The last few years have seen an increase in the infection rate not only of HIV but also TB. The HIV/AIDS pandemic is increasing rapidly mainly in developing countries with 71 % of infections in the Sub-Saharan region of Africa. South Africa, which forms part of the Sub- Saharan region, has the highest infection rate in the world with 3.2 to 3.4 million people living with HIV/AIDS. People with HIV are especially vulnerable to TB, and HIV pandemic is fuelling an explosive growth in TB cases. The increase in the infection rate of TB and HIV exert increased pressure on health service delivery thus reflecting the serious problem in the country with regard to health service delivery to people co-infected with TB and HlV/AlDS. Health service delivery is also hindered by negative attitudes of health workers that have been reported towards people living with HIV/AIDS. They entertain a biased view of their own risk, considering risk only from occupational exposure and denying the possibility of infection in their private life. These attitudes of health workers decreases the quality of care and support delivered to patient co-infected with TB and HIV. This result in people not disclosing their illness even in cases were treatment is available like TB for the fear of stigmatisation. Hence the problem of stigmatisation escalates into a dilemma for the patient co-infected with TB and HIV. Therefore these patients tend to shy away from health services and isolate themselves due to fear of being stigmatised twice. The need to address TB and HIV together in the light of this dimension is urgent so as to improve the utilization of the health services by people co-infected with Ti3 and HIV. The purpose of this research was to explore and describe the experiences of patients co-infected with TB and HIV regarding stigmatisation by the health workers, to explore and describe the attitudes of health workers towards patients co-infected with TB and HIV, and to formulate guidelines for health workers that will facilitate the health service utilization by patients co-infected with TB and HIV in the Potchefstroom district. The research was conducted in the Potchefstroom district in the North West province of South Africa. A qualitative research design was used to explore and describe the experiences of patients co-infected with TB and HIV regarding stigmatisation by the health workers, and to explore and describe the attitudes of health workers toward co-infected patients. A purposive voluntary sampling method was used to select participants who met the set criteria. Two populations were used, that is the patients co-infected with TB and HIV, and the health workers who were involved in their care. In depth unstructured interviews were conducted with the patient population and semi structured interviews with the health worker population using an interview schedule that was formulated from the background literature. Data was captured on an audiotape, and transcribed verbatim. Field notes were taken immediately after each interview. The researcher and a co-coder did data analysis after data saturation was reached and a consensus was reached on the categories that emerged. From the findings of this research it appeared that there were general perceptions by the patients co-infected with TB and HIV that indicated stigmatisation by the health workers. This perceived stigmatisation was reported as being perpetrated by all categories of health workers. Negative behaviours such as the health workers not having time for the patients and being impatient were reported. Lack of sufficient knowledge was related to these behaviours especially amongst lower categories or non-professional health workers. In spite of the above, the researcher also observed that there was a limited number of health workers who were still being perceived as committed and caring by the patients co-infected with TB and HIV. The researcher concluded that the relationship between the health workers and the patients co-infected with TB and HIV was characterised by conflict. The health workers seemed to perceive the patients co-infected with TB and HIV as stubborn, harsh, abuse alcohol, manipulative and not taking responsibility of their illness. These perceptions lead the health workers to have a negative attitude towards these patients and occasionally came across as unsympathetic towards them. On the other hand the researcher observed that there were other health workers who did not present with negative behaviours towards these patients and tried to understand the reasons for their sometimes-unacceptable behaviours. Recommendations are made for the field of nursing education, community health nursing practice and nursing research with the formulation of guidelines for health workers so as to facilitate the utilization of the health services by the patients co-infected with TB and HIV. The guidelines are discussed under three main categories, namely guidelines for the health workers to facilitate the utilization of the health services by the patients co-infected with TB and HIV, guidelines to improve the utilization of the health services more efficiently and adequately by the patients co-infected with TB and HIV, and guidelines to improve the attitudes of the health workers towards the patients co-infected with TB and HIV with the intention of improving the utilization of the health services by these patients. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2006.

