Abstract
to understand the representations about sexuality of people diagnosed late with HIV infection and its implications in the delayed search for diagnosis. this is a qualitative study, whose theoretical and methodological framework was Social Representation Theory. The research was carried out with 18 people diagnosed late with HIV infection through an open interview. For data analysis, Structural Narration Analysis was used, with support from MAXQDA 12®. representations about sexuality contributed to delayed diagnosis, such as trust in a fixed partnership, sexual intercourse is natural, sexuality as a taboo, search for pleasure in sexual intercourse, regardless of risks, denial of risk for HIV infection. representations about sexuality participate in a web of stereotypes and riskier ways of living, which contribute to delayed diagnosis. Sexual health education remains necessary and essential throughout people's lives.
Highlights
METHODSEarly diagnosis of Human Immunodeficiency Virus (HIV) infection and timely initiation of antiretroviral therapy (ART) are priority strategies for coping with the pandemic, aiming at reducing morbidity and mortality, preventing new cases of infection and promoting quality of life of people living with HIV (PLHIV)(1-2).The high prevalence of people who are diagnosed late and who show up late for care with HIV infection, observed in Brazil and other countries[3,4,5], constitutes an emergency problem to be considered in the response to pandemic
Studies have analyzed discourses and representations about PLHIV sexuality and its influence in the process of vulnerability to infection, highlighting the confidence in a fixed partnership as a mediator of unprotected sexual practices; the permanence of old stigmatizing stereotypes, such as AIDS related to promiscuity, the multiplicity of sexual partnerships and the feeling of shame, which contributes to failure to recognize their own vulnerability; the unequal power relations between genders in affective-sexual relationships, which affect the negotiation of condom use[12,13]; the speeches and attitudes of hegemonic masculinity[14]; the stigma related to male homosexuality as a barrier to HIV testing[15]
From the understanding of the original representations related to PLHIV’s sexuality, diagnosed late, the following theoretical categories were constructed: Sexual intercourse is natural; It is in adolescence that sexual life begins; Sexuality as a taboo; Trust in a fixed partner; Heterosexuality: man is polygamous and woman is monogamous; Denial of risk for HIV infection
Summary
Diagnosis of Human Immunodeficiency Virus (HIV) infection and timely initiation of antiretroviral therapy (ART) are priority strategies for coping with the pandemic, aiming at reducing morbidity and mortality, preventing new cases of infection and promoting quality of life of people living with HIV (PLHIV)(1-2). The high prevalence of people who are diagnosed late and who show up late for care with HIV infection, observed in Brazil and other countries[3,4,5], constitutes an emergency problem to be considered in the response to pandemic This problem is configured as a complex and multifactorial phenomenon, which, in addition to being associated with sociodemographic[4,5,6] and sociocultural factors[7,8] and referring to barriers of health services[9,10], relates to psychosocial aspects such as subjectivities and representations about HIV/AIDS that influence the search for diagnosis by vulnerable people[11]. The following question guided this research: what are the representations about sexuality of people diagnosed late with HIV infection and its implications in delayed search for diagnosis?
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