Cervical cancer prevention among quilombola women in the light of Leininger's theory. / Prevenção do câncer do colo uterino de quilombolas à luz da teoria de Leininger.

OBJECTIVE Our purpose was to discuss practices of cervical cancer prevention among Quilombola Women. METHOD This study used, in 2014, a qualitative research approach aiming twenty women from a quilombola community (people who live in quilombos, descendants of Afro-Brazilian slaves), which is located in Bahia. A semi-structured interview was developed by researchers in order to collect data. The Ethno-nursing Research method was used to analyze the data. RESULTS The use of cultural care through medicinal plants, and the nursing professional care (Pap Smear exam procedure) were stated by Quilombola women as serving as prevention practices against cervical cancer. However, most women stated that they did not use any prevention practices. CONCLUSION Social, cultural and health access issues are practices that are linked to the cervical cancer prevention among Quilombola Women. Therefore, it is indispensable to create an appropriate care plan for Quilombola women's reality.

Meanings of HIV/AIDS prevention and sexuality for young Catholics. / Significados a respeito da prevenção ao HIV/aids e da sexualidade para jovens católicos.

OBJECTIVE To analyze the the social representations of young Catholics about HIV/AIDS prevention and sexuality. METHOD Mixed study, based on the theory of social representations, held in 2015 with 84 young Catholics participating in the group "World Youth Day" on Facebook. The data were collected through the technique of free association of words and in-depth interview. For the information analysis, the software Tri-Deux-Mots and Alceste were used. RESULTS Sexuality is processed in the representational field of young people as being associated with the sexual practice. In turn, the prevention of HIV, a phenomenon represented as intrinsic to sexuality, occurs through the use of condoms or fidelity within marriage. CONCLUSION Young Catholics represent the prevention of HIV/AIDS as a transverse phenomenon to sexuality, whose sexual practices are anchored both in hegemonic and progressive discourses.

Uncoordinated psychosocial network compromising the integrality of care.

Objective To discuss the lack of coordination in the Psychosocial Care Network from the conception of professionals of a Psychosocial Care Center for Alcohol and Drugs (Portuguese acronym: CAPSad). Method Qualitative study conducted with professionals from a CAPSad unit. The empirical material was produced through two reflection workshops focused on care experiences, and analysis using the discourse analysis technique. The category of analysis was integrality. Results Nine professionals participated in the study. All of them reported being part of a disarticulated service network, in disagreement with principles of the national mental health policy, which directly affects the resolution of care provided in the unit. Conclusion The operating logic in the Psychosocial Care Network tends to reduce the care of drug users to the CAPSad assistance, hence compromising the integrality of care.

Factors associated with the health and reproductive autonomy of Quilombola women in Brazil.

Objective: To verify the association between reproductive autonomy and sociodemographic, sexual, and reproductive characteristics in Quilombola women (a term indicating the origin of politically organized concentrations of Afro-descendants who emancipated themselves from slavery). Methods: Cross-sectional and analytical study with 160 women from Quilombola communities in the southwest of Bahia, Brazil. Data were collected using the Reproductive Autonomy Scale and the questionnaire from the National Health Survey (adapted). Results: Out of the 160 participating women, 91.9% declared themselves as black, one out of every three were aged ≤ 23 years, 53.8% were married or had a partner, 38.8% had studied for ≤ 4 years, over half (58.1%) were unemployed, only 32.4% had a monthly income > R$ 430 (80 US dollars), 52.5% had their first menstruation at the age of 12, 70.7% had not accessed family planning services in the last 12 months, and over half used some method to avoid pregnancy (59.0%). The women had a high level of reproductive autonomy, especially in the "Decision-making" and "Freedom from coercion" subscales with a score of 2.53 and 3.40, respectively. A significant association (p<0.05) was found between the "Total reproductive autonomy" score and marital status, indicating that single or unpartnered women had higher autonomy compared to married or partnered women. Conclusion: The association of social determinants of health such as marital status, education, and age impacts women's reproductive choices, implying risks for sexual and reproductive health. The intergenerational reproductive autonomy of Quilombola women is associated with sociodemographic and reproductive factors.

Intersection between access difficulties and obstetric violence in abortion itineraries. / Intersecção entre dificuldades de acesso e violência obstétrica em itinerários abortivos.

In Brazil, several limitations are imposed upon the access of women undergoing abortion to the healthcare network, primarily caused by the influence of moral and religious values and gender iniquities. In this light, the present study aimed to analyze the experience of women who had an abortion regarding the care provided by healthcare services as part of the abortion itinerary. This is a qualitative study, carried out with 18 women in three cities - one small city, one mid-sized, and one big - in the state of Bahia. Data were produced by face-to-face or online interviews. The empirical material was analyzed using the discourse analysis technique. The results show, in the three municipalities, abortion itineraries under social and gender iniquities, with greater access difficulties for low-income women. Better financial conditions allow access to clandestine private clinics but without guaranteeing humanized care. In the three municipalities, economically disadvantaged women self-induced abortions and delayed seeking services, having faced embarrassing and prejudicial professional attitudes. The results point to the urgency of implementing public policies in which reproductive rights are as effective as human rights.

