Barreiras no acesso à Atenção Básica pela população LGBTQIA+: uma revisão integrativa

Luan Moraes Ferreira; Gisela Gomes Batista; Leoneide Érica Maduro Boillet

doi:10.5712/rbmfc19(46)3594

Authors

Luan Moraes Ferreira Universidade do Estado do Pará – Santarém (PA), Brasil. https://orcid.org/0000-0002-9634-0098
Gisela Gomes Batista Universidade do Estado do Pará – Santarém (PA), Brasil.
Leoneide Érica Maduro Boillet Universidade do Estado do Pará – Santarém (PA), Brasil.

DOI:

https://doi.org/10.5712/rbmfc19(46)3594

Keywords:

Sexual and gender minorities, Primary Health Care, Health services accessibility.

Abstract

Introduction: The LGBT population is a group whose access to health care has historically been limited and is still crossed by complex issues ranging from the training of health professionals to the very organisational structure of the care system. Despite this, the scientific literature on the obstacles faced by these individuals in Primary Health Care, the gateway and coordinator of care, is particularly scarce. Objective: To characterize the barriers involved in the access of the LGBTQIA+ population to primary care. Methods: This is an integrative review of scientific studies selected from the PubMed and Virtual Health Library (VHL) Regional Portal search platforms, using as search descriptors the terms Sexual and Gender Minorities, LGBTQIA+, Primary Health Care, Health Services Accessibility. Complete articles were included without time restriction, in English, Portuguese and Spanish. Texts such as: literature reviews; editorials; study protocols; expert opinions and experience reports were excluded. Results: The review was composed by the selection of 14 studies, and their contents were assigned to three axes of discussion: physical/organizational barriers, social barriers, barriers related to education/training of health professionals. Conclusions: It is essential to expand the social discussions about the theme of sexual and gender diversity to deconstruct the established prejudices, moreover, it is essential to review the physical and organizational structure — as well as the training of health professionals — to create an inclusive care environment.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Brasil. Ministério da Saúde. A APS e as redes de atenção à saúde. Brasília: CONASS; 2015. 127 p.

Aragusuku HÁ, de Oliveira Lee H. A psicologia Brasileira e as Políticas LGBT no Conselho Federal de Psicologia. Rev Gest Políticas Públicas 2015;5(1):131-154. https://doi.org/10.11606/issn.2237-1095.v5p131-154 DOI: https://doi.org/10.11606/issn.2237-1095.v5p131-154

Nogueira FJS, Aragão TAP. Política Nacional de Saúde Integral LGBT: o que ocorre na prática sob o prisma de usuários (as) e profissionais da saúde. Saúde e Pesqui 2019;12(3):463. https://doi.org/10.17765/2176-9206.2019v12n3p463-470 DOI: https://doi.org/10.17765/2176-9206.2019v12n3p463-470

Gomes JAS, Tesser Junior ZC. Experiências de médicos de família e comunidade no cuidado com a saúde de pacientes lésbicas, gays, bissexuais, travestis e transexuais. Rev Bras Med Fam Comunidade 2022;17(44):2407. https://doi.org/10.5712/rbmfc17(44)2407 DOI: https://doi.org/10.5712/rbmfc17(44)2407

Souza LK de. Pesquisa com análise qualitativa de dados: conhecendo a Análise Temática. Arq Bras Psicol 2019;71(2):51-67. https://doi.org/10.36482/1809-5267.ARBP2019v71i2p.51-67

Guimarães NP, Sotero RL, Cola JP, Antonio S, Galavote HS. Avaliação da implementação da Política Nacional de Saúde Integral à população LGBT em um município da região Sudeste do Brasil. Rev Eletron Comun Inf Inov Saúde 2020;14(2):372-85. https://doi.org/10.29397/reciis.v14i2.1712 DOI: https://doi.org/10.29397/reciis.v14i2.1712

Vermeir E, Jackson LA, Marshall EG. Barriers to primary and emergency healthcare for trans adults. Cult Health Sex 2018;20(2):232-46. https://doi.org/10.1080/13691058.2017.1338757 DOI: https://doi.org/10.1080/13691058.2017.1338757

Ferreira BO, Pedrosa JIS, Nascimento EF. Diversidade de gênero e acesso ao Sistema Único de Saúde. Rev Bras Promoc Saúde 2018;31(1):1-10. https://doi.org/10.5020/18061230.2018.6726 DOI: https://doi.org/10.5020/18061230.2018.6726

