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Drawing on ethnographic research conducted from 2011 to 2015 and the authors' long-term engagement in diverse aspects of HIV and human rights advocacy in Brazil, this paper explores key elements of the Brazilian sex workers' movement response to HIV and the broader political factors that profoundly influenced its trajectory. We argue that the movement has constantly challenged representations of prostitution by affirming sex workers' roles as political actors, not just peer educators, in fighting the HIV epidemic and highlight their development of a sex positive and pleasure centred response that fought stigma on multiple fronts. Moments of tension such as the censorship of an HIV prevention campaign and implementation of 'test and treat' projects are analysed, as are the complex questions that Brazil's 2016 political and economic crisis evokes in terms of how to develop and sustain responses to HIV driven by communities but with material commitment from the State. We conclude with what we see to be the unique, central components of Brazilian sex workers' approach to HIV prevention and what lessons can be learned from it for broader collective health movements in Latin America and beyond. [ABSTRACT FROM AUTHOR]

This paper provides an overview from the perspective of an invited international guest to the 15th Symposium of ANPEPP, held in Bento Gonçalves, Brazil, in May, 2014. ANPEPP, the acronym for "Associação Nacional de Pesquisa e Pós-Graduação em Psicologia," or the "Brazilian National Association for Research and Postgraduate Studies in Psychology" in English, is comprised of psychology faculty at postgraduate programs throughout Brazil. The theme of internationalization is especially relevant for Brazil, where there has been rapid development in science and technology output, affording it a new, emerging international role. The paper discusses the multiple connotations of internationalization, the goals for internationalization from different perspectives, and the impact of internationalization on psychological research and publishing in Brazil. It also addresses the opportunities and challenges of internationalization in Brazil and elsewhere. In addition, the author shares her experiences in the ANPEPP forum-plenary sessions and business meetings. Of particular note as a first-time attendee is the evaluation process for postgraduate education, conducted by CAPES, the Brazilian Federal Agency for Improvement of Higher Education. In closing, the author asks what psychology, as a discipline, can learn from ANPEPP's and Brazil's approach to developing and evaluating academic disciplines, and expresses appreciation for the opportunity to participate in what she characterizes as a unique convocation. [ABSTRACT FROM AUTHOR]

This paper explores medical borderlands where health and enhancement practices are entangled. It draws on fieldwork carried out in the context of two distinct research projects in Brazil on plastic surgery and sex hormone therapies. These two therapies have significant clinical overlap. Both are made available in private and public healthcare in ways that reveal the class dynamics underlying Brazilian medicine. They also have an important experimental dimension rooted in Brazil's regulatory context and societal expectations placed on medicine as a means for managing women's reproductive and sexual health. Off-label and experimental medical use of these treatments is linked to experimentalsocialuse: how women adopt them to respond to the pressures, anxieties and aspirations of work and intimate life. The paper argues that these experimental techniques are becoming morally authorized as routine management of women's health, integrated into mainstream Ob-Gyn healthcare, and subtly blurred with practices ofcuidar-se(self-care) seen in Brazil as essential for modern femininity. [ABSTRACT FROM AUTHOR]

The global health community is increasingly advocating for the local production of pharmaceuticals in developing countries as a way to promote technology transfer, capacity building and improve access to medicines. However, efforts to advance drug manufacturing in these countries revive an old dilemma of fostering technological development versus granting access to social services, such as healthcare. This paper explores the case of Brazil, a country that has developed large-scale health-inspired industrial policies, but is, yet, little understood. Brazil’s experience suggests that progressive healthcare bureaucrats can create innovative practices for technology and knowledge transfers. It also demonstrates that highly competitive pharmaceutical firms can collaborate with each other, if a government provides them the right incentives. Reforming regulatory policies is crucial for guaranteeing high-quality products in developing countries, but governments must play a crucial role in supporting local firms to adapt to these regulations. These findings send a strong message to global health policymakers and practitioners on the conditions to create a suitable environment for local production of medical products. [ABSTRACT FROM PUBLISHER]

This paper focuses on challenges faced by heterosexual couples of mixed HIV status in Porto Alegre, Brazil, and argues for more conceptual nuance in our understanding of ‘serodiscordance’. Couples’ stories, collected over 11 months of qualitative research, demonstrate how profoundly serodiscordance involves both partners and suggest that the timing of relationship formation relative to HIV diagnosis influenced the particular challenges they confronted. In recognition of this variation, we propose the distinction of ‘sero-discovering’ from ‘sero-cognisant’ couples. Though Brazilian health policy strives to address the needs of individuals diagnosed with HIV, the needs of seronegative partners in this cohort received relatively little attention. In addition, the transformation of HIV from a death sentence to a chronic condition both facilitated the formation of serodiscordant unions and raised special challenges for such couples. Conceiving of any person receiving an HIV diagnosis as ‘potentially partnered’ may help address some of these lacunae while promoting primary prevention within mixed-status couples, and HIV testing more generally. More research with this population is needed. [ABSTRACT FROM PUBLISHER]