No Brasil, diversas limitações são impostas ao acesso de mulheres em situação de abortamento à rede de atenção à saúde, sob influência de valores morais, religiosos e iniquidades de gênero. Objetivou-se analisar a experiência de mulheres que realizaram abortamento quanto à atenção pelos serviços de saúde, como parte do itinerário abortivo. Trata-se de pesquisa de abordagem qualitativa, realizada com 18 mulheres em três municípios de pequeno, médio e grande porte, no estado da Bahia. Os dados foram produzidos por meio de entrevista presencial ou virtual. O material empírico foi analisado por meio da técnica de análise de discurso. Os resultados mostram, nos três municípios, itinerários abortivos sob iniquidades sociais e de gênero, com maiores dificuldades de acesso para mulheres de baixa renda. Melhores condições financeiras permitiram acesso a clínicas particulares clandestinas, mas sem garantia de atenção humanizada. Nos três municípios, mulheres desfavorecidas economicamente autoinduziram o aborto e retardaram a busca por serviços, tendo enfrentado atitudes profissionais constrangedoras e preconceituosas. Os resultados apontam a premência de se implementar políticas públicas em que os direitos reprodutivos se efetivem como direitos humanos.

Prenatal care of Brazilian women: racial inequalities and their implications for care. / Pré-natal da mulher brasileira: desigualdades raciais e suas implicações para o cuidado.

The study aimed to characterize women that attended prenatal care in Brazil according to ethnicity/skin color and sociodemographic variables and to verify the association between the indicators of the prenatal care process and the women's ethnicity/skin color. This was a population based, cross-sectional study carried out with data from the National Health Survey of 2013. A bivariate analysis was performed using the multilevel logistic regression model, estimating the odds ratio and the respective 95% confidence intervals to test the association between the indicators of the adequate prenatal care process and the women's ethnicity/skin color. The findings showed that black women have a lower chance of starting prenatal care before 12 weeks of gestation, having 6 or more consultations, performing the HIV test, performing the VDRL exam or receiving advice related to care during gestation and childbirth. Inequalities were identified in the healthcare of Brazilian women during prenatal care, related to ethnicity/skin color and other sociodemographic characteristics. It was concluded that being of black ethnicity and living in a socially disadvantaged area entails disadvantages for women regarding access to a prenatal care considered to be adequate according to the criteria established by the Brazilian Ministry of Health.

Esta investigação teve como objetivo caracterizar as mulheres que realizaram o pré-natal no Brasil segundo raça/cor e variáveis sociodemográficas e verificar associação entre os indicadores de processo do cuidado no pré-natal e a raça/cor das mulheres. Estudo transversal de base populacional empreendido com dados da Pesquisa Nacional de Saúde de 2013. Realizou-se análise bivariada mediante modelo de regressão logística multinível, estimando-se as odds ratio para medir a associação entre os indicadores de processo do cuidado pré-natal adequado e raça/cor das mulheres e verificando os respectivos intervalos de confiança de 95%. Os achados evidenciaram que mulheres negras possuem menor chance de iniciar o pré-natal antes das 12 semanas de gestação, ter seis ou mais consultas, realizar teste de HIV, exame VDRL e receber orientações referentes aos cuidados na gestação e parto. Identificamos desigualdades na atenção à saúde das mulheres brasileiras atendidas no pré-natal relacionadas à raça/cor e a outras características sociodemográficas. Conclui-se que ser negra e ocupar lugares sociais desfavoráveis acarretam desvantagens para as mulheres quanto ao acesso a um pré-natal considerado adequado segundo os critérios estabelecidos pelo Ministério da Saúde do Brasil.

The professional profile of UFBA nursing management graduate students. / Perfil profissional de egressas da Área de Gerenciamento do Programa de Pós-Graduação em Enfermagem da UFBA.

The objective of the present study was to analyze the professional profile of the nursing graduate students of Federal University of Bahia, more specifically of the nursing management area. This descriptive, exploratory study was performed using documental research. The data was collected from the graduates' curriculum on the Lattes Platform and from the graduate program documents, using a form. The study population consisted of graduates enrolled under the line of research The Organization and Evaluation of Health Care Systems, who developed dissertations/theses addressing Nursing/Health Management. The data were stored using Microsoft Excel, and then transferred to the STATA 9.0 statistical software. Results showed that most graduates are women, originally from the State of Bahia, and had completed the course between 2000 and 2011; faculty of public institutions who continued involved in academic work after completing the course. These results point at the program as an academic environment committed to preparing researchers.

