On October 8, Promundo in partnership with Grupo Conexão G promoted the Seminar “Obstacles, Advances and Paths in the Right to Health of the LGBT Population”. The event is linked to research developed by the two organizations called “Access of the LGBT population living in Favelas to health services” and sought to incorporate the perspective of health professionals into the debate on the health of the LGBT population. The research also included two previous stages: 1) holding focus groups to collect data with LGBT groups residing in Maré and; 2) research carried out with the LGBT population participating in the II Maré Gay Parade;
The main obstacles discussed are related to the unpreparedness of professionals in responding to the specificities of the LGBT population. Prejudice, taboo, lack of dialogue about patients' sexual orientation, lack of interest in investing in training and lack of confidentiality in health units are factors that make it difficult to create a trustworthy environment between professionals and patients.
Gilmar Cunha, from Grupo Conexão G, lamented the lack of resources and government support for civil society organizations that work with AIDS. “We are living in the cemetery of NGOs that work with AIDS in Brazil. It is a vicious cycle in which public authorities only support more experienced organizations and do not look at the experiences of small organizations, which are not systematized”, stated Gilmar.
Denise Pires, from the State STD/Aids Management, said that there is a barrier in the legislation for the transfer of resources to smaller organizations that needs to be reviewed. “It’s a contradiction. We receive resources to form partnerships, but there are no legal instruments to implement them. We need to think about how to improve legislation and make the transfer of resources possible.” Denise also said that there is a big gap in HIV/AIDS prevention policy. “It is necessary to advance understanding regarding prevention beyond condoms. There must be a menu that meets the specific needs of each public and expands access to harm reduction inputs.”
Marcos Nascimento, deputy coordinator of CLAM (Latin American Center on Sexuality and Human Rights), drew attention to the diversity that exists within the LGBT movement itself and stated that prejudice in society is structural and cumulative. “Being gay in the favela is different from being gay in the upscale areas of Rio de Janeiro. Gay, black and poor people are even more stigmatized.” Marcos also mentioned that it is necessary to prepare society to deconstruct prejudices and overcome the silence surrounding the topic. “Very little is said about sexuality in both schools and health units. When it comes to sexuality that deviates from the norm, there is even less talk. It is necessary for the health professional to take into account the sexual orientation, religion and race of the individual when providing care. We need to talk about this, because silence is a kind of symbolic violence.”
Mauro Lima, from Conexão G, reinforced the idea that urban violence is still a very important aspect for the LGBT population living in favelas. Regarding HIV prevention, he stated that it is necessary to expand disease risk management policies. “In these spaces, the use of condoms is very easily given up, either because there is no access, or because of shame, or because the community is violent. It is necessary to try new forms of prevention, reduce risks, using the local reality as a starting point”.
Danielle Bittencourt, project coordinator at Instituto Promundo, presented the preliminary results of the research “Access of the LGBT population living in Favelas to health services”, which bring the perspective of the LGBT population in relation to access to care in basic health units. The professionals' vision will be incorporated into this data, which will result in a guidebook for the work of health professionals.
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