In this dissertation, the argument is the understanding of the beliefs of Black farm workers regarding HIV and Aids and how these beliefs that protect them from being infected, will lead to the formulation of suggestions for a belief-sensitive approach, which can be incorporated by health care professionals in HIV and Aids-prevention programmes for Black farm workers. Several authors stress the fact that if any HIV and Aids programme is to be implemented successfully, the health care profession should strive to know more about the beliefs of the community, in this case Black farm workers, so that there can be sound human relations and effective programmes. Based on the problem statement for this study the following research questions were asked: 1. What are the beliefs of black farm workers regarding HIV and Aids? 2. How do these beliefs protect them from being infected? 3. Based on the answers to the first two questions, what suggestions can be formulated regarding a belief-sensitive approach in HIV and Aids-prevention programmes for Black farm workers? The objectives were in line with these questions, namely to explore and describe the beliefs of Black farm workers regarding HIV and Aids; to explore and describe how these beliefs protect them from being infected; and to formulate recommendations, specifically suggestions regarding a belief-sensitive approach in HIV and Aids-prevention programmes for Black farm workers. The study followed a qualitative, explorative and descriptive approach. A participatory rural appraisal (PRA) approach was used to collect data. 'Lekgotla' was used as a strategy to collect data. The results indicated that Black farm workers do have beliefs about HIV and Aids. Most of the beliefs they uphold protect them from being infected, however there are some marginal beliefs that can put them at risk of being infected. Suggestions, which health care professionals can incorporate in HIV and Aids-prevention programmes for Black farm workers, were formulated based on the results, a literature control and ensuing conclusions. Beliefs of Black farm workers that protect them from being infected could be included in the suggestions for prevention strategies. Health care professionals involved in prevention strategies should actively listen to Black farm workers’ beliefs in order for these strategies to be successful. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2009.

In this dissertation, the argument is the understanding of the beliefs of Black farm workers regarding HIV and Aids and how these beliefs that protect them from being infected, will lead to the formulation of suggestions for a belief-sensitive approach, which can be incorporated by health care professionals in HIV and Aids-prevention programmes for Black farm workers. Several authors stress the fact that if any HIV and Aids programme is to be implemented successfully, the health care profession should strive to know more about the beliefs of the community, in this case Black farm workers, so that there can be sound human relations and effective programmes. Based on the problem statement for this study the following research questions were asked: 1. What are the beliefs of black farm workers regarding HIV and Aids? 2. How do these beliefs protect them from being infected? 3. Based on the answers to the first two questions, what suggestions can be formulated regarding a belief-sensitive approach in HIV and Aids-prevention programmes for Black farm workers? The objectives were in line with these questions, namely to explore and describe the beliefs of Black farm workers regarding HIV and Aids; to explore and describe how these beliefs protect them from being infected; and to formulate recommendations, specifically suggestions regarding a belief-sensitive approach in HIV and Aids-prevention programmes for Black farm workers. The study followed a qualitative, explorative and descriptive approach. A participatory rural appraisal (PRA) approach was used to collect data. 'Lekgotla' was used as a strategy to collect data. The results indicated that Black farm workers do have beliefs about HIV and Aids. Most of the beliefs they uphold protect them from being infected, however there are some marginal beliefs that can put them at risk of being infected. Suggestions, which health care professionals can incorporate in HIV and Aids-prevention programmes for Black farm workers, were formulated based on the results, a literature control and ensuing conclusions. Beliefs of Black farm workers that protect them from being infected could be included in the suggestions for prevention strategies. Health care professionals involved in prevention strategies should actively listen to Black farm workers’ beliefs in order for these strategies to be successful. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2009.

