was two and three times higher than that estimated for female sex workers and drug users, respectively, in Brazil. Half of those who tested HIV positive were not aware of their infection. The AIDS epidemic in Brazil is disproportionately concentrated among MSM, as has been found in other countries. Renewed efforts to encourage testing, prevention and treatment are required.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1413-8123
                1678-4561
                2019
                : 24
                : 3
                : 973-982
                Affiliations
                Recife Pernambuco orgnameUniversidade Federal de Pernambuco orgdiv1Centro de Filosofia e Ciências Humanas orgdiv2Departamento de Psicologia Brazil lfelipe.rios@ 123456pq.cnpq.br
                Article
                S1413-81232019000300973
                10.1590/1413-81232018243.34092016

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 33, Pages: 10
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