Centrality of family bonds in the experience of middle-aged women. / Centralidade de vínculos familiares na experiência de mulheres de meia-idade.

OBJECTIVE: To analyze meanings attributed to middle-aged women from their experience in their family relationships. METHOD: Qualitative study of the Convergent Care Research method. Gender was used as an analytical category, developed with a total of thirteen middle-aged women from the coverage area of the Family Health Strategy program in a city in the southwest of Bahia state, through reflection workshops and interviews. Data were analyzed using discourse analysis. RESULTS: They express the affective relationship with children and grandchildren as the greatest highlight of middle age in overlap with the relationship with partners and other bonds, which makes their uniqueness and identification of demands for health care unfeasible. CONCLUSION: Female middle-aged are marked by conceptions of femininity that emerge from their condition as a woman-mother, from her complete donation. The research points to an urgent need to add gender as a reference for the care of middle-aged women, in order to consider the biopsychic and social interlaces in their life experience and that outline demands for care.

Women of different generations living with HIV: social representations about sexuality. / Mulheres de diferentes gerações que vivem com HIV: representações sociais sobre sexualidade.

OBJECTIVE: To analyze the social representations of women diagnosed with HIV about their sexuality considering generational characteristics. METHOD: Qualitative study, carried out with women who participated through interviews. The constituted corpus was processed by the Iramuteq software. The analysis was based on the Theory of Social Representations. RESULTS: A total of 39 women participated in the study, aged between 18-76 years old and most of them had high school education, evoked the terms 'people' (301), 'partner' (277), 'children' (249), 'virus' (275) and 'want' (216). The younger ones accept to reveal and/or 'tell' about their condition to their partner(s) and family members, an aspect that is not revealed in the statements of women of other ages. For women aged 45 and over, children occupy a prominent place and for the older adults, the centrality of representation referred to self-censorship and maintaining the victim/guilty game. CONCLUSION: This study made it possible to identify processes of anchoring sexualities in terms of what 'cannot be revealed' beyond the family context. It should be noted that the elements 'sex', intercourse' conceived by common sense as a synonym for sexuality, regardless of generation, had low frequency.

Intersecção entre dificuldades de acesso e violência obstétrica em itinerários abortivos / Intersection between access difficulties and obstetric violence in abortion itineraries

Resumo No Brasil, diversas limitações são impostas ao acesso de mulheres em situação de abortamento à rede de atenção à saúde, sob influência de valores morais, religiosos e iniquidades de gênero. Objetivou-se analisar a experiência de mulheres que realizaram abortamento quanto à atenção pelos serviços de saúde, como parte do itinerário abortivo. Trata-se de pesquisa de abordagem qualitativa, realizada com 18 mulheres em três municípios de pequeno, médio e grande porte, no estado da Bahia. Os dados foram produzidos por meio de entrevista presencial ou virtual. O material empírico foi analisado por meio da técnica de análise de discurso. Os resultados mostram, nos três municípios, itinerários abortivos sob iniquidades sociais e de gênero, com maiores dificuldades de acesso para mulheres de baixa renda. Melhores condições financeiras permitiram acesso a clínicas particulares clandestinas, mas sem garantia de atenção humanizada. Nos três municípios, mulheres desfavorecidas economicamente autoinduziram o aborto e retardaram a busca por serviços, tendo enfrentado atitudes profissionais constrangedoras e preconceituosas. Os resultados apontam a premência de se implementar políticas públicas em que os direitos reprodutivos se efetivem como direitos humanos.

Abstract In Brazil, several limitations are imposed upon the access of women undergoing abortion to the healthcare network, primarily caused by the influence of moral and religious values and gender iniquities. In this light, the present study aimed to analyze the experience of women who had an abortion regarding the care provided by healthcare services as part of the abortion itinerary. This is a qualitative study, carried out with 18 women in three cities - one small city, one mid-sized, and one big - in the state of Bahia. Data were produced by face-to-face or online interviews. The empirical material was analyzed using the discourse analysis technique. The results show, in the three municipalities, abortion itineraries under social and gender iniquities, with greater access difficulties for low-income women. Better financial conditions allow access to clandestine private clinics but without guaranteeing humanized care. In the three municipalities, economically disadvantaged women self-induced abortions and delayed seeking services, having faced embarrassing and prejudicial professional attitudes. The results point to the urgency of implementing public policies in which reproductive rights are as effective as human rights.

Mental health as a dimension for the care of teenagers.

