Vertical HIV transmission in the health network: bioethics reflections on gender and care based on an emblematic case

Abstract

In a still worrying epidemic scenario, the prevention of Vertical Transmission (VT) of HIV poses complex problems, due to the individual, social, and moral vulnerabilities of women living with the virus, besides the health network’s weaknesses. Based on an emblematic case, this study sought to understand the bioethical challenges of HIV VT prevention in the context of the Porto Alegre/RS Committee. The analytical categories developed reflect on how the production of care is articulated, on the one hand, with relational discourses and practices based on gender and intersected by race and social class, and, on the other, with programmatic vulnerabilities of health policies. A process of extreme stigmatization was revealed, in which the few offers for cisgender women were directed towards reproductive regulation and perpetuated dynamics of structural violence. It discusses ways to build care that incorporates the decolonial perspective and seeks to produce equity and social justice by recognizing women’s trajectories.