{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:11:56Z","timestamp":1785471116831,"version":"3.56.0"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Council for Scientific and Technological Development (CNPq), Brazil","award":["445760\/2023-0"],"award-info":[{"award-number":["445760\/2023-0"]}]},{"name":"National Council for Scientific and Technological Development (CNPq), Brazil","award":["445760\/2023-0"],"award-info":[{"award-number":["445760\/2023-0"]}]},{"name":"National Council for Scientific and Technological Development (CNPq), Brazil","award":["445760\/2023-0"],"award-info":[{"award-number":["445760\/2023-0"]}]},{"name":"National Council for Scientific and Technological Development (CNPq), Brazil","award":["445760\/2023-0"],"award-info":[{"award-number":["445760\/2023-0"]}]},{"name":"National Council for Scientific and Technological Development (CNPq), Brazil","award":["445760\/2023-0"],"award-info":[{"award-number":["445760\/2023-0"]}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>In Brazil, tuberculosis\u2013human immunodeficiency virus (TB\u2013HIV) coinfection remains a major public health challenge despite advances in antiretroviral therapy and tuberculosis preventive treatment (TPT) Civil society has historically contributed to HIV responses, but little is known about how it perceives TB care for people living with HIV (PLHIV). This study examined how organized civil society perceives and represents TB care for PLHIV. We conducted a qualitative study guided by Social Representations Theory, with five focus groups involving 37 representatives from civil society organizations in five Brazilian state capitals in 2025. Three thematic categories were identified: (1) social and institutional neglect of TB, evidenced by the absence of campaigns, delayed diagnosis, and shortages of medications in some localities; (2) stigma, poverty, and social exclusion in the context of coinfection, in which TB\u2013HIV coinfection was described as a factor that exacerbates these phenomena; and (3) civil society and non-governmental organizations (NGOs) as mediators of care, which act as a bridge between socially vulnerable populations and health services. Participants acknowledged that persistent barriers to TB care are further intensified by the presence of HIV. This study advances current knowledge by explicitly framing civil society not only as a mediator, but as a co-producer of TB\u2013HIV care, particularly in contexts of social vulnerability.<\/jats:p>","DOI":"10.1371\/journal.pgph.0006119","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T17:37:57Z","timestamp":1773855477000},"page":"e0006119","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Civil society perspectives on tuberculosis care for people living with HIV in Brazil: A study informed by Social Representations Theory"],"prefix":"10.1371","volume":"6","author":[{"given":"Gabriela Tavares","family":"Magnabosco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6847-3117","authenticated-orcid":true,"given":"Fernanda","family":"de Paulo Pedroso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2542-1488","authenticated-orcid":true,"given":"Isadora Gabriella Silva","family":"Palmieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8712-0732","authenticated-orcid":true,"given":"Let\u00edcia Baio","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5836-244X","authenticated-orcid":true,"given":"Heitor Hortensi","family":"Sesnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5361-0251","authenticated-orcid":true,"given":"Sidnei Nathan","family":"Soares Turquino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketlyn Andriele","family":"Lomes da Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0555-4006","authenticated-orcid":true,"given":"Renato Meggiato","family":"Nabas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3484-3492","authenticated-orcid":true,"given":"Helo\u00edsa","family":"do Carmo Antonio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4882-8814","authenticated-orcid":true,"given":"M\u00e1rcio Vin\u00edcius Ferreira","family":"Resende","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Pavinati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"pgph.0006119.ref001","volume-title":"WHO Civil Society Task Force on Tuberculosis: Engagement with Civil Society as a Driver for Change","author":"World Health Organization","year":"2024"},{"key":"pgph.0006119.ref002","volume-title":"Global tuberculosis report 2024","author":"World Health Organization","year":"2024"},{"key":"pgph.0006119.ref003","volume-title":"Epidemiological bulletin: tuberculosis 2025","author":"Brazil Ministry of Health","year":"2025"},{"key":"pgph.0006119.ref004","first-page":"43","article-title":"Tuberculosis, vulnerabilities, and HIV in homeless persons: a systematic review","volume":"56","author":"JR Gioseffi","year":"2022","journal-title":"Rev Saude Publica"},{"key":"pgph.0006119.ref005","doi-asserted-by":"crossref","first-page":"100587","DOI":"10.1016\/j.ijregi.2025.100587","article-title":"Inequities underlie the alarming resurgence of Tuberculosis as the world\u2019s top cause of death from an Infectious Disease - Breaking the silence and addressing the underlying root causes","volume":"14","author":"A Zumla","year":"2025","journal-title":"IJID Reg"},{"issue":"4","key":"pgph.0006119.ref006","first-page":"1605","article-title":"Primary Health Care sustainability in rural remote territories at the fluvial Amazon: organization, strategies, and challenges","volume":"27","author":"MCR