What are they in it for? Marginalised group members' perceptions of allies differ depending on the costs and rewards associated with their allyship.

Advantaged group allies can incur costs or rewards as a result of their allyship. The present work investigates whether such costs and rewards affect how marginalised group members perceive these allies. Across four experiments that collectively examine marginalised group members' perceptions of individual and corporate allies in the context of allyship for women's rights, Black Lives Matter and the LGBTQI+ community, we find that allies are perceived differently as a function of the costs and rewards associated with their allyship. Allies who face costs are perceived more positively in terms of tenacity and genuine motivations, and are generally evaluated more favourably compared to allies who do not face costs and those who, instead, garner rewards for their allyship. These findings demonstrate that marginalised group members are cognisant of the costs and rewards allies may reap, and that this information can shape their judgements of allies' investment in the cause.

O Real da Violência: Relato de Experiência com um Coletivo de Mulheres / The Real of Violence: Experience Report with a Women's Collective / Lo Real de la Violencia: Informe de Experiencia con un Colectivo de Mujeres

Este trabalho tem como objetivo, a partir da experiência e do testemunho de um Coletivo de Mulheres, propor uma leitura do que nomeamos como o Real da violência por meio do ensino de Lacan e comentadores. Diferente do Real enquanto fundamento ausente ou falta-a-ser, o Real da violência se insere historicamente no dia a dia e na vida de determinados corpos brasileiros, precisamente os corpos negros, femininos e periféricos. Em vista do cenário de impasses socio-políticos do Brasil, mas também de potentes vozes e ações que têm surgido das comunidades atravessadas por estruturas de violência, a experiência do Coletivo ilustra o presente trabalho, a fim de demonstrar caminhos possíveis para um saber-fazer com esse Real ao qual seus filhos e a comunidade estão mais expostos. À luz de conceitos da Teoria Feminista, como, por exemplo, a noção de interseccionalidade e a categoria corpo-território, endossamos essa discussão que demanda à Psicanálise conversar com outros campos do saber. Empreitada que exige engajamento ético e político dos psicanalistas, em especial dos que exercem a práxis analítica no Brasil.

This work aims, through the experience and testimony of a Women's Collective, to propose a reading of what we call the Real of violence through the teaching of Lacan and commentators. Different from the Real as a foundation that is absent or lack-of-being, the Real of violence is historically inserted in the daily life and in the life of certain Brazilian bodies, precisely black, female and peripheral bodies. In view of the scenario of socio-political impasses in Brazil, but also of powerful voices and actions that have emerged from communities crossed by structures of violence, the Collective's experience illustrates the present work, in order to demonstrate possible paths for a know-how to deal with this Real to which their children and the community are more exposed. In the light of concepts from Feminist Theory, such as, for example, the notion of intersectionality and the body-territory category, we endorse this discussion that demands Psychoanalysis to converse with other fields of knowledge. An undertaking that demands ethical and political engagement from psychoanalysts, especially those who practice analytical praxis in Brazil.

Este trabajo pretende, a partir de la experiencia y testimonio de un Colectivo de Mujeres, proponer una lectura de lo que llamamos lo Real de la violencia a través del magisterio de Lacan y comentaristas. A diferencia de lo Real como fundamento ausente o falta-de-ser, lo Real de la violencia se inserta históricamente en el cotidiano y en la vida de ciertos cuerpos brasileños, precisamente negros, femeninos y los barrios marginales. Ante el escenario de impasses sociopolíticos en Brasil, pero también de voces y acciones poderosas que han emergido de comunidades atravesadas por estructuras de violencia, la experiencia del Colectivo ilustra el presente trabajo, con el fin de evidenciar posibles caminos para un saber hacer con este Real al que están más expuestos sus niños y la comunidad. A la luz de conceptos de la Teoría Feminista, como, por ejemplo, la noción de interseccionalidad y la categoría cuerpo-territorio, avalamos esta discusión que exige al Psicoanálisis hablar con otros campos del saber. Un emprendimiento que exige compromiso ético y político de los psicoanalistas, especialmente de aquellos que ejercen la práctica analítica en Brasil.

Personal Agency and Social Supports to Manage Health Among Non-Hispanic Black and Hispanic Men With Diabetes.

The prevalence of type 2 diabetes (T2D) is increasing among non-Hispanic Black and Hispanic communities, especially among men who develop this chronic condition at earlier ages. Personal agency and social support are vital aspects to diabetes management. However, less is known about the relationship between these variables among men living with diabetes. The purposes of this study were to identify (1) levels of personal agency to manage health, (2) sources of social supports to manage health based on personal agency levels, and (3) factors associated with lower personal agency to manage health. Cross-sectional data from non-Hispanic Black (n = 381) and Hispanic (n = 292) men aged 40 years or older with T2D were collected using an internet-delivered questionnaire. Three binary logistic regression models were fitted to assess sociodemographics, health indicators, and support sources associated with weaker personal agency to manage health. About 68% of participants reported having the strongest personal agency relative to 32.1% reporting weaker personal agency. Men who relied more on their spouse/partner (odds ratio [OR] = 1.22, p = .025), coworkers (OR = 1.59, p = .008), or faith-based organizations (OR = 1.29, p = .029) for ongoing help/support to improve their health and manage health problems were more likely to have weaker personal agency. Conversely, men who relied more on their health care providers for ongoing help/support to improve their health and manage health problems were less likely to have weaker personal agency to manage health (OR = 0.74, p < .001). Findings suggest personal agency may influence men's support needs to manage T2D, which may also be influenced by cultural, socioeconomics, and the composition of social networks.