<p>The devastation caused by the Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) is having a major impact on both the social and economic environment in South Africa. HIV/AIDS hits at the core of the businesses structure - the bottom line. In the absence of a cure for the disease or an effective vaccine, the challenge for all the stakeholders is how to successfully contain and limit the impact of the disease. Intervention programmes such as awareness, knowledge sharing and sero-prevailance testing have the potential to limit HIV/AIDS infections and reduce high-risk behaviours. Whilst education and awareness programmes have been relatively successful in highlighting the dangers of HIV infection, perception, attitudes and behaviours of employees towards HIV/AIDS have dampened voluntary HIV screening initiatives. Many South African organisations have commendable HIV/AIDS education and awareness programmes, however, a concerning fact is that employees are reluctant to avail themselves to voluntary HIV/AIDS testing. Stigmatising attitudes toward persons living with HIV/AIDS may reduce people&rsquo / s willingness to have themselves tested for the Human Immunodeficiency Virus (HIV). This may increase the risk of transmission. It may also lead to increased absenteeism in the workplace, and workdays lost resulting from excessive sick.<br /> <br /> The aim of the study was to establish what the perceptions and attitudes are of employees at different levels of the organisation with regard to HIV/AIDS testing. A further aim was to identify possible reasons for the poor employee response to voluntary HIV/AIDS testing. It was thus important for this research to gauge employee knowledge, attitude and behaviour toward HIV/AIDS in order for organisations to develop strategies for effective HIV/AIDS counselling and testing programmes.<br /> <br /> The data for this study was collected by means of a self report questionnaire. The questionnaire was administered to a sample of employees across all levels of the organisation using the convenient sample approach to identify the respondents. Two hundred and forty six (246) out of a total of 600 questionnaires distributed were returned, making the response rate a credible 41%.<br /> The Statistical Package for Social Science (SPSS) was used to analyse the data obtained from the questionnaire. Both inferential and descriptive statistical approaches were used to analyse the data. The Analyses Of Variance (ANOVA) was used to determine whether differences exist in the perceptions and attitudes of employees at different levels and groupings in the organisation. Additionally post hoc tests (i.e. the Scheffe test) were applied to all comparisons of means after the analysis of variance.<br /> <br /> The findings of this research are important for the role of HIV/AIDS testing and awareness/preventions strategies implemented in South Africa. It provides more insight as to why employees resist HIV/AIDS testing. It can furthermore assist organisations in developing strategies for implementing effective HIV/AIDS awareness and/or prevention programmes. More specifically, the findings identified ways in which organisations can redesign their intervention programmes so as to encourage a greater number of employees to submit to voluntary HIV/AIDS testing.</p>

The HIV and AIDS pandemic is arguably the greatest threat facing the world today. The pandemic has a far-reaching impact on society, including the workplace. The effect in the workplace is observed in various areas including a reduction in certain skills levels, mortality and declining job performance of employees living with HIV or AIDS. In addition, the fear of discrimination and stigmatisation prevents infected employees from disclosing their HIV status, thus driving the pandemic underground. Despite the potential negative impact that is looming, many employers still do not have any workplace support programmes in place to manage HIV and AIDS in their organisations. However, some employers have implemented workplace support programmes. This research thus explored the influence of workplace support programmes on the job performance of employees that were living with HIV or AIDS. The findings suggest that job performance is positively influenced where workplace support programmes have been implemented. / Industrial and Organisational Psychology / M.Comm. (Industrial and Organisational Psychology)

