{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T18:37:35Z","timestamp":1648665455831},"reference-count":61,"publisher":"FapUNIFESP (SciELO)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cad. Sa\u00fade P\u00fablica"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p>Resumo: O texto debate as principais orienta\u00e7\u00f5es e procedimentos que configuram a preven\u00e7\u00e3o prim\u00e1ria do HIV\/AIDS em Portugal, prestando especial aten\u00e7\u00e3o \u00e0 redu\u00e7\u00e3o de riscos nos dois grandes cen\u00e1rios de propaga\u00e7\u00e3o da epidemia: a sexualidade e o consumo de drogas injet\u00e1veis. Na an\u00e1lise, os riscos de infec\u00e7\u00e3o s\u00e3o considerados enquanto express\u00f5es de pr\u00e1ticas densamente imbricadas em estruturas sociais e quadros culturais. \u00c0 luz dessa concep\u00e7\u00e3o, procura-se avaliar e compreender em que medida as estrat\u00e9gias preventivas t\u00eam subjacente uma abordagem ampla e integradora, incluindo os indiv\u00edduos e as suas circunst\u00e2ncias. Simultaneamente, s\u00e3o identificados alguns dos grandes constrangimentos estruturais que ainda se colocam \u00e0 concretiza\u00e7\u00e3o de condi\u00e7\u00f5es prop\u00edcias \u00e0 minimiza\u00e7\u00e3o de riscos e \u00e0 ado\u00e7\u00e3o de comportamentos seguros. Nesses exerc\u00edcios anal\u00edticos n\u00e3o se ponderam somente as orienta\u00e7\u00f5es pol\u00edticas e program\u00e1ticas, mas tamb\u00e9m processos no terreno, de forma a mostrar-se como a n\u00e3o operacionaliza\u00e7\u00e3o de medidas j\u00e1 previstas e legisladas constitui, por si mesma, uma poderosa barreira estrutural \u00e0 preven\u00e7\u00e3o do HIV.<\/jats:p>","DOI":"10.1590\/0102-311x00129715","type":"journal-article","created":{"date-parts":[[2016,6,18]],"date-time":"2016-06-18T12:58:09Z","timestamp":1466254689000},"source":"Crossref","is-referenced-by-count":0,"title":["Indiv\u00edduos, estruturas e riscos: panor\u00e2mica da preven\u00e7\u00e3o prim\u00e1ria do HIV em Portugal"],"prefix":"10.1590","volume":"32","author":[{"given":"Oct\u00e1vio","family":"Sacramento","sequence":"first","affiliation":[{"name":"Universidade de Tr\u00e1s-os-Montes e Alto Douro, Portugal"}]}],"member":"530","reference":[{"issue":"8","key":"ref1","doi-asserted-by":"crossref","DOI":"10.4000\/eces.501","article-title":"Rituais de risco e governamentalidade liberal na preven\u00e7\u00e3o do VIH\/SIDA","author":"Seixas E","year":"2010","journal-title":"e-cadernos CES"},{"key":"ref2","series-title":"Routledge handbook in global public health","first-page":"98","volume-title":"From natural history of disease to vulnerability: changing concepts and practices in contemporary public health","author":"Ayres J","year":"2011"},{"key":"ref3","series-title":"Combination HIV prevention: tailoring and coordinating biomedical, behavioural and structural strategies to reduce new HIV infections","year":"2010"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/S0140-6736(08)60887-9","article-title":"Structural approaches to HIV prevention","volume":"372","author":"Gupta G","year":"2008","journal-title":"Lancet"},{"key":"ref5","series-title":"Textos de antropologia aplicada","first-page":"81","volume-title":"A masculinidade como amea\u00e7a: reflex\u00f5es antropol\u00f3gicas aplic\u00e1veis sobre comportamentos sexuais e doen\u00e7as sexualmente transmiss\u00edveis, num contexto de prostitui\u00e7\u00e3o","author":"Sacramento O","year":"2005"},{"key":"ref6","series-title":"Diagn\u00f3stico s\u00f3cio-sanit\u00e1rio do VIH\/SIDA no distrito de Bragan\u00e7a (relat\u00f3rio de pesquisa)","author":"Ribeiro FB","year":"2009"},{"key":"ref7","first-page":"510","article-title":"A despistagem do VIH\/sida: sa\u00fade p\u00fablica e motiva\u00e7\u00f5es dos utentes do teste r\u00e1pido no Nordeste de Portugal","volume":"23","author":"Ribeiro FB","year":"2014","journal-title":"Sa\u00fade Soc"},{"key":"ref8","series-title":"Trabalho em sa\u00fade. Desigualdades e pol\u00edticas p\u00fablicas","first-page":"231","volume-title":"Epidemia sem fronteiras: ac\u00e7\u00e3o global, pol\u00edticas p\u00fablicas e o trajecto da luta contra a sida em Portugal","author":"Ribeiro