OBJECTIVE: To analyze the demands in the field of mental health from the perspective of teenagers. METHOD: A descriptive study with a qualitative approach, having comprehensiveness as an analytical category. It was carried out with 21 teenagers of both genders, students of two public schools of a municipality of the countryside of Bahia state. The empirical material was produced through reflection workshops and analyzed through the technique of Discourse Analysis. RESULTS: Teenagers value the indissociability between body and mind, recognize lack of attention to the psychological dimension in the health network, and point to mental disorders as resulting from contexts of life and lack of Health Care. CONCLUSION: Health services need to be structured to attract teenagers, to recognize singularities through professionals trained in welcoming, listening and accountability. It is urgent to fulfill what is defined in public policies and in specific programs, and that comprehensiveness has a centrality as a perspective to be realized.

Women's experiences of induced abortion resulting from unplanned pregnancy: a qualitative systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to synthesize qualitative evidence on the experiences of women undergoing an induced abortion resulting from an unplanned pregnancy.More specifically, the review question is: how do women experience induced abortions resulting from an unplanned pregnancy?

[Fatherhood: The male experience from a gender focus]. / Sentir-se pai: a vivência masculina sob o olhar de gênero.

Pregnant and postpartum women frequently complain about the limited involvement of their partners with their children, beginning in pregnancy. The current study thus aimed to understand men's feelings towards fatherhood during this period of their lives. The research adopted a qualitative approach and a gender-theory focus. The universe included men whose children were being treated at a pediatric outpatient clinic, and data were collected through semi-structured home interviews. Subjects' testimony was analyzed using discourse analysis, the basic principle of which is to recognize the most abstract levels of the text, identified by themes organized in blocks of meaning and allowing the construction of empirical categories. Study subjects' social position towards fatherhood shows that the model that men assume as father-providers coexists with that of the man who seeks to be a "new father", whose affective bond with the son or daughter begins during pregnancy, thus representing a break with traditional fatherhood.

Condicionantes de gênero na produção de demandas de mulheres de meia-idade / Condicionantes de género en la producción de demandas de mujeres de mediana edad / Gender constraints in the production of demands by middle-aged women

Resumo Objetivo Analisar condicionantes de gênero presentes em demandas de saúde de mulheres de meia-idade oriundas do seu cotidiano. Métodos Estudo de abordagem qualitativa do tipo Pesquisa Convergente Assistencial. A pesquisa foi realizada com dois grupos de participantes: mulheres de meia-idade e profissionais da saúde. No total, participaram 13 mulheres de meia-idade e 18 profissionais de saúde. A produção do material empírico se deu por meio de oficinas de reflexão e entrevistas nos meses de maio e junho de 2017. A análise dos dados foi realizada por meio da técnica de análise de discurso. Resultados Os resultados conformaram duas categorias empíricas em que convergem a posição dos dois grupos de participantes: Atributos de gênero definindo demandas emocionais na meia-idade e o corpo como instrumento do fazer e demandante de cuidado na meia-idade. As experiências de vida relatadas são marcadas por trabalho doméstico e cuidado da família e expressam sobrecargas emocionais e físicas acumuladas ao longo dos anos. Profissionais de saúde revelam escuta sensível às demandas das mulheres, contudo questões estruturais, ligadas à organização da atenção dificultam práticas mais resolutivas. Conclusão Os resultados revelaram que o cotidiano de mulheres de meia idade define demandas para o cuidado vinculadas a atributos de gênero, incorporados ao cotidiano de modo naturalizado. Sem responsabilidades compartilhadas no ambiente familiar, há sobrecarga física e emocional que suscitam cuidados. Os serviços de saúde reconhecem, mas há somente ações pontuais para demandas de ordem biológica e nenhuma proposta sistematizada para um trabalho com mulheres que abram caminhos ao empoderamento.

Resumen Objetivo Analizar condicionantes de género presentes en demandas de salud de mujeres de mediana edad originarias de su cotidiano. Métodos Estudio de abordaje cualitativo del tipo Investigación Convergente Asistencial. La investigación se realizó con dos grupos de participantes: mujeres de mediana edad y profesionales de la salud. En la totalidad, participaron 13 mujeres de mediana edad y 18 profesionales de salud. La producción del material empírico se realizó a través de talleres de reflexión y encuestas en los meses de mayo y de junio de 2017. El análisis de los datos se realizó por medio de la técnica de análisis de discurso. Resultados Los resultados conformaron dos categorías empíricas en las que convergen la posición de los dos grupos de participantes: Atributos de género definiendo demandas emocionales en la mediana edad y el cuerpo como instrumento del quehacer y que demandan cuidado en la mediana edad. Las experiencias de vida relatadas están marcadas por el trabajo doméstico y el cuidado con la familia y expresan sobrecargas emocionales y físicas acumuladas a lo largo de los años. Profesionales de la salud revelan una escucha sensible a las demandas de las mujeres, sin embargo, cuestiones estructurales, relacionadas con la organización de la atención dificultan las prácticas más resolutivas. Conclusión Los resultados revelaron que el cotidiano de mujeres de mediana edad definen demandas con el cuidado vinculadas a atributos de género, incorporados al cotidiano de modo naturalizado. Sin responsabilidades compartidas en el ambiente familiar, hay una sobrecarga física y emocional que suscitan cuidados. Los servicios de salud reconocen, pero existen solamente acciones puntuales para demandas de orden biológico y ninguna propuesta sistematizada para un trabajo con mujeres que abran caminos hacia el empoderamiento.