Health Experiences of African American Mothers, Wellness in the Postpartum Period and Beyond (HEAL): A Qualitative Study Applying a Critical Race Feminist Theoretical Framework.

The objective of this study is to explore the cultural, social, and historical factors that affect postpartum primary care utilization among Black women with cardiometabolic risk factors and to identify the needs, barriers, and facilitators that are associated with it. We conducted in-depth interviews of 18 Black women with one or more cardiometabolic complications (pre-pregnancy chronic hypertension, diabetes, obesity, preeclampsia, or gestational diabetes) within one year of delivery. We recruited women from three early home-visiting programs in Baltimore, Maryland, between May 2020 and June 2021. We used Critical Race Feminism theory and a behavioral model for healthcare utilization as an analytical lens to develop a codebook and code interview transcripts. We identified and summarized emergent patterns and themes using textual and thematic analysis. We categorized our findings into six main themes: (1) The enduring influence of structural racism, (2) personally mediated racism in healthcare and beyond, (3) sociocultural beliefs about preventative healthcare, (4) barriers to postpartum care transitions, such as education and multidisciplinary communication, (5) facilitators of postpartum care transitions, such as patient-provider relationships and continuity of care, and (6) postpartum health and healthcare needs, such as mental health and social support. Critical race feminism provides a valuable lens for exploring drivers of postpartum primary care utilization while considering the intersectional experiences of Black women.

A biomythography introducing the Blafemme Healing framework.

Black feminism has so much to offer. Its philosophical, intellectual, and activist practice grounded in the experiences of Black women is a source of healing and liberation. Building on the Black feminist tradition, the current article introduces an intersectional and practical healing framework titled Blafemme Healing. The framework is designed to support individuals in exploring personal healing regardless of their social location while intentionally providing mechanisms for increasing the experience and outcome of wellness, equity, love, liberation, and survival for Black people. The framework includes eight areas, or chambers, that require people's attention if we are to achieve personal and collective wellness. The author, a Black queer cisgender woman pursuing personal and collective wellness and healing through and beyond the field of psychology, uses the biomythography method to introduce and describe Blafemme Healing. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

O peso da dupla jornada: as alterações na rotina das mães-trabalhadoras da saúde pública durante o primeiro ano da pandemia de COVID19 / The weight of a double shift: The changes in the routine of public health working moms during the first year of the COVID 19 pandemic

O presente trabalho tem como objetivo geral identificar as dificuldades que as mães-profissionais que atuavam na área da saúde pública enfrentaram, a partir de uma crítica ao patriarcalismo, interpretando os desafios para conciliar os afazeres domésticos, o cuidado com os filhos e a vida profissional, durante o primeiro ano da pandemia no Brasil, 2020. As medidas impostas pelas autoridades do Brasil e do mundo acarretaram a reorganização na estrutura familiar e no ambiente de trabalho, em que devido as necessidades de isolamento, as famílias passaram a ficar mais tempo dentro de casa, provocando um aumento de trabalho doméstico. Essa sobrecarga de trabalho doméstico recaiu, principalmente, em cima das mulheres, porém em intensidades diferentes, de acordo com a raça/cor e a classe social em que estão inseridas, reafirmando a ideia de que vivemos em um país com uma estrutura patriarcal, classista e racista. O estudo foi realizado a partir de uma amostra extraída no universo das trabalhadoras-mães que, independente do vínculo profissional e da área de atuação, atuavam no Instituto Nacional da saúde da Criança, da Mulher e do Adolescente Fernandes Figueira e tinham filhos com idade entre 0 e 12 anos, no período em questão. Através da entrevista dirigida e a utilização do método de amostragem bola de neve foram obtidos relatos das trabalhadoras que permitiram fazer uma análise do quanto e de que forma a pandemia afetou a vida dessas trabalhadoras nas mais variadas condições sociais e profissionais, além de concluir para a necessidade de ter um Estado de bem-estar social ampliado e sensível às questões femininas. (AU)

The current paper aims to identify the struggles, from an opposing patriarchal point of view, that working moms who were a part of the public healthcare system faced and to understand the challenges of balancing household chores, taking care of their children and their professional lives, during the first year of the pandemic in Brazil in 2020. The measures imposed by Brazilian and world authorities led to a new organizational structure in home and work-life, in which the need of isolation, resulted in families spending more time indoors thus increasing the domestic workload. This fell, mainly, on women, but in varying degrees, according to the race/skin color and social class they are inserted, reaffirming the idea that we live in a country with a patriarchal, classicist and racist foundation. The study was conducted with working moms that, regardless their professional ties or areas, worked at the Instituto Nacional da Saúde da Criança, da Mulher e do Adolescente Fernandes Figueira and had children from ages that ranged from 0 to 12 years old during that time. Account from workers were acquired through guided interviews and the use of the snowball sample method, which allowed an analysis of how much and how the pandemic affected the lives of those workers in the most diverse social and working conditions, besides inferring the need of a wider welfare system and one more sensitive to women's issues. (AU)

O cuidado em saúde promovido pelas religiões afro-brasileiras / Health care promoted by afro-brazilian religions / El cuidado en salud promovido por las religiones afrobrasileñas