Background: Commensality is a remarkable human act, and tends to be more present among families. Nevertheless, it is possible that eating at the table is being taking for granted when one refers to family meals. Thus, this paper aims to analyze working mothers' discourses about family meals eaten at the table, on the couch and in the bed/bedroom.Methods: The participants were thirty mothers working in public universities of the Brazilian region called Baixada Santista. A qualitative study was conducted, using semi-structured interviews. In the transcripts the words "table", "couch", "bed", "bedroom" were located and the excerpts containing them were extracted and analyzed according to a classical and exploratory content analysis.Results: The table is a significant component of meals that unite the family. While for some the meal at the table is an enjoyable moment, it is a stiff moment for others. Indeed, manners and the notion of hierarchy appeared only for the table. Regarding the couch, it seems that the family chose to eat there, because it is a more casual and relaxed setting. Eating in the bed was related to precarity, intimacy and casualness. In the three settings, watching television was a common practice, replacing or being added to talking.Conclusions: Commensality is such an important practice that appears in different settings and even in precarity contexts. The table emerged as the maximal cornerstone of commensality. However, when it was not present, new arrangements were made. Especially the couch seems to be a new commensal space, less formal and rigid, but able to allow some collective conviviality. Eating in the bed was a less common practice. Finally, the significant role that television assumed in meals is highlighted. [ABSTRACT FROM AUTHOR]

This article analyzes the development of the history of psychology in Argentina and Brazil, beginning with the emergence of the history of psychology at the beginning of the 20th century. The paper analyzes that such old historical reconstructions were written by the same authors or institutions that were introducing Psychology in the two countries. That is, the older historical productions in the field of psychology were Whig biased. An analysis of the last 30 years of history of psychology is also provided. The article describes institutional developments, including archives, journals, scientific meetings, and teaching of history of psychology in academic settings. Main groups devoted to history of psychology, both in Argentina and Brazil are described. Finally, it offers some thoughts on the future of history of psychology in the 2 countries. A comparative study between Argentina and Brazil allows to understand strengths and weakness related to institutionalization of History of Psychology. [ABSTRACT FROM AUTHOR]

Since the fall of the Brazilian military dictatorship in 1984, a number of structural and ideological changes associated with demilitarization and democracy have changed the face of psychiatric theory and practice. Around the country, pockets of innovative, politically sensitive and Marxist-inspired community-based forms of “psi” practice are developing. This emergent psi movement is making a range of positive contributions to the lives of average citizens, including those of poor disenfranchized youth. This paper, however, explores one particular dimension of the work of psi practitioners that has proven antithetical to the psi community’s current politicized community-based aims. Based on qualitative and quantitative longitudinal ethnographic fieldwork with therapists and young men in Pelotas, this paper analyzes how certain kinds of psi interventions being carried out in schools for a subset of lower-class young men during their early teen years are encouraging some youth to seek military training as a life option. Although these young men initially had quite captivating, engaged and politicized—if also conflicting—interactions with therapists, their eventual disillusionment with their therapeutic and scholastic experiences resulted in high levels of social alienation and de-politicization. In these young men’s search for what can best be described as formulaic solutions to troubling psychological experiences associated with a tumultuous institutionalized transition to adulthood, military training came to represent a form of self-cultivation and self-therapy. Several youth also hoped military training would enable them to actively disengage with local political processes and find shelter from troubling social inequities and injustice. The paper ends by reviewing the implications of these results for the future of psi knowledge and practice in Brazil. [ABSTRACT FROM AUTHOR]

This paper focuses first on cultural syncretism, used to characterize Brazilian culture. The other aspect of this socially and racially blended culture is the unfinished assimilation of liberalism in politics and the economy, which defines Brazilian society. The increased assimilation and dissemination of psychology may be linked with these in cultural and social aspects. During the military period (1964-1974) the major expansion in university-level studies in psychology contributed ideologically to the dissemination of psychology throughout Brazilian society. This introduced a type of psychology that was related primarily to clinical practice and developed in opposition to social work practice. This paper examines the ideological bases for this conflict between clinical and social work. Criteria for understanding the cultural dissemination of psychoanalysis are then discussed, and it is argued that cultural incorporation of psychoanalysis involves the development of discourse complexes to reflect particular aspects of Brazilian society. The criteria (a non-totalitarian society and the displacement of a magical and religious interpretation of mental disturbance by psychiatric interpretation) are evaluated in relation to the peculiarities of Brazilian syncretism. The paper argues that cultural syncretism and the incomplete assimilation of liberal ideology must be included as criteria in understanding the particular cultural incorporation of psychoanalysis in Brazil. [ABSTRACT FROM AUTHOR]