FB","year":"2014"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"111","DOI":"10.4000\/ras.268","article-title":"Viver com a infec\u00e7\u00e3o: gest\u00e3o da doen\u00e7a e quotidianos terap\u00eauticos de doentes com VIH\/sida no Nordeste de Portugal","volume":"10","author":"Ribeiro FB","year":"2012","journal-title":"Revista Angolana de Sociologia"},{"key":"ref10","author":"Sacramento O","year":"2015"},{"key":"ref11","series-title":"Planeta sida: express\u00f5es multiculturais da epidemia, pol\u00edticas p\u00fablicas e respostas sociais","author":"Sacramento O"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1146\/annurev.anthro.30.1.163","article-title":"Sexuality, culture, and power in HIV\/AIDS research","volume":"30","author":"Parker R","year":"2001","journal-title":"Annu Rev Anthropol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/S0140-6736(08)60886-7","article-title":"Behavioural strategies to reduce HIV transmission: how to make them work better","volume":"372","author":"Coates T","year":"2008","journal-title":"Lancet"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1080\/17441692.2011.594451","article-title":"Addressing social drivers of HIV\/AIDS for the long-term response: conceptual and methodological considerations","volume":"6","author":"Auerbach J","year":"2011","journal-title":"Glob Public Health"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1377\/hlthaff.28.6.1655","article-title":"Transforming social structures and environments to help in HIV prevention","volume":"28","author":"Auerbach J","year":"2009","journal-title":"Health Aff (Millwood)"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1016\/j.socscimed.2004.12.024","article-title":"The social structural production of HIV risk among injecting drug users","volume":"61","author":"Rhodes T","year":"2005","journal-title":"Soc Sci Med"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1080\/09540121.2010.525812","article-title":"Towards a \"fourth generation\" of approaches to HIV\/AIDS management: creating contexts for effective community mobilization","volume":"22","author":"Campbell C","year":"2010","journal-title":"AIDS Care"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s10461-011-9966-2","article-title":"How can community health programmes build enabling environments for transformative communication? Experiences from India and South Africa","volume":"16","author":"Campbell C","year":"2012","journal-title":"AIDS Behav"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1590\/S0102-311X2006000600022","article-title":"\"Voc\u00ea aprende. A gente ensina?\" Interrogando rela\u00e7\u00f5es entre educa\u00e7\u00e3o e sa\u00fade desde a perspetiva da vulnerabilidade","volume":"22","author":"Meyer DEE","year":"2006","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1590\/S0034-89102006000800015","article-title":"O direito \u00e0 preven\u00e7\u00e3o e os desafios da redu\u00e7\u00e3o da vulnerabilidade ao HIV no Brasil","volume":"40","author":"Paiva V","year":"2006","journal-title":"Rev Sa\u00fade P\u00fablica"},{"key":"ref21","first-page":"33","article-title":"El SIDA como enfermedad social: an\u00e1lisis de su presencia e investigaci\u00f3n","volume":"18","author":"Abad J","year":"2005","journal-title":"Cuadernos de Trabajo Social"},{"key":"ref22","series-title":"Programa nacional de preven\u00e7\u00e3o e controlo da infe\u00e7\u00e3o por VIH\/SIDA 2012-2016"},{"key":"ref23","series-title":"Getting to zero: 2011-2015 strategy","year":"2010"},{"key":"ref24","series-title":"Infec\u00e7\u00e3o VIH\/SIDA: a situa\u00e7\u00e3o em Portugal a 31 de dezembro de 2013","author":"Martins H","year":"2014"},{"key":"ref25","series-title":"Portugal: infe\u00e7\u00e3o VIH, SIDA e tuberculose em n\u00fameros - 2014","year":"2014"},{"key":"ref26","series-title":"Programa troca de seringas: fluxogramas de interven\u00e7\u00e3o"},{"key":"ref27","series-title":"Abertura do processo de candidatura a financiamento p\u00fablico a projetos no \u00e2mbito do programa nacional para a infe\u00e7\u00e3o VIH\/sida"},{"key":"ref28","first-page":"164","article-title":"Sexualidade e g\u00e9nero em campanhas de preven\u00e7\u00e3o da infe\u00e7\u00e3o por VIH\/Sida: \"desconstruir para (re)educar\".","volume":"6","author":"Frias