Abstract Objective To analyze gender conditions present in middle-aged women's health demands from their daily lives. Methods This is a study with a qualitative approach of the Convergent Care Research type. The survey was conducted with two groups of participants: middle-aged women and health professionals. In total, 13 middle-aged women and 18 health professionals participated. The production of empirical material took place through reflection workshops and interviews in May and June 2017. Data analysis was performed using the discourse analysis technique. Results The results formed two empirical categories in which the position of the two groups of participants converge: Gender attributes defining emotional demands in middle age; The body as an instrument of doing and demanding care in middle age. The reported life experiences are marked by housework and family care and express emotional and physical burdens accumulated over the years. Health professionals reveal sensitive listening to women's demands; however, structural issues related to the organization of care hinder more resolving practices. Conclusion The results revealed that the daily life of middle-aged women defines demands for care linked to gender attributes, incorporated into daily life in a naturalized way. Without shared responsibilities in the family environment, there is a physical and emotional burden that prompts care. The health services recognize this, but there are only punctual actions for demands of a biological order and no systematic proposal for working with women that open paths to empowerment.

Iniquidades sociais e de gênero nas demandas de mulheres por acolhimento / Iniquidades sociales y de género en las demandas de acogida de las mujeres / Social and gender inequalities in women's needs for user embracement

RESUMO Objetivo analisar demandas de mulheres segundo o olhar de equipes multiprofissionais. Métodos estudo qualitativo desenvolvido em Unidade de Saúde da Família de um Distrito Sanitário de Saúde em Salvador, Bahia, Brasil. Realizou-se grupo focal e o material empírico foi analisado pela técnica de Análise de Discurso. Resultados participaram da pesquisa 12 profissionais de saúde com idades entre 27 e 60 anos e atuação de dois a 13 anos na Estratégia Saúde da Família. As profissionais caracterizaram as usuárias com vulnerabilidade social e econômica e as demandas de ordem afetivo-emocional relacionadas a iniquidades de gênero, com sobrecarga do trabalho doméstico e do cuidado à família. A equipe de saúde constitui ponto de apoio e oferece acolhimento e escuta sensível. Conclusão carência afetiva e desgastes pelas funções no âmbito doméstico, familiar e pela relação com o parceiro marcam as demandas de mulheres por cuidado. Profissionais realizam práticas na perspectiva da integralidade, mas há limites institucionais e da equipe em lidar com singularidades. Construir a superação requer abrir caminhos ao empoderamento das mulheres, o que não retrata a realidade problematizada. Implicações para a prática subsidiar profissionais no atendimento ao princípio da integralidade diante de contextos de mulheres em vulnerabilidades sociais e econômicas.

RESUMEN Objetivo analizar las demandas de las mujeres desde la óptica de equipos multidisciplinarios. Métodos estudio cualitativo realizado en la Unidad de Salud de la Familia de un Distrito de Salud de Salvador, Bahía, Brasil. Se realizó un grupo focal y se analizó el material empírico mediante la técnica de Análisis del Discurso. Resultados participaron de la investigación 12 profesionales de la salud, con edades entre 27 y 60 años y actuando de dos a 13 años en la Estrategia Salud de la Familia. Los profesionales caracterizaron a los usuarios con vulnerabilidad social y económica y las demandas afectivo-emocionales relacionadas a las inequidades de género, con sobrecarga de trabajo doméstico y cuidado de la familia. El equipo de salud es un punto de apoyo y ofrece acogida y escucha sensible. Conclusión la carencia y el desgaste afectivo por las funciones domésticas, familiares y la relación de pareja marcan las demandas de cuidado de las mujeres. Los profesionales realizan prácticas desde la perspectiva de la integralidad, pero existen límites institucionales y de equipo en el abordaje de las singularidades. Construir la superación de desafíos requiere abrir caminos al empoderamiento de las mujeres, lo que no retrata la realidad problematizada. Implicaciones para la práctica subsidiar a profesionales en la atención al principio de integralidad ante contextos de mujeres en situación de vulnerabilidad social y económica.