No decorrer da história, sempre foram infindáveis os casos em que os sujeitos recorriam a centros espíritas ou terreiros de religiões de matrizes africanas em decorrência de problemas como doenças, desempregos ou amores mal resolvidos, com o objetivo de saná-los. Por conta disso, este artigo visa apresentar os resultados da pesquisa relacionados ao objetivo de mapear os processos de cuidado em saúde ofertados em três terreiros de umbanda de uma cidade do litoral piauiense. Para isso, utilizamos o referencial da Análise Institucional "no papel". Os participantes foram três líderes de terreiros e os respectivos praticantes/consulentes dos seus estabelecimentos religiosos. Identificamos perspectivas de cuidado que se contrapunham às racionalidades biomédicas, positivistas e cartesianas, e faziam referência ao uso de plantas medicinais, ao recebimento de rezas e passes e à consulta oracular. A partir desses resultados, podemos perceber ser cada vez mais necessário, portanto, que os povos de terreiros protagonizem a construção, implementação e avaliação das políticas públicas que lhe sejam específicas.(AU)

In history, there have always been endless cases of people turning to spiritual centers or terreiros of religions of African matrices due to problems such as illnesses, unemployment, or unresolved love affairs. Therefore, this article aims to present the research results related to the objective of mapping the health care processes offered in three Umbanda terreiros of a city on the Piauí Coast. For this, we use the Institutional Analysis reference "on Paper." The participants were three leaders of terreiros and the respective practitioners/consultants of their religious establishments. We identified perspectives of care that contrasted with biomedical, positivist, and Cartesian rationalities and referred to the use of medicinal plants, the prescript of prayers and passes, and oracular consultation. From these results, we can see that it is increasingly necessary, therefore, that the peoples of the terreiros lead the construction, implementation, and evaluation of public policies that are specific to them.(AU)

A lo largo de la historia, siempre hubo casos en los cuales las personas buscan en los centros espíritas o terreros de religiones africanas la cura para sus problemas, como enfermedades, desempleo o amoríos mal resueltos. Por este motivo, este artículo pretende presentar los resultados de la investigación con el objetivo de mapear los procesos de cuidado en salud ofrecidos en tres terreros de umbanda de una ciudad del litoral de Piauí (Brasil). Para ello, se utiliza el referencial del Análisis Institucional "en el Papel". Los participantes fueron tres líderes de terreros y los respectivos practicantes / consultivos de los establecimientos religiosos que los mismos conducían. Se identificaron perspectivas de cuidado que se contraponían a las racionalidades biomédicas, positivistas y cartesianas, y hacían referencia al uso de plantas medicinales, al recibimiento de rezos y pases y a la consulta oracular. Los resultados permiten concluir que es cada vez más necesario que los pueblos de terreros sean agentes protagónicos de la construcción, implementación y evaluación de las políticas públicas destinadas específicamente para ellos.(AU)

Notas para decolonizar os estudos transpessoais no brasil: contribuições do pluriperspectivismo participativo / Notes for decolonizing transpersonal studies in brazil: contributions of participatory pluriperspectivism / Apuntes para la decolonización de los estudios transpersonales en brasil: aportes del pluriperspectivismo participativo

O campo dos estudos transpessoais tem avançado em diversas áreas no Brasil. Comemorou seus 40 anos com uma inserção ativa nas Instituições de Ensino Superior (IES) e uma ampliação de núcleos formativos e apoiadores de ensino, pesquisa e ações sociais, além de diálogos com o Sistema de Conselhos de Psicologia. Desafios são apresentados a partir do levantamento de uma série de questões importantes e ignoradas dentro da Psicologia Transpessoal no Brasil. Apresentamos o pluriperspectivismo participativo como possibilidade de decolonizar as matrizes eurocêntricas e estadunidenses, que dão suporte ao pensamento transpessoal brasileiro, buscando honrar nossas raízes históricas e incluir outras epistemologias e ontologias, que dão continuidade à crítica à lógica cartesiana moderna. Indicamos uma breve agenda de notas temáticas que carecem de um processo decolonizador no campo transpessoal: a) crítica às perspectivas de um pensamento hegemônico, em termos globais por meio da dominação Norte-Sul ou no campo das relações sociais; b) revisão das formas de "centrocentrismo"; c) questionamento da noção de universalismo das ciências e da ética; d) aprofundamento da análise crítica da supremacia restritiva da racionalidade formal técnico-científica em relação às formas de subjetividade, de vivências holísticas e integradoras e de valorização do corpo; e) revisão da noção de sujeito moderno desprovida da cocriação do humano com a comunidade, a história, a natureza e o cosmos.(AU)

The field of transpersonal studies has advanced in several areas in Brazil. It celebrated its 40th anniversary with an active insertion in Higher Education Institutions (HEI) and an expansion of training centers and supporters of teaching, research, and social actions, in addition to dialogues with the System of Councils of Psychology. Challenges are presented based on a survey of a series of important and ignored issues within Transpersonal Psychology in Brazil. We present participatory pluriperspectivism as a possibility to decolonize the Eurocentric and North American matrices that support Brazilian transpersonal thought, seeking to honor our historical roots and include other epistemologies and ontologies, which continue the critique of modern Cartesian logic. We indicate a brief agenda of thematic notes that lack a decolonizing process in the transpersonal field: a) criticism of the perspectives of a hegemonic thought, whether in global terms via North-South domination or in the field of social relations; b) review of the forms of "centrocentrism"; c) questioning of the notion of universalism of science and ethics; d) deepening of the critical analysis of the restrictive supremacy of the technical-scientific formal rationality in relation to the forms of subjectivity, of holistic and integrative experiences, and of valuing the body; e) review of the notion of the modern subject devoid of the co-creation of the human with the community, the history, the nature, and the cosmos.(AU)

