Challenges and Opportunities for Primary Health Care in Tuberculosis Control among People Experiencing Homelessnes
1
Department Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
2
Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
3
Nursing Degree, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
4
Nursing Department, Federal University of São Carlos - Brazil, São Carlos, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A2725
ABSTRACT
INTRODUCTION:
Tuberculosis remains a serious public health problem globally, determined by social inequities(1). People experiencing homelessness are exposed to a risk of illness that is up to 54 times higher when compared to general population, being considered as priority group by National Program of Tuberculosis Control in Brazil. In 2024, was registered the highest number of cases in Brazil since 2015, with 3.042 new diagnosis cases(2-4). The treatment outcomes are shown as unfavorable to this population, with low cure rates, high treatment interruption, and high mortality. In the Brazillian Unified Health System, the Street Clinic (CnaR), inserted in Primary Health Care (PHC), engages in itinerant practices around the integrated care on the people experiencing homelessness. Within this context, this study objectively analyses the discursive meanings attributed to tuberculosis-related illness on people experiencing homelessness diagnosed with tuberculosis and professionals from CnaR(5).
METHODS:
Qualitative study, descriptive and exploratory, made in São Paulo city, Brazil, with people experiencing homelessness diagnosed with tuberculosis and professionals of CnaR team, after approval by Research Ethics Committees. Interviews were taken in a semi structured way, audio-recorded and analyzed in the light of the theorical-methodological framework of French Discourse Analysis.
RESULTS:
The tuberculosis diagnosis was associated to stigma, physical pain and fear of death. The main care barriers involved immediate needs of survival, itinerance practice, use of psychoactive substances, and adverse medicine effects. The CnaR teams activities have made flexible healthcare practices possible, territorialized, and bond based. Paradoxically, tuberculosis also operates as a device of social visibility, enhancing healthcare access and social care.
CONCLUSIONS:
Although tuberculosis intensifies the stigma process and social exclusion, the care made by Street Clinic team shows the PHC potential to transform the illness experience into an integrated care possibility.
Tuberculosis remains a serious public health problem globally, determined by social inequities(1). People experiencing homelessness are exposed to a risk of illness that is up to 54 times higher when compared to general population, being considered as priority group by National Program of Tuberculosis Control in Brazil. In 2024, was registered the highest number of cases in Brazil since 2015, with 3.042 new diagnosis cases(2-4). The treatment outcomes are shown as unfavorable to this population, with low cure rates, high treatment interruption, and high mortality. In the Brazillian Unified Health System, the Street Clinic (CnaR), inserted in Primary Health Care (PHC), engages in itinerant practices around the integrated care on the people experiencing homelessness. Within this context, this study objectively analyses the discursive meanings attributed to tuberculosis-related illness on people experiencing homelessness diagnosed with tuberculosis and professionals from CnaR(5).
METHODS:
Qualitative study, descriptive and exploratory, made in São Paulo city, Brazil, with people experiencing homelessness diagnosed with tuberculosis and professionals of CnaR team, after approval by Research Ethics Committees. Interviews were taken in a semi structured way, audio-recorded and analyzed in the light of the theorical-methodological framework of French Discourse Analysis.
RESULTS:
The tuberculosis diagnosis was associated to stigma, physical pain and fear of death. The main care barriers involved immediate needs of survival, itinerance practice, use of psychoactive substances, and adverse medicine effects. The CnaR teams activities have made flexible healthcare practices possible, territorialized, and bond based. Paradoxically, tuberculosis also operates as a device of social visibility, enhancing healthcare access and social care.
CONCLUSIONS:
Although tuberculosis intensifies the stigma process and social exclusion, the care made by Street Clinic team shows the PHC potential to transform the illness experience into an integrated care possibility.
| eISSN: | 2654-1459 |
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