Use of STD/HIV/AIDS-Oriented Public Health care Services by Quilombo Communities in Brazil

Introduction: The Aids epidemic affects vulnerable groups with more intensity. Tendencies show that countryside territories, poor populations and female patients are vulnerable; thus, the black population find themselves in social disadvantage regarding the construction of coping responses. Objectives: To describe the black population's conditions of access to HIV/AIDS and STD diagnosis and assistance, and the use of healthcare services in such context. Methods: Cross-sectional epidemiological study with a sample of 218 sexually active adults, living in 11 different quilombos (hiding places of runaway slaves) in Brazil. Results: 75% said they use public primary care services. Previous symptoms of STD were reported by 10% of the interviewees, and most of them said they contacted the public healthcare service (70%). HIV testing was performed by 22% of the subjects. The public non-specialized healthcare service was used by 73% of the interviewees. Among the participants who reported previous symptons of STD, women went to the public healthcare service and performed the HIV testing with higher frequency than men. Young people had greater perception of assistance difficulties, and they also searched more for assistance in the private healthcare services and performed testing more frequently. Black people perceived greater difficulty in receiving assistance, reported previous symptoms of STD with higher frequency, and resorted to self-medication more often when compared to non-black individuals. However, service ratings were considered good/great by 45% of the participants. Non-black people claimed to seek for public services more frequently than the other subjects. Conclusion: The study highlights the necessity of public policies targeted at the most vulnerable segments of population. It is important to mention the need to train the medical teams of Programa de Agentes Comunitarios de Saude (PACS - Health Community Agents Program) and Programa Saude da Familia (PSF - Family Health Program), due to their relevance in the assistance provided for these communities.