Cele NH, Sibiya MN, Sokhela DG. Experiences of homosexual patients’ access to primary health care services in Umlazi, KwaZulu-Natal. Curationis 2015;38(2):1522. https://doi.org/10.4102/curationis.v38i2.1522 DOI: https://doi.org/10.4102/curationis.v38i2.1522

Gahagan J, Subirana-Malaret M. Improving pathways to primary health care among LGBTQ populations and health care providers: key findings from Nova Scotia, Canada. Int J Equity Health 2018;17(1):76. https://doi.org/10.1186/s12939-018-0786-0 DOI: https://doi.org/10.1186/s12939-018-0786-0

Hirsch O, Löltgen K, Becker A. Lesbian womens’ access to healthcare, experiences with and expectations towards GPs in German primary care. BMC Fam Pract 2016;17(1):162. https://doi.org/10.1186/s12875-016-0562-4 DOI: https://doi.org/10.1186/s12875-016-0562-4

Whitehead J, Shaver J, Stephenson R. Outness, stigma, and primary health care utilization among rural LGBT populations. PLoS One 2016;11(1):e0146139. https://doi.org/10.1371/journal.pone.0146139 DOI: https://doi.org/10.1371/journal.pone.0146139

Clark BA, Veale JF, Greyson D, Saewyc E. Primary care access and foregone care: a survey of transgender adolescents and young adults. Fam Pract 2018;35(3):302-6. https://doi.org/10.1093/fampra/cmx112 DOI: https://doi.org/10.1093/fampra/cmx112

Shires DA, Stroumsa D, Jaffee KD, Woodford MR. Primary care clinicians’ willingness to care for transgender patients. Ann Fam Med 2018;16(6):555-8. https://doi.org/10.1370/afm.2298 DOI: https://doi.org/10.1370/afm.2298

Oliveira GS, Nogueira JA, Costa GOP, Medeiros RLSFM, de Oliveira T, de Almeida SA. Serviços de saúde para lésbicas, gays, bissexuais e travestis/transexuais. Rev Enferm UFPE Online 2018;12(10):2598. https://doi.org/10.5205/1981-8963-v12i10a237014p2598-2609-2018 DOI: https://doi.org/10.5205/1981-8963-v12i10a237014p2598-2609-2018

Goldenberg T, Jadwin-Cakmak L, Popoff E, Reisner SL, Campbell BA, Harper GW. Stigma, gender affirmation, and primary healthcare use among black transgender youth. J Adolesc Heal 2019;65(4):483-90. https://doi.org/10.1016/j.jadohealth.2019.04.029 DOI: https://doi.org/10.1016/j.jadohealth.2019.04.029

Hinrichs A, Link C, Seaquist L, Ehlinger P, Aldrin S, Pratt R. Transgender and gender nonconforming patient experiences at a Family Medicine Clinic. Acad Med 2018;93(1):76-81. https://doi.org/10.1097/ACM.0000000000001837 DOI: https://doi.org/10.1097/ACM.0000000000001837

Stroumsa D, Shires DA, Richardson CR, Jaffee KD, Woodford MR. Transphobia rather than education predicts provider knowledge of transgender health care. Med Educ 2019;53(4):398-407. https://doi.org/10.1111/medu.13796 DOI: https://doi.org/10.1111/medu.13796

Scheim AI, Coleman T, Lachowsky N, Bauer GR. Health care access among transgender and nonbinary people in Canada, 2019: a cross-sectional survey. C Open 2021;9(4):E1213-22. https://doi.org/10.9778/cmajo.20210061 DOI: https://doi.org/10.9778/cmajo.20210061

Brasil. Ministério da Saúde. Política nacional de saúde integral de lésbicas, gays, bissexuais, travestis e transsexuais [Internet]. Ministério da Saúde; 2013. p. 34 [acessado em 01 dez. 2022]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/politica_saude_lesbicas_gays_bissexuais_travestis.pdf

Furness BW, Goldhammer H, Montalvo W, Gagnon K, Bifulco L, Lentine D, et al. Transforming primary care for lesbian, gay, bisexual, and transgender people: A collaborative quality improvement initiative. Ann Fam Med 2020;18(4):292-302. https://doi.org/10.1370/afm.2542 DOI: https://doi.org/10.1370/afm.2542

Miskolci R, Gomes Pereira PP. Between visibility and listening: access of the LGBTI+ population to primary healthcarei. Soc Estado 2022;37(1):193-215. https://doi.org/10.1590/s0102-6992-202237010009 DOI: https://doi.org/10.1590/s0102-6992-202237010009