ABSTRACT Objective to analyze the demands of women from the point of view of multi-professional teams. Methods This is a qualitative study developed in a Family Health Unit of a Health Sanitary District in Salvador, Bahia, Brazil. A focus group was conducted, and the empirical material was analyzed using the Discourse Analysis technique. Results twelve health professionals aged between 27 and 60 years and working for two to 13 years in the Family Health Strategy participated in the research. The professionals characterized the users with social and economic vulnerability and the demands of affective-emotional order related to gender inequities, with an overload of domestic work and family care. The health team constitutes a support point and offers welcoming and sensitive listening. Conclusion and implications for practice affective deprivation and wear and tear due to domestic and family functions and the relationship with the partner mark women's demands for care. Professionals perform practices from the perspective of integrality, but there are institutional and team limits in dealing with singularities. Overcoming these limitations requires opening paths to the empowerment of women, which does not portray the problematized reality, and support professionals in meeting the principle of integrality in the context of women in social and economic vulnerabilities.

Pré-natal da mulher brasileira: desigualdades raciais e suas implicações para o cuidado / Prenatal care of Brazilian women: racial inequalities and their implications for care

Resumo Esta investigação teve como objetivo caracterizar as mulheres que realizaram o pré-natal no Brasil segundo raça/cor e variáveis sociodemográficas e verificar associação entre os indicadores de processo do cuidado no pré-natal e a raça/cor das mulheres. Estudo transversal de base populacional empreendido com dados da Pesquisa Nacional de Saúde de 2013. Realizou-se análise bivariada mediante modelo de regressão logística multinível, estimando-se as odds ratio para medir a associação entre os indicadores de processo do cuidado pré-natal adequado e raça/cor das mulheres e verificando os respectivos intervalos de confiança de 95%. Os achados evidenciaram que mulheres negras possuem menor chance de iniciar o pré-natal antes das 12 semanas de gestação, ter seis ou mais consultas, realizar teste de HIV, exame VDRL e receber orientações referentes aos cuidados na gestação e parto. Identificamos desigualdades na atenção à saúde das mulheres brasileiras atendidas no pré-natal relacionadas à raça/cor e a outras características sociodemográficas. Conclui-se que ser negra e ocupar lugares sociais desfavoráveis acarretam desvantagens para as mulheres quanto ao acesso a um pré-natal considerado adequado segundo os critérios estabelecidos pelo Ministério da Saúde do Brasil.

Abstract The study aimed to characterize women that attended prenatal care in Brazil according to ethnicity/skin color and sociodemographic variables and to verify the association between the indicators of the prenatal care process and the women's ethnicity/skin color. This was a population based, cross-sectional study carried out with data from the National Health Survey of 2013. A bivariate analysis was performed using the multilevel logistic regression model, estimating the odds ratio and the respective 95% confidence intervals to test the association between the indicators of the adequate prenatal care process and the women's ethnicity/skin color. The findings showed that black women have a lower chance of starting prenatal care before 12 weeks of gestation, having 6 or more consultations, performing the HIV test, performing the VDRL exam or receiving advice related to care during gestation and childbirth. Inequalities were identified in the healthcare of Brazilian women during prenatal care, related to ethnicity/skin color and other sociodemographic characteristics. It was concluded that being of black ethnicity and living in a socially disadvantaged area entails disadvantages for women regarding access to a prenatal care considered to be adequate according to the criteria established by the Brazilian Ministry of Health.

Factors Associated with Abortion in Women of Reproductive Age.

Purpose To verify sociodemographic factors associated with the occurrence of abortion in women of reproductive age, in areas covered by the Family Health Strategy (FHS), a program from the Brazilian Ministry of Health. Methods A cross-sectional study using household surveys of 350 women aged 15 to 49. The report of abortion was a variable indicator, and sociodemographic aspects were covariables. Prevalence ratio (PR) and respective 95% confidence intervals were used to estimate the magnitude of the associations. Results There were associations among age, civil status, race/color, and religion; an increase in the prevalence of lower levels of education, age less than 20, and student status were protective factors. Conclusion The association between sociodemographic characteristics and the report of abortion is attributed to the fact that there is a lack at the FHS in the availability of fundamental healthcare services for young women; these findings call for action to guarantee the access to information about contraceptives and guidance to decrease the risk of unplanned pregnancies and abortions.

