Health care for women with HIV: analysis from the perspective of institutional ethnography
DOI:
https://doi.org/10.21527/2176-7114.2026.51.15670Keywords:
HIV, Institutional organization, Healthcare networksAbstract
Objective: To analyze the institutional context of the Primary and Specialized Healthcare Network in the healthcare of women with Human Immunodeficiency Virus (HIV). Method: This qualitative participatory research was conducted with 11 healthcare professionals and managers from municipal and federal healthcare services in a municipality in southern Brazil. Data were collected through focus groups and participant observation. The data were triangulated for analysis, and the discussion was mediated by interpretation in light of Institutional Ethnography. Results: The results were based on the discursive constructions of professionals and managers, and their observation notes. Three categories were then created: (1) trivialization of HIV infection and devaluation of women's health needs, (2) institutional routines versus the needs of these women, and (3) disarticulation of the Primary and Specialized Healthcare Network. Conclusion: Healthcare is shaped, organized, and institutionalized under the influence of healthcare professionals' understanding of HIV, and it appears to meet the demands of local services in a disjointed way, different from what these women need.
References
1. Melo EA, Agostini R, Damião J de J. Filgueiras S L, Maksud I. Cuidado de pessoas vivendo com HIV na atenção primária à saúde: reconfigurações na rede de atenção à saúde? Cad. Saúde Pública. 2021; 37(12), e00344120. DOI: https://doi.org/10.1590/0102-311X00344120
2. Zhylka NY, Pedachenko NY, Shcherbinska OS, Gruzieva T, Pakharenko LV. Improvement of the health services for the prevention of hiv transmission from mother to child at the level of primary health care. Wiad Lek. 2022; 75(10): 2507-2513. DOI: 10.36740/WLek202210136.
3. Celuppi IC, Meirelles BHS. Management in the care of people living with HIV in primary health care. Texto contexto - enferm. 2022; 31: e20220161. DOI: https://doi.org/10.1590/1980-265X-TCE-2022-0161en.
4. Brasil. Ministério da Saúde. Departamento de HIV/Aids, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis. Boletim Epidemiológico HIV e Aids. Brasília, DF, 2023.
5. Mandu JBS, Teston EF, Andrade GKS, Marcon SS. Coping with the health condition from the perspective of people with HIV who abandoned treatment. Rev Bras Enferm. 2022; 75:e20210958. DOI: https://doi.org/10.1590/0034-7167-2021-0958.
6. Pinho CM, Lima MCL, Silva MAS, Dourado CARO, Oliveira RC, Aquino JM, Pinto ESG, Andrade MS. Development and validation of an instrument for the evaluation of HIV care in Primary Health Care. Rev Bras Enferm. 2023; 30;76(1):e20220247. DOI: 10.1590/0034-7167-2022-0247.
7. Alves BL, Lago RF, Engstrom EM. O cuidado às Pessoas Vivendo com HIV/Aids na Atenção Primária à Saúde na cidade do Rio de Janeiro: uma avaliação de implantação. Saúde debate [Internet]. 2022; 46(spe7):31–47. DOI: https://doi.org/10.1590/0103-11042022E702.
8. Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Secretaria de Vigilância em Saúde. Protocolo Clínico e Diretrizes Terapêuticas para Prevenção da Transmissão Vertical do HIV, Sífilis e Hepatites Virais. Brasília: Ministério da Saúde, 2022 Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/protocolo_clinico_hiv_sifilis_hepatites.pdf.
9. Lobo LC; Costa PF; Abreu GM; Oliveira NF; Medeiros MS; Sachett JAG; Gonçalves, ICM. Characterization of the rapid test for HIV/AIDS, syphilis and viral hepatitis in pregnant women. Mundo saúde (Impr.). 2019; 43(2): 281-305. DOI: 10.15343/0104-7809.20194302281305
10. Smith, DE. Institutional ethnograph: a sociology for people. AltaMira Press; 2005.
11. Le Boterf G. Pesquisa participante: propostas e reflexões metodológicas. In: BRANDÃO, CR (org). Repensando a pesquisa participante. 2 ed. São Paulo: Brasiliense; 1985.
12. Kinalski DDF, Paula CC, Padoin SMM, Neves ET, Kleinubing RE, Cortes LF. Grupo focal na pesquisa qualitativa: relato de experiência. Rev Bras Enferm. 2017 abr;70(2):424-9. DOI: http://dx.doi.org/10.1590/0034-7167-2016-0091
13. Minayo, MCS. Análise qualitativa: teoria, passos e fidedignidade. Ciência & Saúde Coletiva, 2012. 17(3):621-626. DOI: https://doi.org/10.1590/S1413-81232012000300007
14. Coelho AVC, Coelho HFC, Arraes LC, Crovella S. HIV-1 mother-to-child transmission in Brazil (1994–2016): a time series modeling. Braz J Infect Dis. 2019; 23(4):218–23. DOI: 10.1016/j.bjid.2019.06.012.
