Desde a identificação das primeiras pessoas com aids vêm ocorrendo mudanças no perfil da epidemia. Acometendo inicialmente homens, adultos com alta escolaridade e com práticas homossexuais, passou a atingir cada vez mais os jovens, os grupos sociais de maior exclusão social, as pessoas com práticas heterossexuais e as mulheres. Observa-se crescimento de casos em mulheres a partir da década de 90, embora proporcionalmente o número de casos seja ainda maior em homens. Até novembro de 2000, do total de 196 016 casos de aids notificados no Brasil, um quarto era do sexo feminino. Após o diagnóstico da infecção pelo HIV, as mulheres enfrentam dificuldades das mais variadas formas, desde aquelas relacionadas à infecção e ao adoecimento, ao tratamento e aos cuidados diários, até aquelas referidas ao campo afetivo-relacional. Dado que a doença é envolta em preconceito, estigma que podem levar a discriminação há preocupação das mulheres com o \"segredo\" da infecção pelo HIV. Considerando isto, o Programa Saúde da Família (PSF) pode incluir ações que desenvolvam habilidades de busca e recepção de apoio social, fortalecimento de vínculos familiares e sociais na assistência e convivência com as pessoas acometidas pelo HIV/AIDS. O PSF convergindo para a promoção da qualidade de vida das pessoas e de seu ambiente pode intensificar as ações de promoção à saúde e prevenção do HIV. Desta forma, entende-se que, considerando a autonomia da usuária, a abertura da privacidade pela usuária pode auxiliar na resposta às necessidades de saúde pelas equipes de PSF. As discussões sobre os conflitos que os profissionais de saúde do PSF encontram no seu cotidiano e que envolvem a manutenção da privacidade e sigilo das informações das usuárias, na perspectiva da Bioética, especialmente na questão do HIV/AIDS, são objetos do presente estudo. Seus resultados podem servir como subsídios para a reflexão das práticas do PSF e conseqüentemente para a melhoria da qualidade da assistência em saúde. Este estudo teve como objetivo discutir as situações que envolvem questões de privacidade e sigilo das informações nas experiências de assistência às mulheres portadoras de HIV/AIDS, vivenciadas pelas equipes do PSF. Trata-se de um estudo qualitativo descritivo, exploratório, na qual foram utilizadas as metodologias de grupo focal e entrevista semi estruturada. Foi realizada numa Unidade Básica de Saúde que opera com modelo de PSF no município de São Paulo. Foram coletadas as falas de dois grupos focais com agentes comunitários de saúde (ACS) e 25 entrevistas individuais com enfermeiros, médicos e auxiliares de enfermagem. Os depoimentos foram analisados segundo Bardin e organizados nos temas: a) a revelação do diagnóstico de HIV para a usuária; b) acolhimento e vínculo na abertura da privacidade; c) a revelação do diagnóstico de HIV aos membros da equipe de PSF e, d) discussão em equipe e o sigilo das informações. Verificou-se que os profissionais do PSF tomam conhecimento sobre o diagnóstico do HIV pela própria usuária, familiares, vizinhos, ACS ou outro membro da equipe e profissionais de saúde dos serviços de referência, além do prontuário e dos resultados de exames. A mulher revela seu diagnóstico de HIV, abrindo sua privacidade quando há confiança e vínculo na relação usuáriaprofissional. Os profissionais buscam assegurar o sigilo referente ao diagnóstico do HIV. A abertura da privacidade da informação possibilita a discussão das necessidades de saúde da usuária e o planejamento das ações pelas equipes de PSF / Ever since the first cases of Aids were identified, there has been a change on the profile of the disease. In the beginning its was predominantly seen in well-informed adult males with homosexual practices, then changing to a much younger group, with less access to information and also women. After the 90`s you will see a significant increase in the number of cases in women although men are still the most affected. In November of 2000, there were 196016 cases of Aids identified in Brazil, where 25% were females.After diagnosis, women would face many difficulties such as things related to the infection and illness itself, treatment and everyday care and also personal relationships. Those infected with Aids, are many times worried about discrimination and stereotyping what makes them keep it secret. The objective of the Family\'s Health Program (PSF) is to make people seek help to strengthen social and family links and also learn to live and socialize with other people with HIV/AIDS. The PSF promotes quality of life, healthy practices and HIV prevention. Patients disclose more information and that helps PSF professionals find more answers to the healthcare questions they might have. That creates another problem that refers to confidentiality and bioethics which are also subjects of the present study. Its Results can increase awareness about the practices of PSF and with that, improve the quality of healthcare