Values are often used to examine cultural variability. Yet, little research has focused on the functions that values fulfill and the implications of these functions for understanding cultural variability. This paper describes a theoretical analysis of the functions of values based on 2 widely accepted pan-cultural functions: values guide actions and express needs. The theoretical model proposes that the first function differentiates values according to the goals pursued (personal, central, or social goals), whereas the second function differentiates values according to the needs expressed (survival or thriving needs). A combination of these 2 functions yields 6 basic values (structural hypothesis) with specific marker values (content hypothesis). Support for the hypotheses was obtained in a large convenience national sample (N = 5,176) of Brazilian university students with confirmatory factor analysis and multidimensional scaling. Central values were located between personal and social values, and survival and thriving values separated into 2 regions. Theoretical and cross-cultural implications of the findings, especially the universality of the general structure of motivational aims, are discussed, along with interpretations of existing value scales from a functional perspective. [ABSTRACT FROM AUTHOR]

In the late 1990s researchers in Pelotas Southern Brazil began documenting what they considered to be unacceptably high rates of licensed psychotropic use among individuals of all ages, including youth. This came as a surprise, since the vast majority of psychiatrists in Pelotas draw on psychoanalytic theory and approach pharmaceutical use, especially for children and adolescents, in a consciously tempered way. Drawing from a longitudinal ethnographic sub-study, part of a larger 1982 birth cohort study, this paper follows the circuitous trajectories of emergent pharma-patterns among “shantytown” youth over a ten-year period, exploring the thickly layered and often moralized contingencies in which psychodynamic psychiatrists' intention to resist excessive pharmaceuticalization both succeed and crumble. I juxtapose these trajectories with the growing salience of an “anti-biologizing” explanatory framework that psychiatrists and researchers are using to pre-empt the kind of diagnostics-driven “biopsychiatrization” so prevalent in North America. My analysis suggests that psychiatrists' use of this framework ironically contributes to their failed attempts to “resist” pharmaceuticalization. [ABSTRACT FROM AUTHOR]

Abstract: Explanations for the association between teen-childbearing and subsequent mental morbidity vary considerably, from those based on neurological theories of development to those investigating underlying social and economic determinants. Based on longitudinal epidemiological and ethnographic sub-studies of the 1982 Pelotas birth cohort study, this paper explores the hypothesis that teen childbearing and subsequent mental morbidity have become associated through the interplay of culture, society, and biology in situations where teen pregnancy has become a stigmatised object of scientific and public health attention. Results show that the effect of teen childbearing on subsequent mental morbidity remained significant in the multivariate analysis. Ethnographic analysis, together with epidemiological effect modification analyses, suggest that this association is partially accounted for by the fact that it is more pronounced amongst a specific subgroup of women of low socio-economic status who, being more politicised about societal injustice, were also more critically engaged with – and thus troubled by – the inequitable institutionalisation of life-cycle transitions. With time, these women became highly critical of the institutionalised identification of early childbearing as a key violation of life-cycle norms and the differential class-based application of scientific knowledge on its causes and consequences. Public health campaigns should consider how the age-based institutionalisation of developmental norms has enabled the stigmatisation of those identified as transgressors. [Copyright &y& Elsevier]

Background: Health is recognized as a fundamental right in Brazil's constitution. In the absence of a clearly defined benefit packages of healthcare services that are financed under the Unified Health System (Sistema Único de Saúde, SUS), courts have become important in adjudicating coverage decisions. Empirical assessments of equity and the right to health tend to focus on simple measures of access. However, these empirical perspectives belie the significant inequalities and rights violations that arise in the case of more complex health needs such as cancer. To shed light on these issues, this paper focuses on the care pathways for breast and cervical cancer and explores access and quality issues that arise at different points along the care pathway with implications for the realization of the right to health in Brazil. Method: A mixed method approach is used. The analysis is primarily based on a quantitative analysis of national representative administrative data principally from the cervical and breast cancer information systems and the hospital cancer registry. To gain more insights into the organization of cancer care, qualitative data was collected from the state of Bahia, through document analysis, direct observation, roundtable discussions with health workers (HWs), and structured interviews with health care administrators. Results: The paper reveals that the volume of completed screening exams is well below the estimated need, and a tendency toward lower breast cancer screening rates in poorer states and for women in the lowest income brackets. Only 26% of breast cancer cases and 29% of cervical cancer cases are diagnosed at an early stage (stage 0 or I), thereby reducing the survival prospects of patients. Waiting times between confirmed diagnosis and treatment are long, despite new legislation that guarantees a maximum of 60 days. The waiting times are significantly longer for patients that follow the recommended patient pathways, and who are diagnosed outside the hospital. Conclusion: The study reveals that there are large variations between states and patients, where the poorest states and patients fare worse on key indicators. More broadly, the paper shows the importance of collecting data both on patient characteristics and health system performance and carry out detailed health system analysis for exposing, empirically, rights violations and for identifying how they can be addressed. [ABSTRACT FROM AUTHOR]