15. Celuppi IC, Meirelles BHS. Management in the care of people living with HIV in primary health care. Texto contexto - enferm. 2022;31:e20220161. DOI: https://doi.org/10.1590/1980-265X-TCE-2022-0161.
16. Alves BL, Lago Rf, Engstrom EM. O cuidado às Pessoas Vivendo com HIV/ Aids na Atenção Primária à Saúde na cidade do Rio de Janeiro: uma avaliação de implantação. Saúde & Debate. 2022, 46(7): 31-47. DOI: 10.1590/0103-11042022E702
17. Melo LP, Cortez LCA, Santos RP. Is the chronicity of HIV/AIDS fragile? Biomedicine, politics and sociability in an online social network. Rev. Latino-Am. Enfermagem. 2020;28:e3298. DOI: http://dx.doi.org/10.1590/1518-8345.4006.3298.
18. De Sá MD, Santana Z. A implantação do programa saúde na escola e a abordagem da temática infecções sexualmente transmissíveis/aids: validação da cartilha para profissionais da rede de ensino. Rease 2022; 8(3):464-77. DOI: doi.org/10.51891/rease.v8i3.460.
19. Harris J, Thaiprayoon S. Common factors in HIV/AIDS prevention success: lessons from Thailand. BMC Health Serv Res. 2022;22(1):1487. DOI: 10.1186/s12913-022-08786-6.
20. Primeira MR, Santos WM, Paula CC, Padoin SMM. Qualidade de vida, adesão e indicadores clínicos em pessoas vivendo com HIV. Acta Paulista de Enfermagem.2020; 33, p. eAPE20190141-eAPE20190141, DOI: https://doi.org/10.37689/acta-ape/2020AO0141
21. Colaço AD, Meirelles BHS, Heidemann,ITSB, Villarinho HMV. O cuidado à pessoa que vive com hiv/aids na atenção primária à saúde. Texto & Contexto Enfermagem 2019; 28(e20170339). DOI: https://doi.org/10.1590/1980-265X-TCE-2017-0339.
22. Pinho CM, Cabral J da R, Lima MCL de, Silva MAS da, Oliveira RC de, Aquino JM de, et al.. Evaluation of care for people with HIV in Primary Health Care: construct validation. Rev Bras Enferm [Internet]. 2024;77(6):e20230190. DOI: https://doi.org/10.1590/0034-7167-2023-0190
23. Belloto PCB, Lopez LC, Piccinini CA, Gonçalves TR. Between the woman and saving the baby: HIV-positive women’s experiences of giving birth. V. Interface (Botucatu). 2019; 23: e180556. DOI: https://doi.org/10.1590/Interface.180556.
24. Kleinubing RE, Langendorf TF, Padoin SMM, Paula CC. Construção de uma linha de cuidado para atenção à saúde de mulheres vivendo com HIV. Escola Anna Nery. 2021; 25(5). Doi: https://doi.org/10.1590/2177-9465-EAN-2021-0033.
25. Geng EH et al. Adaptive Strategies for Retention in Care among Persons Living with HIV. NEJM Evid. 2023 Apr;2(4):10.1056/evidoa2200076. DOI: 10.1056/evidoa2200076.
26. Lazarus JV, Janamnuaysook R, Caswell G. A people-centred health system must be the foundation for person-centred care in the HIV response. J Int AIDS Soc. 2023 .Suppl 1(Suppl 1):e26125. DOI: 10.1002/jia2.26125.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Raquel Einloft Kleinubing, Gabriele Schek, Stela Maris de Mello Padoin, Cristiane Cardoso de Paula, Tassiane Ferreira Langendorf.

This work is licensed under a Creative Commons Attribution 4.0 International License.
By publishing in Revista Contexto & Saúde, authors agree to the following terms:
The works are licensed under the Creative Commons Atribuição 4.0 Internacional (CC BY 4.0) license, which allows:
Share — to copy and redistribute the material in any medium or format;
Adapt — to remix, transform, and build upon the material for any purpose, including commercial.
These permissions are irrevocable, provided that the following terms are respected:
Attribution — authors must be properly credited, with a link to the license and indication of any changes made.
No additional restrictions — no legal or technological measures may be applied that restrict the use permitted by the license.
Notes:
The license does not apply to elements in the public domain or covered by legal exceptions.
The license does not grant all rights necessary for specific uses (e.g., image rights, privacy, or moral rights).
The journal is not responsible for opinions expressed in the articles, which are the sole responsibility of the authors. The Editor, with the support of the Editorial Board, reserves the right to suggest or request modifications when necessary.
Only original scientific articles presenting research results of interest that have not been published or simultaneously submitted to another journal with the same objective will be accepted.
Mentions of trademarks or specific products are intended solely for identification purposes, without any promotional association by the authors or the journal.
License Agreement (for articles published from September 2025): Authors retain copyright over their article and grant Revista Contexto & Saúde the right of first publication.