El campo de los estudios transpersonales ha avanzado en varias áreas de Brasil. Se celebró su 40.º aniversario con una inserción activa en Instituciones de Educación Superior (IES) y una ampliación de los centros de formación y promotores de la docencia, la investigación y la acción social, además de diálogos con el Sistema de Consejos de Psicología. Los desafíos se presentan a partir de una encuesta de una serie de temas importantes e ignorados dentro de la Psicología Transpersonal en Brasil. Presentamos el pluriperspectivismo participativo como una posibilidad para decolonizar las matrices eurocéntrica y americana, que sustentan el pensamiento transpersonal brasileño, buscando honrar nuestras raíces históricas e incluir otras epistemologías y ontologías que continúan la crítica de la lógica cartesiana moderna. Indicamos una breve agenda de apuntes temáticos que carecen de un proceso decolonizador en el campo transpersonal: a) crítica de las perspectivas de un pensamiento hegemónico, ya sea en términos globales a través del dominio Norte-Sur o en el campo de las relaciones sociales; b) revisión de las formas de "centrocentrismo"; c) cuestionamiento de la noción de universalismo de la ciencia y la ética; d) profundización del análisis crítico de la supremacía restrictiva de la racionalidad formal técnico-científica en relación a las formas de subjetividad, de experiencias holísticas e integradoras y de valoración del cuerpo; e) revisión de la noción de sujeto moderno desprovisto de la cocreación de lo humano con la comunidad, la historia, la naturaleza y el cosmos.(AU)

Paradigma manicomial e proibicionismo como operadores da guerra de raças no Brasil / Asylum paradigm and prohibitionism operating the racial war in Brazil / Paradigma asilar y prohibicionismo como operadores de la guerra racial en Brasil

Este artigo relaciona o paradigma manicomial, relativo à assistência psiquiátrica, à compreensão e ao manejo do campo da saúde mental, ao paradigma proibicionista, referente ao porte, uso e à circulação de drogas, como duas séries de políticas e práticas sociais que operam a guerra de raças que está na base do Estado brasileiro. Com isso, propomos uma investigação arqueogenealógica acerca do emaranhado de condições de emergência das práticas e objetos de saber-poder mobilizados por esses dois paradigmas, atentando ao caráter político das verdades que as sustentam. Dedicamo-nos especialmente ao período entre o final do século XIX e o começo do XX ao interrogar as dinâmicas de forças que constituem as práticas sociais e seus efeitos de subjetivação, produzidos pela sujeição de corpos por meio de uma diversidade de mecanismos morais, disciplinares, eugênicos, higienistas e biopolíticos que articulam os anseios de modernização e produtividade do Estado brasileiro à gestão dos problemas de saúde e segurança do país, colocando a pobreza, o vício e a doença como desdobramento da sua constituição racial. Concluímos, por fim, que o conflito de raças aparece como fundo intrínseco que se atualiza no cerne e a partir dos campos problemáticos da saúde mental e das drogas, colocando como saída dos impasses sociais e políticos eliminar ou pelo menos diluir, via miscigenação ou submissão para integração, o elemento físico e cultural do negro do Brasil.(AU)

This article puts in relation the asylum paradigm, associated to psychiatric care, to the understanding and management of the mental health field, to the prohibitionist paradigm, that refers to the possession, use and circulation of drugs, as two series of social policies and practices that operate racial war that is in the base of the Brazilian State. So on, we propose an archeogenealogical investigation about the emergency conditions of the practices and objects of knowledge-power organized by these two paradigms, paying attention to the political character of the truths that support them. Looking especially at the period between the end of the 19th century and the beginning of the 20th, we questioned the dynamics of forces that constitute social practices and their effects of subjectivation, produced by the subjection of bodies through moral, disciplinary, eugenic, hygienist and biopolitics mechanisms that articulate the modernization and productivity aspirations of the Brazilian State to the management of the country's health and safety problems, understanding poverty, addiction and disease as consequences of its racial constitution. We conclude that the conflict of races is an intrinsic background that is updated at the heart of the problematic fields of mental health and drugs. Considering this, the solution for social and political impasses is the elimination or at least dilution, through miscegenation or submission for integration, of the physical and cultural element of black people in Brazil.(AU)