Fausto","year":"2022","journal-title":"Cien Saude Colet"},{"key":"pgph.0006119.ref007","doi-asserted-by":"crossref","first-page":"10","DOI":"10.11606\/s1518-8787.2024058005531","article-title":"Clusters of heterogeneity of tuberculosis-HIV coinfection in Brazil: a geospatial study","volume":"58","author":"LV de Lima","year":"2024","journal-title":"Rev Saude Publica"},{"key":"pgph.0006119.ref008","article-title":"HIV\/AIDS activism and the Unified Health System in Bel\u00e9m, Brazil, 1990\u20132003","volume":"32","author":"PHS Santos","year":"2025","journal-title":"Hist Cienc Saude Manguinhos"},{"key":"pgph.0006119.ref009","volume-title":"Social Representations: Explorations in Social Psychology","author":"S Moscovici","year":"2000"},{"key":"pgph.0006119.ref010","author":"ASP Moreira","year":"1998"},{"issue":"6","key":"pgph.0006119.ref011","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"A Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"pgph.0006119.ref012","volume-title":"The challenge of knowledge: qualitative research in health","author":"MCS Minayo","year":"2014","edition":"14"},{"key":"pgph.0006119.ref013","first-page":"101","article-title":"Theory and methods in social representations.","author":"LM Bertoni","year":"2017","journal-title":"Theoretical and methodological notes of research in education: concepts and trajectories. Ilh\u00e9us: Editus"},{"key":"pgph.0006119.ref014","doi-asserted-by":"crossref","DOI":"10.1590\/2177-9465-ean-2022-0156en","article-title":"Conceptions about treatment and diagnosis of pulmonary tuberculosis by those who experience it","volume":"27","author":"LM Teixeira","year":"2023","journal-title":"Esc Anna Nery"},{"key":"pgph.0006119.ref015","article-title":"Tuberculosis\/HIV coinfection focusing on care and quality of life","volume":"35","author":"MVF Carvalho","year":"2022","journal-title":"Acta Paul Enferm"},{"issue":"1","key":"pgph.0006119.ref016","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1186\/s12913-025-12967-4","article-title":"Review: missed tuberculosis cases in India: a systematic analysis of diagnostic, treatment, and reporting gaps","volume":"25","author":"R Shrisunder","year":"2025","journal-title":"BMC Health Serv Res"},{"key":"pgph.0006119.ref017","article-title":"Factors associated with loss to follow-up in tuberculosis treatment in Brazil: a retrospective cohort study","volume":"44","author":"LV de Lima","year":"2023","journal-title":"Rev Gaucha Enferm"},{"issue":"3","key":"pgph.0006119.ref018","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(21)00550-7","article-title":"The effect of primary health care on tuberculosis in a nationwide cohort of 7\u00b73 million Brazilian people: a quasi-experimental study","volume":"10","author":"GS Jesus","year":"2022","journal-title":"Lancet Glob Health"},{"key":"pgph.0006119.ref019","volume-title":"Epidemiological bulletin: tuberculosis 2024","author":"Brazil Ministry of Health","year":"2024"},{"key":"pgph.0006119.ref020","author":"Brazil Ministry of Health","year":"2022"},{"key":"pgph.0006119.ref021","volume-title":"Brazil free of tuberculosis: national plan to end tuberculosis as a public health problem, 2021\u20132025","author":"Brazil Ministry of Health","year":"2021"},{"key":"pgph.0006119.ref022","article-title":"Adherence to tuberculosis treatment: biopolitical health promotion strategies in the neoliberal approach","volume":"27","author":"PTN Zago","year":"2023","journal-title":"REME Rev Min Enferm"},{"key":"pgph.0006119.ref023","article-title":"New insights on tuberculosis transmission dynamics and drug susceptibility profiles among the prison population in Southern Brazil based on whole-genome sequencing","volume":"56","author":"LMP Anselmo","year":"2023","journal-title":"Rev Soc Bras Med Trop"},{"issue":"1","key":"pgph.0006119.ref024","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1186\/s12913-023-09320-y","article-title":"Sustainability of community health programme using community-based organizations: a challenge for stakeholders","volume":"23","author":"FMG Donessoun\u00e9","year":"2023","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"pgph.0006119.ref025","doi-asserted-by":"crossref","DOI":"10.1016\/S1473-3099(22)00500-X","article-title":"Ending tuberculosis in a post-COVID-19 world: a person-centred, equity-oriented approach","volume":"23","author":"T Ryckman","year":"2023","journal-title":"Lancet Infect Dis"},{"issue":"1","key":"pgph.0006119.ref026","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s44263-024-00077-y","article-title":"Strengthening accountability for tuberculosis policy implementation in South Africa: perspectives from policymakers, civil society, and communities","volume":"2","author":"H-M van der Westhuizen","year":"2024","journal-title":"BMC Glob Public Health"},{"key":"pgph.0006119.ref027","doi-asserted-by":"crossref","first-page":"1576875","DOI":"10.3389\/fpubh.2025.1576875","article-title":"Building community networks and engagement for effective TB case management","volume":"13","author":"A Kumah","year":"2025","journal-title":"Front Public Health"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0006119","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T17:38:05Z","timestamp":1773855485000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0006119"}},"subtitle":[],"editor":[{"given":"Graeme","family":"Hoddinott","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,3,18]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0006119","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,18]]}}}