(322) The COVID-19 Pandemic and Outpatient Follow-up of Victims of Sexual Violence in a Public Health Service in Northeast Brazil

Abstract

Abstract Introduction Before the pandemic context, domestic violence was already considered a violation of human rights with high visibility worldwide. With the COVID-19 pandemic and the adoption of preventive measures such as social distancing and prioritization of care for cases of the disease in health units, there was a lack of care for other health issues, such as assistance to women victims of violence. Objective To analyze how the repercussions of the pandemic context and the measures to combat SARS-CoV-2 affected the follow-up of women victims of sexual violence assisted in a reference service in Northeast Brazil. Methods Qualitative analysis with a descriptive character. A semi-structured interview and simple observation were used. To complement the data, bibliographic and documental research were carried out. Bardin's content analysis was adopted. A convenience sample was used, which resulted in 14 women, and data saturation. As inclusion criteria, they were older than 18 years old, attended by the service between March and November 2020, attended at least one appointment and who freely agreed to participate. Male and under 18 years old patients were excluded. Results In 2020, there was a reduction in appointment bookings (24%) and outpatient visits (27%) compared to the same period in 2019. Regarding the sample, 64.28% were between 19-39 years old, the majority declared themselves brown /black (50%) and being single (71%). About 36% had completed high school, the same percentage that was unemployed. Half (50%) of the interviewees did not receive social or social security benefits and lived in a rented house (50%). Most did not know about the service offered and found out from the referral of friends or a public safety or health agency that they sought as a result of the episode of sexual violence. Regarding the pandemic context and outpatient follow-up, it was noted that many mentioned the decrease in the supply of transport and also made reference to the fear of leaving home and being contaminated. A factor greatly reinforced by the interviewees was the economic risk that the pandemic brought to the routine, whether due to formal unemployment or the impediment to carrying out their autonomous activities. In this context, economic insecurity was cited as one of the recurring reasons for not attending appointments. Questions were also asked about the understanding and evaluation of multidisciplinary care and a positive response was received, validating the intersectoral work developed in the service. Conclusions Violence is a dynamic that is constantly being reformulated, due to the historical context. The decrease in demand and increase in absenteeism were linked to fear of contamination, financial difficulties and lack of knowledge about the service. Actions to improve surveillance and management of sexual violence must be an essential part of the fight against COVID-19. Disclosure No