“Só sei por cima só”: as comunidades quilombolas do Município de Santarém-Pará e a vulnerabilidade ao HIV/AIDS.

Abstract

The few studies about the HIV/(AIDS) theme and the quilombola communities point out to a vulnerability to the virus infection, mainly at the programmatic level, i.e., policies and public services. The aim of this paper is to identify the conditions of access and use of the public services for HIV (AIDS) of the quilombola communities in the municipality of Santarém, State of Pará, identifying its prevention and care actions as for this aggravation, under the quilombolas perspective. It is a qualitative type of study performed with 04 communities (Tiningú, Murumurutuba, Saracura and Pérola do Maicá), through 20 semi-structured interviews (04 leaderships, 03 health agents, 13 residents), informal talks and participative observation. The results have shown that the persons interviewed had some information about HIV/(AIDS) and, in general, the information sources from superior education institutions (SEI) through the performance of research and extension projects; the most referred transmission via of the virus was sexual; the most mentioned piece of information about prevention actions was the use of male condoms, although sexual abstinence and having only one sexual partner were considered prevention methods; the prevention actions of the Public Health Service are focused on pregnant women through the pre-birth program (secondary prevention), with difficulties to the access to the budget to wider actions for education and health; there are difficulties to the access to the Public Health Service, specially at the dale area. This paper has shown a context of programmatic vulnerability with low access to the Sistema Único de Saúde (Unified Health System) what was considered a form of institutional racism. The relationships established amongst the local quilombola movement and the SEI have contributed to allow visibility to the discussion about health in such communities. There is a necessity for the local public health to intensify education for health, including prevention actions, where racial and cultural diversity is one of the elements to be considered for their planning, aiming to guarantee the construction of health public policies that do respect these territories, i.e., so that they are included into their legitimate right to citizenship.