A","year":"2014","journal-title":"Indagatio Did\u00e1ctica"},{"key":"ref29","author":"Pinto-Coelho Z","year":"2009"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1590\/S1414-32832010005000045","article-title":"Homens e a preven\u00e7\u00e3o da aids: an\u00e1lise da produ\u00e7\u00e3o do conhecimento da \u00e1rea da sa\u00fade","volume":"15","author":"Rebello L","year":"2011","journal-title":"Interface Comun Sa\u00fade Educ"},{"key":"ref31","first-page":"39","article-title":"Algumas considera\u00e7\u00f5es sobre sexualidade e g\u00eanero no contexto da AIDS","volume":"I","author":"Dowsett G","year":"2006","journal-title":"Quest\u00f5es de Sa\u00fade Reprodutiva"},{"key":"ref32","series-title":"Masculinities","author":"Connell R","year":"1995"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1590\/S0101-73302010000100008","article-title":"Discursos de jovens adolescentes portugueses sobre sexualidade e amor: implica\u00e7\u00f5es para a educa\u00e7\u00e3o sexual","volume":"31","author":"Saavedra L","year":"2010","journal-title":"Educa\u00e7\u00e3o & Sociedade"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S0870-9025(11)70003-7","article-title":"Educa\u00e7\u00e3o sexual, conhecimentos, cren\u00e7as, atitudes e comportamentos nos adolescentes","volume":"29","author":"Ramiro L","year":"2011","journal-title":"Rev Port Sa\u00fade P\u00fablica"},{"issue":"151","key":"ref35","article-title":"Lei no 60\/2009, de 6 de agosto - Estabelece o regime de aplica\u00e7\u00e3o da educa\u00e7\u00e3o sexual em meio escolar","volume":"5097-8","year":"2009","journal-title":"Di\u00e1rio da Rep\u00fablica Portuguesa"},{"key":"ref36","first-page":"335","article-title":"Educa\u00e7\u00e3o sexual em Portugal: legisla\u00e7\u00e3o e avalia\u00e7\u00e3o da implementa\u00e7\u00e3o nas escolas","volume":"15","author":"Matos M","year":"2014","journal-title":"Psicol Sa\u00fade Doen\u00e7as"},{"key":"ref37","first-page":"8","article-title":"O papel da educa\u00e7\u00e3o no caminho que falta percorrer em Portugal na desconstru\u00e7\u00e3o dos estere\u00f3tipos de g\u00e9nero: breves reflex\u00f5es","author":"Alvarez T","year":"2014","journal-title":"Exedra"},{"key":"ref38","article-title":"GAT defende \"preven\u00e7\u00e3o espec\u00edfica\" para grupos mais vulner\u00e1veis \u00e0 infe\u00e7\u00e3o por VIH","author":"Noronha N","year":"2013","journal-title":"Ag\u00eancia Lusa"},{"key":"ref39","series-title":"Manifesto pela preven\u00e7\u00e3o do VIH: precisamos da PrEP agora!"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s11904-007-0024-7","article-title":"Risk compensation in HIV prevention: implications for vaccines, microbicides, and other biomedical HIV prevention technologies","volume":"4","author":"Eaton L","year":"2007","journal-title":"Curr HIV\/AIDS Rep"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.socscimed.2013.03.020","article-title":"Study designs for identifying risk compensation behavior among users of biomedical HIV prevention technologies: balancing methodological rigor and research ethics","volume":"94","author":"Underhill K","year":"2013","journal-title":"Soc Sci Med"},{"key":"ref42","series-title":"VIH\/sida e ci\u00eancias sociais: diversidade e percursos de investiga\u00e7\u00e3o","first-page":"31","volume-title":"Respostas institucionais \u00e0 SIDA: o papel do Estado e das ONGs","author":"Delicado A","year":"2014"},{"key":"ref43","first-page":"77","article-title":"As organiza\u00e7\u00f5es da sociedade civil na preven\u00e7\u00e3o das infe\u00e7\u00f5es sexualmente transmiss\u00edveis em trabalhadoras do sexo, em Portugal","volume":"23","author":"Maia M","year":"2014","journal-title":"Sa\u00fade Soc"},{"key":"ref44","first-page":"538","article-title":"Redu\u00e7\u00e3o de riscos no trabalho sexual em Portugal: representa\u00e7\u00f5es dos t\u00e9cnicos interventores","volume":"15","author":"Coutinho J","year":"2014","journal-title":"Psicol Sa\u00fade Doen\u00e7as"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.socscimed.2007.11.008","article-title":"Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work","volume":"66","author":"Shannon K","year":"2008","journal-title":"Soc Sci Med"},{"key":"ref46","first-page":"183","article-title":"Direito, ci\u00eancia