Access of the LGBTQI+ population from the perspective of community health agents, Brazil

Abstract

Introduction In Brazil, according to the National Policy for Integral Health for Lesbians, Gays, Bisexuals, Transvestites, Transsexuals, Queers, Intersexuals and other identities (LGBTQI+), it is increasingly necessary to guarantee access to the health system, as well as to train qualified professionals. Objective describing the perception of Community Health Agents (CHA) about the approach to and access of LGBTQI+ people to primary health care. Methods Quantitative research conducted in October 2019 with 60 community health workers from the municipality of Rio de Janeiro, Brazil. The research was approved by the Ethics and Research Committees of the participating institutions. Results it was found that 100% of the CHA have already supported LGBTQI+ people, 19.2% identify prejudiced attitudes and delay in service as barriers to accessing the unit, and 19.2% recognize the presence of group activities in the unit. In the view of the CHA interviewed, LGBTQI+ patients could be approached in groups (50%), individually (19.2%) or both (30.8%). Among the strategies to increase the access of those patients, 61.5% are unaware and 38.5% listed possible strategies to be implemented in the unit. The topics of interest for discussion were: approach to reception, sexual identity, prejudice, psychological support, family, diseases, violence, and rights. Conclusions From the perspective of community health agents, the study allowed reflections on how approaching and making access available to LGBTQI+ patients in the primary care network. This evidences stigmas and fragility of professionals in the individual and collective approach to deal with issues regarding guidance sexuality and gender identity of the clientele served. It is important to emphasize permanent education actions among professionals, aiming at a comprehensive health care for the LGBTQI+ population. Key messages Welcoming and qualified listening promote comprehensive health care for the LGBTQI+ population. Improvements in the access of the LGBTQI+ population to the primary health care network decrease morbidity and mortality.

COVID-19 vulnerability among Brazilian sexual and gender minorities: a cross-sectional study

“…Nevertheless, descriptive analysis evidenced a higher proportion of individuals diagnosed with depression and worse mental health during the pandemic in the higher income vulnerability group. For example, transgender individuals use fewer health care services due to disrespect to their social name 33 which is a barrier to health care access 34 . Moreover, they experience harassment, trauma, and mental health disorders more frequently than cisgender individuals 35 , derived from higher discrimination in several life aspects 36 .…”