A magnitude da epidemia da aids e os desafios em garantir uma rede de atenção que atenda às necessidades das pessoas que vivem com HIV/AIDS justificam a realização do presente estudo, que tem por objetivos: contextualizar a trajetória em busca por cuidados de uma mulher que vive com HIV/AIDS e discutir os nós críticos da integralidade neste percurso. Trata-se de um estudo de caso, qualitativo, exploratório, na perspectiva teórico-conceitual da Integralidade. Utilizou-se a História de Vida Focal e o Itinerário Terapêutico. Para análise dos resultados, utilizou-se análise de discurso proposta por Fiorin. Identificou-se neste percurso que os desafios de conviver com o HIV consistiram em: lidar com o risco da transmissão vertical; conviver com o medo de ter o diagnóstico revelado; e conciliar a rotina de vida com a manutenção da terapia antirretroviral. As fragilidades da integralidade neste percurso consistiram em: predominante visão biológica do adoecimento na Atenção Básica; falta de articulação entre UBS, SAE-DST/AIDS e maternidade; falta de fluxos estruturados para a assistência da mulher com HIV na maternidade; e a invisibilidade do trabalho da enfermeira. Como potencialidades da integralidade: as Redes de Sustentação (família e amiga) e Apoio (trabalho, estudo, igreja e alguns profissionais de saúde); e a organização dos serviços ao favorecer acessibilidade à usuária no sistema de serviços de saúde. Concluiu-se que a articulação dos serviços ainda se encontra fragilizada e que está no usuário a centralidade da busca por cuidados, sendo ele e sua família, elos integradores entre os diferentes serviços assistenciais de saúde. Apontou-se a necessária implementação de Linhas de Cuidado na Atenção em HIV/AIDS, a fim de buscar integralidade na organização dos fluxos assistenciais. / The magnitude of the AIDS epidemic and the need for a network of comprehensive care to people living with HIV/AIDS justify the conduct of this study. The study aims were: to contextualize the trajectory in search for care of a woman living with HIV/AIDS and to discuss the critical points of the Comprehensiveness in this trajectory. This was a case-study, qualitative, exploratory, with the theoretical-conceptual of the Comprehensiveness. The method used was the Focused Life History and the Therapeutic Itinerary. The data were analyzed using the Fiorins Technical Discourse. The study identified that there are challenges of living with HIV: afraid of the risk of vertical transmission during pregnancy; to omit the diagnosis of HIV for afraid of prejudice and social isolation; and to reconcile the routine of study, work, care for her daughter and her mother, with the need to remain adhered to antiretroviral therapy. The problems of the Comprehensiveness in this trajectory were: predominantly biological view of illness in Primary Health Care; lack of articulation between Basic Health Units, Reference Units on HIV/AIDS and maternity hospital; lack of structured flows for the assistance of women with HIV in maternity hospital; and invisibility of the nurses work. As potentials Comprehensiveness: networks of support (family, friend, some health workers, church, work and study) and the organization of services to facilitate user access to the system of health services. It was concluded that the articulation of the services is still fragile and that the search for care has centrality in the user of health services. Furthermore, the study concluded that is the user of health services and her family that make link in the network of health services. The study indicated the necessary implementation of Lines of Care in HIV/AIDS Attention, to get Comprehensiveness in the organization of care flows.

The widespread epidemic HIV/AIDS still remains a confirmed and terminal disease without any currable vaccine and therapy. The only means of protection to resist an infection and HIV spread is a patient´s education, motivation and proper prevention, whose essential tool for everybody is getting information. Especially young people are threatened by the attack of that infection, so mainly basic school should participate in the HIV/AIDS prevention. The first aim of my thesis is to find out, whether and what preventive activities are accomplished at basis schools in Pilsner Region. The research work has a qualitative character. The applied method was a questionaire which was sent and applied to 31 organizations associated in Forum of non-governmental organizations at National Comisssion for HIV/AIDS problem solving in 2006. Another applied method was the derived analysis of data and documents. The second aim of my thesis was to find out basic pupil´s knowledge about HIV/AIDS infection. A qualitative research was chosen to achieve objective results. A questionaire was a research method. 319 pupils from 8th and 9th classes created a selective group. HIV/AIDS problems are always included in some school subjects at all the basic schools. Tution of the appropriate topic is provide only by school teachers and outweighs the use of supporting preventive programmes. Increased demands on school teachers education about HIV/AIDS result from that fact. Basis school pupils have basic knowledge about HIV/AIDS infection. Most pupils acquired information about HIV/AIDS at basic schools. Pupils consider a condom to be a hundrer-per-cent protection to resist veneral diseases. Despite the knowledge of this danger pupils don´t feel threatened by HIV/AIDS infection. Results of my thesis proved that as for information handover, the prevention accomplished at basic schools is efficient. Pupils´ have information about HIV/AIDS. If they act up to them even in possible risky situations that is another question. Since it is a serious problem, it seems to be necessary to keep acting this prevention whose part should be not only the information handover, but also the action at pupil´s behaviour and their responsibility.