Este artículo relaciona el paradigma asilar de atención psiquiátrica, comprensión y manejo del campo de la salud mental, con el paradigma prohibicionista, referente a al uso y circulación de drogas, como dos series de políticas y prácticas sociales que operan la guerra racial que está en el fundamento del Estado brasileño. Así, proponemos una investigación arqueogenealógica sobre las condiciones de emergencia de prácticas y objetos de saber-poder movilizados por estos dos paradigmas, prestando atención al carácter político de las verdades que los sustentan. Nos dedicamos especialmente al período entre finales del siglo XIX y principios del XX buscando la dinámica de fuerzas que constituyen a las prácticas sociales y sus efectos de subjetivación, producidos por la sujeción de los cuerpos a través de una diversidad de mecanismos morales, disciplinarios, eugenésicos, higienistas y biopolíticos que articulan las aspiraciones de modernización y productividad del Estado brasileño a la gestión de los problemas de salud y seguridad del país, comprendiendo la pobreza, la adicción y la enfermedad como resultado de su constitución racial. Finalmente, concluimos que el conflicto racial aparece como un trasfondo intrínseco que se actualiza en el cerne y desde los campos problemáticos de la salud mental y de las drogas, tomando como soluciones a los impasses sociales y políticos nacionales, la eliminación o al menos la dilución, a través del mestizaje o de la sumisión para fines de integración, del elemento físico y cultural del negro en Brasil.(AU)

Violência por parceiro íntimo entre homens que se relacionam com homens / Intimate partner violence among men who relate with men / Violencia de pareja íntima entre hombres que tienen relaciones con hombres

A violência por parceiro íntimo (VPI) consiste em atos que ameacem causar ou efetivamente causem danos em um parceiro dentro de uma relação afetivo-sexual, independente da configuração ou tempo do relacionamento ou de haver coabitação ou não entre as partes. Nas relações homossexuais, a VPI é invisibilizada de diversas maneiras, mesmo sendo reconhecida como uma grave violação de direitos humanos. O estudo objetivou compreender os significados da VPI para um grupo de homens que se relacionam com homens (HRH). Participaram da pesquisa oito HRH, selecionados através da técnica "bola de neve", utilizada devido à sensibilidade do tema, considerando os estigmas de ser HRH. Os dados foram obtidos através de entrevista semiestruturada e foram analisados pela Análise Temática. Como resultados, foram construídas seis categorias: 1º) O armário; 2º) Homofobia 3º) Racismo, poder e vulnerabilidade a VPI; 4º) Sexualidade; 5º) Infidelidade; 6º) HIV, que discutem a interseccionalidade de diversas formas de opressão na produção de VPI entre HRH. Conclui-se que a VPI vivenciada por esse grupo é influenciada por diversos fatores que envolvem a interseccionalidade de vários marcadores sociais, como os estereótipos de masculinidade em relação a hipersexualização e infidelidade, a homofobia como fator direto do estresse minoritário, o racismo que hierarquiza os corpos e invisibiliza o afeto de homens negros, e o estigma de HIV no imaginário social.(AU)

Intimate partner violence (IPV) consists of acts that threaten to harm or actually harm to a partner within an affective-sexual relationship, regardless of the configuration or duration of the relationship or whether or not there is cohabitation between the parties. In homosexual relationships, IPV is made invisible in several ways, even though it is recognized as a serious violation of human rights. The study aimed to understand the meanings of IPV for a group of men in same sex relationships (MSSR). Eight MSSR participated in the research, selected by snowball sampling, used due to the topic's sensitivity, considering the stigmas involved in being MSSR. Data were constructed via semi-structured interviews and analyzed using Thematic Analysis. As a result, six categories were constructed: 1) The closet persons; 2) Homophobia; 3) Racism, power, and vulnerability to IPV; 4) Sexuality; 5) Infidelity; 6) HIV, which discuss the intersectionality of various forms of oppression in the production of IPV among MSSR. Thus, the IPV experienced by this group is influenced by several factors that involve the intersectionality between different social markers, such as stereotypes of masculinity in relation to hypersexualization and infidelity, homophobia as a direct factor of minority stress, the racism that hierarchizes bodies and makes the affection of Black men and the stigma of HIV invisible in the social imaginary.(AU)

La violencia de pareja (VP) consiste en actos que amenazan con causar o de hecho causan daño a una pareja dentro de una relación afectivo-sexual, independientemente de la configuración o duración de la relación o de si existe o no cohabitación entre las partes. En las relaciones homosexuales, la VP se invisibiliza de varias formas, a pesar de que se reconoce como una grave violación de los derechos humanos. Este estudio tuvo como objetivo comprender los significados de VP para un grupo de hombres que se relacionan con hombres (HRH). Ocho HRH participaron de la investigación, seleccionados mediante la técnica de "bola de nieve", utilizada debido a la sensibilidad del tema, considerando los estigmas de ser HRH. Los datos se construyeron mediante entrevistas semiestructuradas y se sometieron a análisis temático. Como resultado se construyeron seis categorías: 1.ª) El armario; 2.º) Homofobia; 3.º) Racismo, poder y vulnerabilidad a la VP; 4.º) Sexualidad; 5.º) Infidelidad; 6.ª) HIV; que discuten la interseccionalidad de diferentes formas de opresión en la producción de VP entre HRH. Se concluye que la VP vivida por este grupo está influida por varios factores que involucran la interseccionalidad entre distintos marcadores sociales, como los estereotipos de masculinidad en relación con la hipersexualización y la infidelidad, la homofobia como factor directo de estrés minoritario, el racismo que jerarquiza cuerpos e invisibiliza en el imaginario social el afecto de los hombres negros y el estigma del HIV en el imaginario social.(AU)

O conceito de "lugar de fala": das possibilidades de delimitação aos riscos de esvaziamento conceitual / The concept of "lugar de fala": from the possibilities of delimitation to the risks of conceptual emptying / El concepto de "lugar de fala": de las posibilidades de delimitación a los riesgos de vaciamiento conceptual