assistance. The objective of this study is to discuss privacy and confidentiality of information related to women infected with HIV/AIDS, that were assisted by PSF teams. It is a descriptive, qualitative, exploratory study that focused on focal groups and semi structured interview methods. It was done at a Health Basic Unit that operates using a PSF model in São Paulo. Data was collected from two groups with communitarian agents of health (ACS) and also 25 different interviews with nurses, tecnics, and doctors. Testimonies were analyzed according to Bardin and put into different categories: a) Revealing HIV diagnosis to users of PSF; b) Welcoming and using bonding experiences when talking about the subject; c) Revealing HIV diagnosis to the members of PSF team; d) Team discussion and confidentiality of information.We found that PSF professionals learn about the diagnosis through the patients themselves, their families, ACS and other healthcare professionals and of course, official test results. The women patients feel comfortable to talk about their HIV diagnosis when there is trust in the healthcare professional - user relationship. Professionals always try to ensure confidentiality of information about the diagnosis. This information enables professionals to talk about the health condition of the users and help PSF team members set up a plan of action.

Desde a identificação das primeiras pessoas com aids vêm ocorrendo mudanças no perfil da epidemia. Acometendo inicialmente homens, adultos com alta escolaridade e com práticas homossexuais, passou a atingir cada vez mais os jovens, os grupos sociais de maior exclusão social, as pessoas com práticas heterossexuais e as mulheres. Observa-se crescimento de casos em mulheres a partir da década de 90, embora proporcionalmente o número de casos seja ainda maior em homens. Até novembro de 2000, do total de 196 016 casos de aids notificados no Brasil, um quarto era do sexo feminino. Após o diagnóstico da infecção pelo HIV, as mulheres enfrentam dificuldades das mais variadas formas, desde aquelas relacionadas à infecção e ao adoecimento, ao tratamento e aos cuidados diários, até aquelas referidas ao campo afetivo-relacional. Dado que a doença é envolta em preconceito, estigma que podem levar a discriminação há preocupação das mulheres com o \"segredo\" da infecção pelo HIV. Considerando isto, o Programa Saúde da Família (PSF) pode incluir ações que desenvolvam habilidades de busca e recepção de apoio social, fortalecimento de vínculos familiares e sociais na assistência e convivência com as pessoas acometidas pelo HIV/AIDS. O PSF convergindo para a promoção da qualidade de vida das pessoas e de seu ambiente pode intensificar as ações de promoção à saúde e prevenção do HIV. Desta forma, entende-se que, considerando a autonomia da usuária, a abertura da privacidade pela usuária pode auxiliar na resposta às necessidades de saúde pelas equipes de PSF. As discussões sobre os conflitos que os profissionais de saúde do PSF encontram no seu cotidiano e que envolvem a manutenção da privacidade e sigilo das informações das usuárias, na perspectiva da Bioética, especialmente na questão do HIV/AIDS, são objetos do presente estudo. Seus resultados podem servir como subsídios para a reflexão das práticas do PSF e conseqüentemente para a melhoria da qualidade da assistência em saúde. Este estudo teve como objetivo discutir as situações que envolvem questões de privacidade e sigilo das informações nas experiências de assistência às mulheres portadoras de HIV/AIDS, vivenciadas pelas equipes do PSF. Trata-se de um estudo qualitativo descritivo, exploratório, na qual foram utilizadas as metodologias de grupo focal e entrevista semi estruturada. Foi realizada numa Unidade Básica de Saúde que opera com modelo de PSF no município de São Paulo. Foram coletadas as falas de dois grupos focais com agentes comunitários de saúde (ACS) e 25 entrevistas individuais com enfermeiros, médicos e auxiliares de enfermagem. Os depoimentos foram analisados segundo Bardin e organizados nos temas: a) a revelação do diagnóstico de HIV para a usuária; b) acolhimento e vínculo na abertura da privacidade; c) a revelação do diagnóstico de HIV aos membros da equipe de PSF e, d) discussão em equipe e o sigilo das informações. Verificou-se que os profissionais do PSF tomam conhecimento sobre o diagnóstico do HIV pela própria usuária, familiares, vizinhos, ACS ou outro membro da equipe e profissionais de saúde dos serviços de referência, além do prontuário e dos resultados de exames. A mulher revela seu diagnóstico de HIV, abrindo sua privacidade quando há confiança e vínculo na relação usuáriaprofissional. Os profissionais buscam assegurar o sigilo referente ao diagnóstico do HIV. A abertura da privacidade da informação possibilita a discussão das necessidades de saúde da usuária e o planejamento das ações pelas equipes de PSF / Ever since the first cases of Aids were identified, there