A infecção pelo HIV/aids no mundo atinge, desproporcionalmente, determinados grupos sociais, dentre eles a população privada de liberdade. Mediante o impacto da epidemia no âmbito carcerário, organismos internacionais orientam a adoção de estratégias de cuidado, pautadas em evidências científicas, o que determina o impacto positivo no controle do agravo nas prisões. Este estudo objetivou identificar e analisar as evidências científicas disponíveis na literatura sobre a assistência prestada às pessoas que vivem com HIV/aids (PVHA) no âmbito prisional. Trata-se de uma Revisão Integrativa da Literatura, tendo a prática baseada em evidências (PBE) como referencial teórico. No que se refere às etapas de desenvolvimento da revisão integrativa, procedeu-se à seleção dos estudos, por meio da utilização de descritores controlados e palavras-chaves junto às bases de dados LILACS, PUBMED, CINAHL e Web of Science. Dos 894 estudos recuperados, após leitura de forma independente por duas pesquisadoras, derivou-se uma amostra final de 15 estudos. Houve predomínio de pesquisas realizadas nos Estados Unidos, com população masculina, indivíduos afrodescendentes e com história pregressa de mais de um encarceramento ao longo da vida. A população abordada se encontrava em situação de privação de liberdade, contudo, em processo de transição para a comunidade. De modo geral, as estratégias de cuidado prestadas às PVHA em situação de encarceramento, enfocaram a coordenação e a transição para a comunidade, mediante estratégias de gestão de caso com referência e vínculo para serviços de saúde e sociais, planejamento de alta, tratamento de substituição com a utilização de metadona para dependentes químicos e a Terapia Antirretroviral Diretamente Administrada (DAART) para grupos com baixa adesão ao tratamento, em especial os usuários de drogas. Há que se ressaltarem as investiduras na identificação, sensibilização e engajamento de outros atores-chave, com destaque para egressos do sistema prisional visando a implementação de estratégias educativas, assistenciais e de suporte por pares, bem como a identificação, tentativa de reestabelecimento e fortalecimento de vinculo com a rede de suporte social dos indivíduos privados de liberdade em transição para a comunidade. Destaca-se o papel da enfermagem na viabilização das estratégias de gestão do caso, planejamento de alta, sensibilização e capacitação de atores-chave com potencial de engajamento nas atividades envolvendo o cuidado por pares. Concluiu-se que a assistência no âmbito prisional pautou-se no cuidado ampliado, transcendendo a dimensão clínica do manejo do HIV/aids em si, uma vez que incorporou no bojo das ações desenvolvidas, a identificação e integração de ações e serviços sociais e de saúde, valorizando, deste modo, um processo de cuidar pautado na reinserção social dos sujeitos no período que corresponde ao pré e pós-livramento prisional / The HIV infection affects certain social groups disproportionately, among them the prisoners. By the impact of the epidemic in prisonal ambit, international organizations guide to care strategies, conducted by scientific evidence, which determines the positive impact in controlling the disease in prisons. This study aimed to identify and analyze the scientific evidence available in the literature on assistance provided to people living with HIV/AIDS (PLWHA) in the prison context. This is an integrative review of the literature, and evidence-based practice (EBP) as the theoretical reference. With regard to development stages of the integrative review, we proceeded to the selection of studies, using controlled descriptors and keywords together to databases LILACS, PUBMED, CINAHL and Web of Science. Independently, two investigators read 894 recovered studies and derived a final sample of 15 studies. There was a predominance of researches done in the United States, with male population, Afro-descendant and individuals with a history of more than one life-long imprisonment. The covered population was in a situation of deprivation of liberty. However, they were in transition process to the community again. Generally, the care strategies provided to PLWHA in incarceration situation, focused on the coordination and the transition to the community, through case management strategies with reference and link to health and social services, discharge planning, substitution treatment with the use of methadone for drug addicts and the Directly Administered Antiretroviral Therapy (DAART) for groups with low adherence to treatment, particularly drug users. We have to highlight the investitures in identification, awareness and engagement of other key actors, especially former convicts, aiming the educational strategies implementation, care and support by peers, as well as the identification, attempt to re-establishment and strengthening of bonds with the social support network of private individuals of freedom in transition to the community. Besides, it is important to point the nursing role in the feasibility of case management strategies, discharge planning, sensitization and training of key actors with potential engagement in activities involving peer care. In conclusion, the assistance in the prison context was characterized in the extended care, transcending the clinical dimension of the management of HIV/AIDS itself. It is explained once it had incorporated in the core of the actions taken, the identification and integration of actions and social services and health, valuing, thus, a process of care founded on the social reintegration of the subjects in the period corresponding to the pre and post-prison