O objetivo deste estudo foi mapear os usos do conceito de lugar de fala em artigos acadêmicos, avaliando eventuais delimitações propostas nessa literatura. Para tanto, foi realizada uma revisão integrativa, na qual a palavra-chave "lugar de fala" foi buscada no Portal de Periódicos da Capes e na Scielo. Dos 142 artigos recuperados, 66% utilizou a expressão sem referências bibliográficas ou definições explícitas, mantendo, portanto, os riscos de esvaziamento conceitual. No demais dos artigos (34%), cinco apresentaram um uso negativo, com críticas mais ou menos explícitas ao conceito. Os artigos que fizeram um uso positivo do conceito de lugar de fala foram agrupados em campos de investigação mais ou menos específicos, com destaque para o feminismo negro, feminismo e estudos pós-coloniais. Nesses campos o conceito de lugar de fala tem um uso francamente político, abordando criticamente as relações de poder que permeiam as produções discursivas e silenciam grupos marginalizados.

This study aimed to map the uses of the concept "lugar de fala" (place of speech) in academic articles, in order to evaluate eventual delimitations proposed in this literature. For that, an integrative review was carried out in Portal de Periódicos da CAPES and in Scielo databases, using the keyword "lugar de fala" in Portuguese. 66% of 142 recovered articles used the expression without bibliographical references or explicit definitions, thus maintaining the risks of conceptual emptying. Five of the remaining 34 % of the articles presented a negative use, showing more or less explicit criticism of the concept. Articles that made positive use of the concept were grouped into more or less specific fields of investigation, with emphasis on black feminism, feminism and postcolonial studies. In these fields, the concept of "local de fala" has a frankly political use, critically approaching the power relations that permeate discursive productions and that silence marginalized groups.

El objetivo de este estudio fue mapear los usos del concepto de "lugar de fala" en artículos académicos, evaluando eventuales delimitaciones propuestas en esta literatura. Para eso, se realizó una revisión integradora, en la que se buscó la palabra clave "lugar de fala" en Portugués en el Portal de Periódicos de CAPES y en Scielo. De los 142 artículos recuperados, el 66% utilizó la expresión sin referencias bibliográficas ni definiciones explícitas, manteniendo así los riesgos de vaciamiento conceptual. En los demás artículos (34%), cinco presentaron un uso negativo, con críticas más o menos explícitas al concepto. Los artículos que hicieron un uso positivo del concepto de "lugar de fala" fueron agrupados en campos de investigación más o menos específicos, con énfasis en el feminismo negro, el feminismo y los estudios poscoloniales. En estos campos, el concepto tiene un uso francamente político, abordando críticamente las relaciones de poder que permean las producciones discursivas y silencian grupos marginados.

Advancing behavioral interventions for African American/Black and Latino persons living with HIV using a new conceptual model that integrates critical race theory, harm reduction, and self-determination theory: a qualitative exploratory study.

BACKGROUND: Rates of participation in HIV care, medication uptake, and viral suppression are improving among persons living with HIV (PLWH) in the United States. Yet, disparities among African American/Black and Latino PLWH are persistent, signaling the need for new conceptual approaches. To address gaps in services and research (e.g., insufficient attention to structural/systemic factors, inadequate harm reduction services and autonomy support) and improve behavioral interventions, we integrated critical race theory, harm reduction, and self-determination theory into a new conceptual model, then used the model to develop a set of six intervention components which were tested in a larger study. The present qualitative study explores participants' perspectives on the study's acceptability, feasibility, and impact, and the conceptual model's contribution to these experiences. METHODS: Participants in the larger study were African American/Black and Latino PLWH poorly engaged in HIV care and with non-suppressed HIV viral load in New York City (N = 512). We randomly selected N = 46 for in-depth semi-structured interviews on their experiences with and perspectives on the study. Interviews were audio-recorded and professionally transcribed verbatim, and data were analyzed using directed qualitative content analysis. RESULTS: On average, participants were 49 years old (SD = 9) and had lived with HIV for 19 years (SD = 7). Most were male (78%) and African American/Black (76%). All had taken HIV medication previously. Challenging life contexts were the norm, including poverty, poor quality/unstable housing, trauma histories exacerbated by current trauma, health comorbidities, and substance use. Participants found the study highly acceptable. We organized results into four themes focused on participants' experiences of: 1) being understood as a whole person and in their structural/systemic context; 2) trustworthiness and trust; 3) opportunities for self-reflection; and 4) support of personal autonomy. The salience of nonjudgment was prominent in each theme. Themes reflected grounding in the conceptual model. Participants reported these characteristics were lacking in HIV care settings. CONCLUSIONS: The new conceptual model emphasizes the salience of systemic/structural and social factors that drive health behavior and the resultant interventions foster trust, self-reflection, engagement, and behavior change. The model has potential to enhance intervention acceptability, feasibility, and effectiveness with African American/Black and Latino PLWH.

What does person-centred care mean, if you weren't considered a person anyway: An engagement with person-centred care and Black, queer, feminist, and posthuman approaches.