has been a change on the profile of the disease. In the beginning its was predominantly seen in well-informed adult males with homosexual practices, then changing to a much younger group, with less access to information and also women. After the 90`s you will see a significant increase in the number of cases in women although men are still the most affected. In November of 2000, there were 196016 cases of Aids identified in Brazil, where 25% were females.After diagnosis, women would face many difficulties such as things related to the infection and illness itself, treatment and everyday care and also personal relationships. Those infected with Aids, are many times worried about discrimination and stereotyping what makes them keep it secret. The objective of the Family\'s Health Program (PSF) is to make people seek help to strengthen social and family links and also learn to live and socialize with other people with HIV/AIDS. The PSF promotes quality of life, healthy practices and HIV prevention. Patients disclose more information and that helps PSF professionals find more answers to the healthcare questions they might have. That creates another problem that refers to confidentiality and bioethics which are also subjects of the present study. Its Results can increase awareness about the practices of PSF and with that, improve the quality of healthcare assistance. The objective of this study is to discuss privacy and confidentiality of information related to women infected with HIV/AIDS, that were assisted by PSF teams. It is a descriptive, qualitative, exploratory study that focused on focal groups and semi structured interview methods. It was done at a Health Basic Unit that operates using a PSF model in São Paulo. Data was collected from two groups with communitarian agents of health (ACS) and also 25 different interviews with nurses, tecnics, and doctors. Testimonies were analyzed according to Bardin and put into different categories: a) Revealing HIV diagnosis to users of PSF; b) Welcoming and using bonding experiences when talking about the subject; c) Revealing HIV diagnosis to the members of PSF team; d) Team discussion and confidentiality of information.We found that PSF professionals learn about the diagnosis through the patients themselves, their families, ACS and other healthcare professionals and of course, official test results. The women patients feel comfortable to talk about their HIV diagnosis when there is trust in the healthcare professional - user relationship. Professionals always try to ensure confidentiality of information about the diagnosis. This information enables professionals to talk about the health condition of the users and help PSF team members set up a plan of action.

La première partie de l’étude est consacrée à l’invocation, intra et extra muros, du droit à un procès équitable. Sont analysés ainsi, dans un premier temps, l’applicabilité directe de l’article 6 et la subsidiarité de la Convention par rapport au droit national et de la Cour Européenne des Droits de l’Homme par rapport aux juridictions nationales. Le droit à un procès équitable étant un droit jurisprudentiel, l’étude se focalise, dans un second temps, sur l’invocabilité des arrêts de la Cour Européenne et plus précisément sur l’invocabilité directe de l’arrêt qui constate une violation du droit à un procès équitable dans une affaire mettant en cause l’Etat et l’invocabilité de l’interprétation conforme à l’arrêt qui interprète l’article 6 dans une affaire mettant en cause un Etat tiers. L’introduction dans l’ordre juridique français et hellénique de la possibilité de réexamen de la décision pénale définitive rendue en violation de la Convention a fait naitre un nouveau droit d’accès à la Cour de cassation lequel trouve son terrain de prédilection aux violations de l’article 6 et constitue peut-être le pas le plus important pour le respect du droit à un procès équitable après l’acceptation (par la France et la Grèce) du droit de recours individuel. Quant au faible fondement de l’autorité de la chose interprétée par la Cour Européenne, qui est d’ailleurs un concept d’origine communautaire, cela explique pourquoi un dialogue indirect entre la Cour Européenne et la Cour de cassation est possible sans pour autant changer en rien l’invocabilité de l’interprétation conforme et le fait que l’existence d’un précédent oblige la Cour de cassation à motiver l’interprétation divergente qu’elle a adoptée.La seconde partie de l’étude, qui est plus volumineuse, est consacrée aux garanties de bonne administration de la justice (article 6§1), à la présomption d’innocence (article 6§2), aux droits qui trouvent leur fondement conventionnel dans l’article 6§1 mais leur fondement logique dans la présomption d’innocence et aux droits de la défense (article 6§3). Sont ainsi analysés le droit à un tribunal indépendant, impartial et établi par la loi, le délai raisonnable, le principe de l’égalité des