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / As doenÃas sexualmente transmissÃveis (DST) sÃo consideradas risco ocupacional para as prostitutas, podendo ser prevenidas com o uso do preservativo. Faz-se necessÃria uma conscientizaÃÃo acerca da sua importÃncia mediante a EducaÃÃo em SaÃde, pois esta à a estratÃgia mais eficiente na prevenÃÃo das DST/Aids, trazendo mudanÃa de comportamentos, valores e atitudes. Diante de toda a problemÃtica que à a prostituiÃÃo e sua relaÃÃo com as DST, interessou compreender o trabalho realizado pelas prostitutas da AssociaÃÃo das Prostitutas do Cearà - APROCE no que se refere à prevenÃÃo das DST/Aids. Nesse contexto, este estudo objetivou analisar o trabalho educativo realizado pelas prostitutas da APROCE no que se refere à prevenÃÃo das DST e Aids, e verificar se essa EducaÃÃo em SaÃde estimula a reflexÃo, criticidade, mudanÃa de comportamento, ou à somente um repasse de informaÃÃes. Dessa forma, despertou-se para a relaÃÃo do objeto de estudo com a abordagem teÃrica baseada nas reflexÃes de Paulo Freire, pois âmudanÃaâ, ao lado de âconscientizaÃÃoâ, à um âtema geradorâ da prÃtica teÃrica de Paulo Freire. Trata-se de uma pesquisa qualitativa, inspirada na teoria e prÃtica de Paulo Freire e analisada segundo a Teoria CrÃtica. Os dados foram agrupados de acordo com as etapas em que foram coletados: Observando as Educadoras Sociais e Dialogando com as Educadoras Sociais. Posteriormente, dividida a segunda parte em duas categorias: o perfil e o diÃlogo com as educadoras sociais. No diÃlogo com as educadoras sociais, foram identificados seus sentimentos quanto ao trabalho realizado; as principais dificuldades; os pontos facilitadores; como percebem seus resultados; os pontos mais e menos importantes do trabalho que realizam. Conclui-se, portanto, que conscientizar-se da importÃncia da prevenÃÃo das DST e Aids, e mudar de comportamento, nÃo sÃo tarefas simples, pois vÃrios fatores interferem na vida da prostituta. As estratÃgias de EducaÃÃo em SaÃde utilizadas pela AssociaÃÃo nÃo estimulam a reflexÃo, criticidade, mudanÃa de comportamento, como se deseja e espera, mas jà deu um grande passo, pois repassa informaÃÃes e entrega freqÃentemente o preservativo para as prostitutas, e, como essa à uma aÃÃo que acontece hà alguns anos, muitas mulheres jà mudaram de comportamento. Devem ser realizados projetos, estratÃgias mais eficazes, para que conscientizaÃÃo e mudanÃa aconteÃam em um menor espaÃo de tempo. Para obtenÃÃo desse fim, foram elaboradas estratÃgias metodolÃgicas de EducaÃÃo em SaÃde na prevenÃÃo das DST/Aids para prostitutas / Sexually Transmitted Diseases (STD) are considered an occupational risk for prostitutes, and they can be prevented with the use of condom. A conscientization about its importance through health education is necessary, as it is the most efficient strategy in STD/Aids prevention, what will bring changes in behavior, values and attitudes. In face of all this problematic situation of prostitution and its relation with STD, we got interested in understanding the work carried out by the prostitutes from the Association of Prostitutes from Cearà - APROCE concerning STD/Aids prevention. In this context, this study objectified to analyze the educational work carried out by the prostitutes from APROCE concerning STD and Aids prevention, and to verify if this Health Education estimulates reflexion, criticism and behavior change, or if it is only an information provider. This way, we awakened to the relation between the object of study and the theoretical approach based on Paulo Freireâs reflexions, considering that âchangeâ, together with âconscientizationâ, is a âtheme generatorâ of Paulo Freireâs theoretical practice. It is a qualitative research inspired in Paulo Freireâs theory and practice, and analyzed according to the Critical Theory. The data were grouped according to the stages they were collected: Observing Social Educators and Dialoguing with Social Educators. Later, the second part was divided in two categories: the profile and the dialogue with social educators. In the dialogue with social educators their feelings about the work done were identified, as well as the main difficulties; the facilitator points; how they perceive their results; and the most and least important points of their work. Therefore, we can conclude that being aware of the importance of STD and Aids prevention and changing behavior are not easy tasks because many factors interfere in prostitutesâ lives. The Health Education strategies used by the Association are not estimulating reflexion, criticism and behavior change as expected, but it has given a great step, as they provide information and condom to prostitutes. And, as it is an action that has happened for some years, many women have already changed behavior. More efficient strategies and projects must be carried out so that conscientization and change happen in a shorter period of time. For the obtention of this aim, Health Education methodological strategies in STD/Aids prevention for prostitutes were elaborated