Centralidade de vínculos familiares na experiência de mulheres de meia-idade / La centralidad de los vínculos familiares en la experiencia de las mujeres de mediana edad / Centrality of family bonds in the experience of middle-aged women

RESUMO Objetivo Analisar sentidos atribuídos à meia-idade a partir da experiência de mulheres que a vivenciam em suas relações familiares. Método Estudo qualitativo do tipo Pesquisa Convergente Assistencial. Gênero foi utilizado como categoria analítica, desenvolvida com treze mulheres de meia-idade de área de cobertura da Estratégia Saúde da Família em um município do sudoeste baiano, por oficinas de reflexão e entrevistas. Os dados foram analisados por meio da análise de discurso. Resultados Expressam a relação afetiva com filhos/as e netos/as como maior marca da meia-idade em sobreposição à relação com parceiros e outros vínculos, o que inviabiliza sua singularidade e identificação de demandas para o cuidado à saúde. Conclusão A meia-idade feminina é marcada por concepções de feminilidade que emergem a partir da sua condição de mulher-mãe, de completa doação. A pesquisa aponta para uma necessidade urgente de agregar gênero como referencial para o cuidado à mulher de meia-idade, de modo a considerar os entrelaçamentos biopsíquicos e sociais na sua experiência de vida e que delineiam demandas para o cuidado.

RESUMEN Objetivo Analizar los significados adjudicados a la mediana edad desde la experiencia de mujeres que la viven en sus relaciones familiares. Método Se trata de un estudio cualitativo de la clase Investigación de Cuidados Convergentes en el que se utilizó el género como categoría analítica. Se llevó a cabo mediante talleres de reflexión y entrevistas entre trece mujeres de mediana edad que estaban bajo la Estrategia de Salud Familiar de un municipio del suroeste de Bahía. Los datos se analizaron a través del análisis del discurso. Resultados Se identificó la relación afectiva con hijos/as y nietos/as como una marca importante de la mediana edad que se superpone a la relación con la pareja y otros vínculos, lo que restringe la identificación de su singularidad y las demandas para el cuidado de la salud. Conclusión La mediana edad femenina está marcada por concepciones de feminidad que surgen de su condición de mujer-madre, de entrega total. La investigación señala la necesidad urgente de añadir el género como referencia para el cuidado de las mujeres de mediana edad, con el fin de considerar el entramado biopsicosocial en su experiencia de vida que perfila las demandas del cuidado.

ABSTRACT Objective To analyze meanings attributed to middle-aged women from their experience in their family relationships. Method Qualitative study of the Convergent Care Research method. Gender was used as an analytical category, developed with a total of thirteen middle-aged women from the coverage area of the Family Health Strategy program in a city in the southwest of Bahia state, through reflection workshops and interviews. Data were analyzed using discourse analysis. Results They express the affective relationship with children and grandchildren as the greatest highlight of middle age in overlap with the relationship with partners and other bonds, which makes their uniqueness and identification of demands for health care unfeasible. Conclusion Female middle-aged are marked by conceptions of femininity that emerge from their condition as a woman-mother, from her complete donation. The research points to an urgent need to add gender as a reference for the care of middle-aged women, in order to consider the biopsychic and social interlaces in their life experience and that outline demands for care.

Sexualidade vivida por mulheres de diferentes gerações e soropositivas para o HIV / Sexualidad vivida por mujeres de diferentes generaciones VIH-positivas / Sexuality experienced by women of different generations and HIV positive

Resumo Objetivo Analisar as representações sociais de mulheres de diferentes gerações e que vivem com HIV sobre sua sexualidade. Métodos Pesquisa de abordagem qualitativa, com referencial teórico-metodológico baseado na Teoria das Representações Sociais, desenvolvida em um serviço de atenção especializada, no Estado da Bahia, região Nordeste do Brasil, com 39 mulheres. As entrevistas foram processadas pelo software Iramuteq, o qual gerou a Análise Fatorial de Correspondência e Classificação Hierárquica Descendente. Resultados As representações revelaram (im)possibilidades que permeiam a intimidade afetivossexual entre as mulheres de meia-idade; a busca por novas estratégias para vivenciar a sexualidade para mulheres com idade de 30-44 anos; a reafirmação do medo das idosas em revelar o diagnóstico; e, perpassando todas as gerações, a manutenção do tratamento como demonstração de afeto ao parceiro. Conclusão O recorte geracional revelou aspectos distintos das representações sociais sobre a vivência da sexualidade. Ratifica-se a necessidade de novos estudos sobre a temática.

Resumen Objetivo Analizar las representaciones sociales de mujeres de diferentes generaciones que viven con el VIH sobre su sexualidad. Métodos Estudio de enfoque cualitativo, con marco referencial teórico-metodológico basado en la teoría de las representaciones sociales, llevado a cabo en un servicio de atención especializada en el estado de Bahia, región Nordeste de Brasil, con 39 mujeres. Las encuestas fueron procesadas por el software Iramuteq, que generó el análisis factorial de correspondencia y la clasificación jerárquica descendiente. Resultados Las representaciones revelan (im)posibilidades que se impregnan en la intimidad afectiva-sexual de las mujeres de mediana edad, en la búsqueda de nuevas estrategias para vivir la sexualidad en mujeres entre 30 y 44 años, en la reafirmación del miedo de las mujeres mayores a revelar el diagnóstico y en mantener el tratamiento como demostración de afecto al compañero, que abarca a todas las generaciones. Conclusión El recorte generacional reveló distintos aspectos de las representaciones sociales sobre la vivencia de la sexualidad. Se confirma la necesidad de nuevos estudios sobre esta temática.

