Attention to Women’s Sexual and Reproductive Health at the Street Outreach Office

Abstract

The aim of study was to understand care strategies for homeless women, focusing on aspects of sexual and reproductive health from the perspective of Street Outreach Office strategy professionals. This is a qualitative study carried out in a large city in the countryside of São Paulo, Brazil. Data were collected from December 2020 to April 2021 through semi-structured interviews, and the results were obtained through content analysis and thematic modality. Nine health professionals participated in this study, and the analysis of the interviews allowed identifying three thematic categories: (i) being female and sex on the streets (violence and oppression); (ii) gynecology as a gateway to comprehensive care for homeless women; and (iii) pregnancy, puerperium and motherhood in the context of the streets. This study contributes to the reflection of professional practices within the Street Outreach Office, allowing the understanding of challenges in assisting homeless women, aiming to raise awareness of professionals and services that make up the health care network.

Healthcare experiences of pregnant and postnatal women and healthcare professionals when facing child protection in the perinatal period: A systematic review and Critical Interpretative Synthesis

“…For instance, studies reported on the importance of ‘trust’ for women to feel safe with a HCP and only then would they feel comfortable to disclose the extent of their issues [ 15 , 55 , 59 , 60 , 63 , 77 , 85 ]. Conversely, several studies capturing HCPs’ experiences reported that they were fully aware trust was an essential requirement to provide optimal care to women [ 57 , 72 , 75 , 80 – 83 , 90 , 91 ]. Continuity of care provider was often mentioned by HCPs and women as a pre-requisite to build a relationship of trust and honesty [ 49 , 75 , 80 – 83 , 85 , 89 – 91 ].…”

“…Included studies were published between 1993 and 2024, with study settings predominantly in the Global North, including Cananda (n = 4) [ 52 – 55 ], Germany (n = 1) [ 56 ], United States of America (n = 16) [ 50 , 51 , 57 – 74 ], United Kingdom (n = 7) [ 9 , 49 , 75 – 80 ] and Australia (n = 12) [ 13 , 15 , 81 – 89 ]. One study was carried out in Brazil [ 90 ]. Nine studies included both women’s and HCPs’ views, twenty-two studies focused on women’s perspectives only and ten studies focused on HCPs’ perspectives only.…”

Sexual assault and vulnerability to sexually transmitted infections among homeless Brazilian women: a cross sectional qualitative study

“…Addressing STIs prevention needs of homeless women can be enhanced through the integrating sexual health, and other health references services to homeless population [ 1 ]. A Brazilian study has found that gynecological care and sexual and reproductive health care in a Street Outreach Office represent an opportunity for welcoming and comprehensive care to the women being assisted, allowing the identification and care of the health needs and different demands of this population [ 9 ].…”

“…The social environment of the streets is complex, stigmatizing and permeated by gender-based power imbalances [ 5 , 6 ]. In this context, women are subject to violence, sexual exploitation, rape, prostitution, reproductive disorders, and a greater risk of sexually transmitted infections (STI) and unintended pregnancy, contributing to the perpetuation of the cycle of poverty and misery, in addition to unsafe abortion practices [ 6 – 9 ]. Among their numerous deprivations on the streets, sex can be configured as a means of meeting the subsistence needs of these women in a context of marginalization [ 10 ].…”

“…Thus, women who experience homelessness have unique sexual and reproductive health needs [ 7 ] that represent challenges for health services and systems [ 9 ]. However, these women have less access to essential sexual and reproductive health services than the general population [ 7 ].…”