Estudou-se a experiência de mulheres vivendo com HIV e aids também conviverem com situações de violência por parceiro íntimo, e as repercussões destes entrecruzamentos para o cuidado de sua saúde. Tomamos como referência o conceito de vulnerabilidade já formulado para a AIDS e retrabalhado especificamente para as questões de gênero, permitindo explorar o conceito nas situações de violência doméstica contra as mulheres. Partiu-se do pressuposto que os contextos do HIV/Aids podem gerar situações de violência de mulheres soropositivas e que as representações amorosas, o ideal de conjugalidade e de família podem influenciar no impacto do cuidado da saúde das mulheres. Foram realizadas 20 entrevistas em profundidade com mulheres em acompanhamento do HIV/Aids, inseridas nos Serviços de Saúde da Rede Especializada em DST/Aids da cidade de São Paulo, na modalidade história de vida. Encontraram-se diversos contextos da vulnerabilidade, denominada de gênero, nas narrativas produzidas, na infância, adolescência e fase adulta, reforçando padrões hegemônicos de gênero ao longo dos diferentes ciclos de vida dessas mulheres. O estudo aponta que as experiências do adoecimento na revelação do diagnóstico é o elemento disparador de medos e sofrimentos em decorrência da reação dos parceiros e a das preocupações com os filhos. O diagnóstico do HIV é o momento não só do contato com a doença, mas de desvelar ou reconhecer situações de violência. É a partir das concepções e contextos de vida que as mulheres identificam o modo de se situarem no enfrentamento do HIV e da violência. O cuidado da saúde foi abordado tanto como cuidado de si, quanto na relação com os serviços de saúde, o que mostrou a grande preocupação representada pelas dificuldades que, em função de suas condições de portadoras do HIV, essas mulheres viam para se manterem na condição tradicional de cuidadoras, dentro das referências do padrão social de gênero, quer em torno de seus adoecimentos e expectativas de vida futura, quer para com os filhos. Tais preocupações surgem como justificativas da manutenção da família diante de parceiros violentos. Embora presente, observou-se que o tema violência não é pauta na atenção à saúde da mulher vivendo com HIV e aids, nos serviços de saúde especializados. A vulnerabilidade de gênero destaca-se pela ênfase na condição materna, em que por ela e para ela as mulheres dão significados às suas vidas, ao adoecimento e ao cuidado. / This work studied the experience of women living with HIV and AIDS also live with situations of violence by their intimate partner and the implications of these intersections for their health care. We took as reference the concept of vulnerability already formulated to AIDS and adapted for gender issues, allowing explore it in situations of domestic violence against women. We started from the assumption that the contexts of HIV / AIDS can lead to situations of domestic violence involving HIV positive women and that the representations of love, the ideal of marital and family can influence on health care of these women. We made 20 in-depth interviews with women living with HIV / AIDS, followed on STD / AIDS reference centers of the Municipality of São Paulo, using living history method. We found in the narratives several contexts of the so called gender vulnerability occurred in childhood, adolescence and adulthood, reinforcing hegemonic gender patterns over the different life cycles of these women. The study shows that the fact of the diagnosis disclosure to be made during an illness is the element that triggers fear and suffering in relation to the reaction of the partners and worries with their children. The time of HIV diagnosis is not only the moment of contact with the disease, but also the time to uncover or recognize situations of violence. It is through conceptions and contexts of life that women identify how to locate themselves in the struggle against HIV and violence. Health care was addressed as much as caring for oneself as well in relation with the health services. This approach showed the great concern about the difficulties perceived by these women in order to keep the condition of traditional caregivers within the references of hegemonic social pattern of gender, either about their illnesses and future life expectations either about children. Such concerns arise as a justification for maintaining the family when there is coexistence with a violent partner. Although present, it was observed that violence is not an issue discussed in health care of women living with HIV and AIDS in specialized health services. The vulnerability of gender of these women is distinguished by an emphasis on maternal condition which gives meaning to their lives, illness and care.