Abstract Objective To analyze women's social representations of different generations that live with HIV about their sexuality. Methods Qualitative research with theoretical and methodological framework based on Social Representations theory carried out in a specialized attention service, in Bahia state, northeast Brazilian region, with 39 women. We processed the interviews with the Iramuteq software, which generated the Correspondence Factorial Analysis and the Descending Hierarchical Classification. Results The representations revealed (im)possibilities that pervade the sexual and affective intimacy between middle-aged women, the search for new strategies to experience sexuality for women of 30-44 years; the reaffirmation of fear of older women in revealing the diagnosis; and, through all generations, the treatment maintenance as a demonstration of affection to the partner. Conclusion The generational cutout revealed distinct aspects of social representations about sexuality experience. We highlight the necessity of new studies about the theme.

Mulheres de diferentes gerações que vivem com HIV: representações sociais sobre sexualidade / Mujeres de diferentes generaciones que viven con VIH: representaciones sociales sobre la sexualidad / Women of different generations living with HIV: social representations about sexuality

RESUMO Objetivo Analisar as representações sociais de mulheres com diagnóstico de HIV sobre sua sexualidade, considerando características geracionais. Método Pesquisa qualitativa, com mulheres que participaram por meio de entrevista. O corpus constituído foi processado pelo software Iramuteq. A análise ancorou-se na Teoria das Representações Sociais. Resultados Participaram 39 mulheres, com idade entre 18-76 anos e em sua maioria com ensino médio, que evocaram os termos 'gente' (301), 'companheiro' (277), 'filho' (249), 'vírus' (275) e 'querer' (216). As mais jovens aceitam revelar e/ou 'contar' sobre a sua condição para seu(s) parceiro(s) e familiares, aspecto que não se revela nas falas de mulheres com outras idades. Para as mulheres com 45 e mais anos, o/a filho/a ocupa lugar de destaque, e para as idosas a centralidade da representação remetia à autocensura e à manutenção do jogo vítimas/culpadas. Conclusão Este estudo possibilitou a identificação de processos de ancoragem das sexualidades em termos do que 'não pode ser revelado' para além do âmbito familiar. Nesse sentido, os elementos 'sexo' e 'relação-sexual', concebidos pelo senso comum como sinônimo de sexualidade, independentemente da geração, apresentaram baixa frequência.

RESUMEN Objetivo Analizar las representaciones sociales sobre sexualidad de mujeres con diagnóstico de VIH, teniendo en cuenta las características generacionales. Método Se trata de una investigación cualitativa entre mujeres que participaron por medio de entrevistas. El corpus constituido se procesó con el software Iramuteq. El análisis se basó en la Teoría de las Representaciones Sociales. Resultados Participaron 39 mujeres de 18 a 76 años, en su mayoría con el secundario completo, que evocaron los términos "personas" (301), "pareja" (277), "hijo" (249), "virus" (275) y "querer" (216). Las más jóvenes aceptaron revelar y/o "contar" su condición a su(s) pareja(s) y familiares, aspecto que no se reveló en las declaraciones de mujeres de otras edades. Para las mujeres de 45 años o más, el hijo/a ocupa un lugar prominente, y para las mayores, la centralidad de la representación se remite a la autocensura y al mantenimiento del juego víctima/culpable. Conclusión Este estudio permitió identificar los procesos de anclaje de la sexualidad en términos de lo que "no puede revelarse" más allá de la esfera familiar. En este sentido, los elementos "sexo" y "relación sexual", concebidos por el sentido común como sinónimo de sexualidad independiente de la generación, presentaron una frecuencia baja.

ABSTRACT Objective To analyze the social representations of women diagnosed with HIV about their sexuality considering generational characteristics. Method Qualitative study, carried out with women who participated through interviews. The constituted corpus was processed by the Iramuteq software. The analysis was based on the Theory of Social Representations. Results A total of 39 women participated in the study, aged between 18-76 years old and most of them had high school education, evoked the terms 'people' (301), 'partner' (277), 'children' (249), 'virus' (275) and 'want' (216). The younger ones accept to reveal and/or 'tell' about their condition to their partner(s) and family members, an aspect that is not revealed in the statements of women of other ages. For women aged 45 and over, children occupy a prominent place and for the older adults, the centrality of representation referred to self-censorship and maintaining the victim/guilty game. Conclusion This study made it possible to identify processes of anchoring sexualities in terms of what 'cannot be revealed' beyond the family context. It should be noted that the elements 'sex', intercourse' conceived by common sense as a synonym for sexuality, regardless of generation, had low frequency.