armes, le droit à une procédure contradictoire, le droit de la défense d’avoir la parole en dernier, la publicité de l’audience et du prononcé des jugements et arrêts, l’obligation de motivation des décisions, la présomption d’innocence, dans sa dimension procédurale et personnelle, le « droit au mensonge », le droit de l’accusé de se taire et de ne pas contribuer à son auto-incrimination, son droit d’être informé de la nature et de la cause de l’accusation et de la requalification envisagée des faits, son droit au temps et aux facilités nécessaires à la préparation de la défense, y compris notamment la confidentialité de ses communications avec son avocat et le droit d’accès au dossier, son droit de comparaître en personne au procès, le droit de la défense avec ou sans l’assistance d’un avocat, le droit de l’accusé d’être représenté en son absence par son avocat, le droit à l’assistance gratuite d’un avocat lorsque la situation économique de l’accusé ne permet pas le recours à l’assistance d’un avocat mais les intérêts de la justice l’exigent, le droit d’interroger ou faire interroger les témoins à charge et d’obtenir la convocation et l’interrogation des témoins à décharge dans les mêmes conditions que les témoins à charge et le droit à l’interprétation et à la traduction des pièces essentielles du dossier. L’analyse est basée sur la jurisprudence strasbourgeoise et centrée sur la position qu’adoptent la Cour de cassation française et l’Aréopage. / The first party of the study is dedicated to the invocation of the right to a fair trial intra and extra muros and, on this basis, it focuses on the direct applicability of Article 6 and the subsidiarity of the Convention and of the European Court of Human Rights. Because of the fact that the right to a fair trial is a ‘‘judge-made law’’, the study also focuses on the invocability of the judgments of the European Court and more precisely on the direct invocability of the European Court’s judgment finding that there has been a violation of the Convention and on the request for an interpretation in accordance with the European Court’s decisions. The possibility of reviewing the criminal judgment made in violation of the Convention has generated a new right of access to the Court of cassation which particularly concerns the violations of the right to a fair trial and is probably the most important step for the respect of the right to a fair trial after enabling the right of individual petition. As for the weak conventional basis of the authority of res interpretata (“autorité de la chose interprétée”), this fact explains why an indirect dialogue between the ECHR and the Court of cassation is possible but doesn’t affect the applicant’s right to request an interpretation in accordance with the Court’s decisions and the duty of the Court of cassation to explain why it has decided to depart from the (non-binding) precedent.The second party of the study is bigger than the first one and is dedicated to the guarantees of the proper administration of justice (Article 6§1), the presumption of innocence (Article 6§2), the rights which find their conventional basis on the Article 6§1 but their logical explanation to the presumption of innocence and the rights of defence (Article 6§3). More precisely, the second party of the study is analyzing the right to an independent and impartial tribunal established by law, the right to a hearing within a reasonable time, the principle of equality of arms, the right to adversarial proceedings, the right of the defence to the last word, the right to a public hearing and a public pronouncement of the judgement, the judge’s duty to state the reasons for his decision, the presumption of innocence, in both its procedural and personal dimensions, the accused’s right to lie, his right to remain silent, his right against self-incrimination, his right to be informed of the nature and the cause of the accusation and the potential re-characterisation of the facts, his right to have adequate time and facilities for the preparation of the defence, including in particular the access to the case-file and the free and confidential communication with his lawyer, his right to appear in person at the trial, his right to defend either in person or through legal assistance, his right to be represented by his counsel, his right to free legal aid if he hasn’t sufficient means to pay for legal assistance but the interests of justice so require, his right to examine or have examined witnesses against him and to obtain the attendance and examination of witnesses on his behalf under the same conditions as witnesses against him and his right to the free assistance of an interpreter and to the translation of the key documents. The analysis is based on the decisions of the European Court of Human Rights and focuses on the position taken by the French and the Greek Court of Cassation (Areopagus) on each one of the above mentioned rights.