e o corpo feminino: a prostitui\u00e7\u00e3o como \"objecto de fronteira\"","volume":"18","author":"Silva MC","year":"2002","journal-title":"Cadernos do Noroeste"},{"key":"ref47","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1590\/S0102-311X2010000500022","article-title":"Conhecimentos sobre o uso de contraceptivos e preven\u00e7\u00e3o de DST: a percep\u00e7\u00e3o de mulheres imigrantes","volume":"26","author":"Rocha CMF","year":"2010","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1111\/j.1360-0443.2007.01761.x","article-title":"HIV, injecting drug use and harm reduction: a public health response","volume":"102","author":"Ball AL","year":"2007","journal-title":"Addiction"},{"key":"ref49","series-title":"Harm reduction: pragmatic strategies for managing high-risk behaviors","first-page":"3","volume-title":"Current status, historical highlights, and basic principles of harm reduction","author":"Collins SE","year":"2012"},{"key":"ref50","series-title":"Pol\u00edticas da droga em Portugal"},{"key":"ref51","series-title":"Estruturas existentes"},{"key":"ref52","first-page":"9","article-title":"Para al\u00e9m do espelho: a interven\u00e7\u00e3o de proximidade nas toxicodepend\u00eancias","volume":"13","author":"Andrade PV","year":"2007","journal-title":"Revista Toxicodepend\u00eancias"},{"key":"ref53","series-title":"Programa de troca de seringas"},{"key":"ref54","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1590\/S0101-81082009000300002","article-title":"Comportamentos de risco ao HIV em utilizadores de hero\u00edna em um distrito portugu\u00eas: estudo qualitativo","volume":"31","author":"Marsden VF","year":"2009","journal-title":"Rev Psiquiatr Rio Gd Sul"},{"key":"ref55","article-title":"Sala de chuto avan\u00e7a com nova localiza\u00e7\u00e3o","author":"Bastos JP","year":"2015","journal-title":"Jornal Expresso"},{"key":"ref56","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/S1473-3099(08)70305-0","article-title":"Interventions to reduce HIV transmission related to injecting drug use in prison","volume":"9","author":"J\u00fcrgens R","year":"2009","journal-title":"Lancet Infect Dis"},{"key":"ref57","first-page":"33","article-title":"A emerg\u00eancia da redu\u00e7\u00e3o de danos em Portugal: da \"clandestinidade\" \u00e0 legitima\u00e7\u00e3o pol\u00edtica","volume":"15","author":"Barbosa J","year":"2009","journal-title":"Revista Toxicodepend\u00eancias"},{"key":"ref58","doi-asserted-by":"crossref","first-page":"116","DOI":"10.21101\/cejph.a3477","article-title":"A survey of HIV and HCV among female prison inmates in Portugal","volume":"16","author":"Barros H","year":"2008","journal-title":"Cent Eur J Public Health"},{"key":"ref59","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.1016\/j.drugpo.2014.10.012","article-title":"People who inject drugs in prison: HIV prevalence, transmission and prevention","volume":"26","author":"Dolan K","year":"2015","journal-title":"Int J Drug Policy"},{"key":"ref60","doi-asserted-by":"crossref","first-page":"46","DOI":"10.2307\/4065334","article-title":"Prisoners who inject drugs: public health and human rights imperatives","volume":"8","author":"J\u00fcrgens R","year":"2005","journal-title":"Health Hum Rights"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1590\/0102-311x00172514","article-title":"The current state of play of research on the social, political and legal dimensions of HIV","volume":"31","author":"Paiva V","year":"2015","journal-title":"Cad Sa\u00fade P\u00fablica"}],"container-title":["Cadernos de Sa\u00fade P\u00fablica"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/csp\/v32n6\/1678-4464-csp-32-06-e00129715.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T22:51:52Z","timestamp":1568069512000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-311X2016000603001&lng=pt&tlng=pt"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016]]},"references-count":61,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016]]}},"alternative-id":["S0102-311X2016000603001"],"URL":"https:\/\/doi.org\/10.1590\/0102-311x00129715","relation":{},"ISSN":["0102-311X"],"issn-type":[{"value":"0102-311X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016]]}}}