Despite the prominence of person-centred care (PCC) in nursing, there is no general agreement on the assumptions and the meaning of PCC. We sympathize with the work of others who rethink PCC towards relational, embedded, and temporal selfhood rather than individual personhood. Our perspective addresses criticism of humanist assumptions in PCC using critical posthumanism as a diffraction from dominant values  We highlight the problematic realities that might be produced in healthcare, leading to some people being more likely to be disenfranchised from healthcare than others. We point to the colonial, homo- and transphobic, racist, ableist, and ageist consequences of humanist traditions that have influenced the development of PCC. We describe the deep rooted conditions that structurally uphold inequality and undermine nursing practice that PCC reproduces. We advocate for the self-determination of patients and emphasize that we support the fundamental mechanisms of PCC enabling patients' choice; however, without critical introspection, these are limited to a portion of humans. Last, we present limitations of our perspective based on our white*-cisheteropatriarchy** positionality. We point to the fact that any reimagining of models such as PCC should be carefully done by listening, following, and ceding power to people with diversity dimensions*** and the lived experience or expertise that exists from diverse perspectives. We point towards Black, queer feminism, and critical disabilities studies to contextualize our point of critique with humanism and PCC to amplify equity for all people and communities. Theory and philosophy are useful to understand restrictive factors in healthcare delivery and to inform systematic strategies to improve the quality of care so as not to perpetuate the oppression of groups of people with diversity dimensions. * We purposely capitalize Black and use lower case for white to decentre whiteness and as an intentional act of antiracism (see White Homework a podcast series by Tori W. Douglas). ** Cisheteropatriarchy describes people with intersecting identities of dominant social groups; cisgender is the gender identity that aligns with the gender you were assigned at birth, hetero means heterosexual, and patriarchy refers to structural systems of power based on maleness where women are often excluded and hold less power. *** With diversity dimensions, we refer to subjective lived experience and material realities of people that exist outside the 'dominant minorities' of white-cisheteropatriarchy, meaning groups of people in society who historically and currently hold more power and through this, structurally dominate the norms and possibilities of living for other people.

Social justice, activism and dentistry in the era of #BLM.

The #Black Lives Matter (BLM) movement thrust the dental profession into a period of critical reflection. Whilst there is enthusiasm for critical reflection and change now, we know from other social movements, like feminism, that this initial phase or 'wave' of activity will subside, hopefully to be replaced by a next 'wave'. How will we nurture this moment of activism and ensure that this initial energetic phase of activism and mobilisation transforms into more sustained and sustainable change? This article offers a sociological-ethical framework to ascertain if dentistry is the progressive and responsive profession it claims to be in the immediate aftermath of the #BLM movement. The dual theory of justice developed by Nancy Fraser (2001, 2004, 2005) and its distinction of the role played by redistribution and recognition in the pursuit of justice will be used to illuminate the challenges that dentistry and oral health face in this regard. It then plots the current efforts of the dental profession against the known trajectory of social movements to adjudicate what has been achieved and what work is yet to be done to ensure inclusion and race-based justice.

'Eventually I wanted something more': sexual self-reflections of South African women engaged in transactional sexual relationships with blessers.

The term 'blesser' emerged from social media in South Africa, typically denoting an older man who provides a younger woman with money and/or luxury items in exchange for sex. Within an increasingly consumerist culture, such transactional sexual relationships hold powerful appeal, and remain highly prevalent. An estimated one in three Black South African women have engaged in transactional sex. While these liaisons are associated with negative health outcomes for women, especially in high HIV prevalence settings, attention to how they affect Black women's sexuality is under-studied-especially with respect to emotional and sexual development-an important part of sexual rights and wellbeing. We used qualitative methods to investigate 22 women's experiences with blessers. A sexual rights framework was utilised to explore human rights dimensions. We found women's rights to engage in consensual sex, pursue sexual pleasure and ensure their bodily integrity were compromised. Many participants recognised the psychological costs and limitations of engaging in blesser relationships. Women communicated that they realised such partnerships failed to meet their emotional and relationship needs. Against the backdrop of structural gender inequality, Black South African women's narratives should inform research, programmes and educational interventions aimed at advancing women's sexual development, rights and wellbeing.

'Doing' or 'using' intersectionality? Opportunities and challenges in incorporating intersectionality into knowledge translation theory and practice.

Intersectionality is a widely adopted theoretical orientation in the field of women and gender studies. Intersectionality comes from the work of black feminist scholars and activists. Intersectionality argues identities such as gender, race, sexuality, and other markers of difference intersect and reflect large social structures of oppression and privilege, such as sexism, racism, and heteronormativity. The reach of intersectionality now extends to the fields of public health and knowledge translation. Knowledge translation (KT) is a field of study and practice that aims to synthesize and evaluate research into an evidence base and move that evidence into health care practice. There have been increasing calls to bring gender and other social issues into the field of KT. Yet, as scholars outline, there are few guidelines for incorporating the principles of intersectionality into empirical research. An interdisciplinary, team-based, national health research project in Canada aimed to bring an intersectional lens to the field of knowledge translation. This paper reports on key moments and resulting tensions we experienced through the project, which reflect debates in intersectionality: discomfort with social justice, disciplinary divides, and tokenism. We consider how our project advances intersectionality practice and suggests recommendations for using intersectionality in health research contexts. We argue that while we encountered many challenges, our process and the resulting co-created tools can serve as a valuable starting point and example of how intersectionality can transform fields and practices.

"I'm not going to be a guinea pig:" Medical mistrust as a barrier to male contraception for Black American men in Los Angeles, CA.

