Efeito da orientação sexual e da identidade de gênero nas atribuições de causalidade pela infecção por HIV

Abstract

The HIV/AIDS epidemic affects the Brazilian population significantly. According to data from the Ministry of Health, 0.6% of the Brazilian population lives with HIV. Yet, the state of Rio Grande do Sul is one of the most affected by the epidemic. In 2017, Rio Grande do Sul was the third Brazilian state with the highest AIDS detection rate, behind only to the states of Roraima and Amapá. The capital of the state of Rio Grande do Sul, however, had the highest rate of AIDS detection among Brazilian capitals. The population of men who have sex with men (MSM) and transgender women are disproportionately affected by the epidemic. In Porto Alegre, it is estimated that the prevalence of HIV in MSM who know their serological condition is 4.1%. Furthermore, a meta-analysis using data from fifteen countries stated that trans women are 48.8 times more likely to be infected with HIV than the general population. This index is even higher in a study conducted in Rio Grande do Sul, which indicates a 55.55 times greater chance. Part of the theoretical explanation of why the epidemic reaches disproportionately this population lies in the processes of stigma and prejudice. The theoretical section of this Master's dissertation presents such concepts, explaining how the experience of stigma related to HIV/AIDS can bring negative outcomes in health and how prejudice, together with stigma, leads the subject to vulnerability to the epidemic. In the empirical section of this dissertation, we present and discuss the results of an empirical study conducted with the intention of testing the hypothesis that people attribute more guilt, control and responsibility for HIV infection to homosexual men and trans women, in scenarios of infection through blood transfusion or by unprotected sex. In the literature, similar studies have been found that identified greater attributions of guilt, control and responsibility when the infection is via unprotected sex, and which also indicate higher indexes of these attributions to homosexual individuals. However, this study has as innovation aspect the investigation of these attributions in trans women. The experimental method was used, through six experimental scenarios, to which the study participants were allocated randomly. The scenarios contained a situation of HIV infection, which could be by unprotected sex or through blood transfusion and could have happened to a heterosexual man, a homosexual man or a trans woman. After reading the scenario, participants responded to Likert-type scales (from 1 to 5) on the assignments of control, guilt and responsibility as well as emotional reactions (anger/sympathy) and intent to help. The final sample had 206 people (graduate students from health courses or health professionals already trained). Data were analyzed using one-way ANOVAs, which were performed to analyze participants responses on the scales. The results indicated that people attribute more guilt, responsibility and control for HIV infection to homosexual men and trans women, only in the scenario of unprotected sex. Such a result was not found in the blood scenario. Still, there were no significant results for anger and intent to help, although it was found that the participants had more sympathy for heterosexual individuals. Finally, it is understood that this result is worrisome, since this negative attribution bias for gay men and transgender women may be contributing to the increase of the epidemic in this population.