BACKGROUND: Racial disparities in unintended pregnancy and contraceptive use in the United States are not mediated by access to family planning services alone. Rather, a history of medical mistrust underlies Black Americans' adoption of new medical technologies, inclusive of contraception. Efforts to develop hormonal male contraceptives need to incorporate Black Americans' experiences and perspectives so that new contraceptives enable their reproductive goals and promote gender equity. STUDY DESIGN: Working with our community-based partner, Healthy African American Families in Los Angeles, California, we conducted six 60-minute focus group discussions with 39 Black men over age 18, in ongoing heterosexual relationships, to explore attitudes towards and willingness to use hormonal male contraceptives. RESULTS: Just over one-third (35%) of respondents reported willingness to use or rely on hormonal male contraceptives. The majority held negative attitudes about hormonal male contraceptives, citing concerns about side effects and safety. Several respondents expressed mistrust of the medical community and medical research, noting that hormonal male contraceptives could be used against Black communities; several expressed unwillingness to trial hormonal male contraceptives without years of testing. However, all groups described scenarios where they would use them despite stated concerns. CONCLUSIONS: Black men's hypothetical willingness to use hormonal male contraceptives is limited by medical mistrust, which may be overcome by their concerns about the unreliability of current options or the contraceptive behaviors of female partners. Nevertheless, addressing Black Americans' history of medical mistreatment and exploitation will be essential for hormonal male contraceptives to positively contribute to Black men's reproductive options and agency. IMPLICATIONS: While the development of reversible, hormonal male contraception intends to fulfill unmet global needs for contraception, the utility of these hormonal male contraceptive methods among Black men living on low incomes in Los Angeles, California cannot be fully realized until developers address and overcome historical and ongoing medical mistrust.

Empowered Choices: African-American Women's Breast Reconstruction Decisions.

Objectives: Breast reconstruction (BR) potentially can improve quality of life in postmastectomy breast cancer survivors (BCS); however, African-American women are less likely to undergo BR than Caucasian women. This qualitative study was undertaken to explore individual, sociocultural, and contextual factors influencing African-American women's BR decision-making processes and preferences. Methods: Postmastectomy African-American BCS with and without BR participated in semi-structured interviews. We adopted a grounded theory approach using the constant comparison method to understand the contexts and processes informing participants' BR decision-making. Results: Twenty-three women participated, of whom 17 elected BR and 6 did not. Whereas women's primary reasons for deciding for or against BR differed, our core category, "empowered choices ," describes both groups' decision-making as a process focused on empowering themselves physically and/or psychologically, through self-advocacy, informed and shared decision-making, and giving back/receiving communal and spiritual support from church and African-American survivor groups. Socioeconomic factors influenced women's access to BR. Women preferred autologous BR and expressed the need for greater culturally-matched resources and support to inform treatment and shared BR decision-making. Conclusions: Understanding and supporting African-American women's BR preferences and empowerment is essential to ensuring equal access, and culturally-relevant, high-quality, and informed patient-centered care.

Development of the person-centered prenatal care scale for people of color.

BACKGROUND: Given the stark disparities in maternal mortality and adverse birth outcomes among Black, indigenous, and other people of color, there is a need to better understand and measure how individuals from these communities experience their care during pregnancy. OBJECTIVE: This study aimed to develop and validate a tool that can be used to measure person-centered prenatal care that reflects the experiences of people of color. STUDY DESIGN: We followed standard procedures for scale development-integrated with community-based participatory approaches-to adapt a person-centered maternity care scale that was initially developed and validated for intrapartum care in low-resource countries to reflect the needs and prenatal care experiences of people of color in the United States. The adaptation process included expert reviews with a Community Advisory Board, consisting of community members, community-based health workers, and social service providers from San Francisco, Oakland, and Fresno, to assess content validity. We conducted cognitive interviews with potential respondents to assess the clarity, appropriateness, and relevance of the questions, which were then refined and administered in an online survey to people in California who had given birth in the past year. Data from 293 respondents (84% of whom identified as Black) who received prenatal care were used in psychometric analysis to assess construct and criterion validity and reliability. RESULTS: Exploratory factor analysis yielded 3 factors with eigenvalues of >1, but with 1 dominant factor. A 34-item version of the person-centered prenatal care scale was developed based on factor analyses and recommendations from the Community Advisory Board. We also developed a 26-item version using stricter criteria for relevance, factor loadings, and uniqueness. Items were grouped into 3 conceptual domains representing subscales for "dignity and respect," "communication and autonomy," and "responsive and supportive care." The Cronbach alphas for the 34-item and the 26-item versions and for the subscales were >0.8. Scores based on the sum of responses for the 2 person-centered prenatal care scale versions and all subscales were standardized to range from 0 to 100, where higher scores indicate more person-centered prenatal care. These scores were correlated with global measures of prenatal care satisfaction suggesting good criterion validity. CONCLUSION: We present 2 versions of the person-centered prenatal care scale: a 34-item and a 26-item version. Both versions have high validity and reliability in a sample made up predominantly of Black women. This scale will facilitate measurement to improve person-centered prenatal care for people of color and could contribute to reducing disparities in birth outcomes. The similarity with the original scale also suggests that the person-centered prenatal care may be applicable across different contexts. However, validation with more diverse samples in additional settings is needed.