Access of the LGBTQIA+ Population to Brazilian Public Primary Health Care Services: A Scoping Review

巴西 LGBTQIA+ 人群获得公共初级卫生保健服务的机会:一项范围界定综述

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Abstract

BACKGROUND: LGBTQIA+ individuals in Brazil face persistent inequities in accessing Primary Health Care (PHC), largely due to structural barriers, institutional discrimination, and limited professional training. Despite the existence of the National Policy for Integral LGBT Health, significant challenges remain in ensuring inclusive and equitable care. OBJECTIVE: To map the available scientific evidence regarding the access of the LGBTQIA+ population to Brazilian public PHC services, identifying barriers, facilitators, and research gaps. METHOD: This scoping review followed the JBI framework and PRISMA-ScR guidelines. Searches were conducted in MEDLINE/PubMed, Embase, Scopus, CINAHL, SciELO, LILACS for studies published between 2018 and 2023. RESULTS: A total of 19 studies were included, predominantly qualitative (84.2%) and concentrated in the Northeast and Southeast regions, with no studies from the Central-West. Most investigations prioritized healthcare professionals' perspectives, particularly nurses and physicians, while the experiences of LGBTQIA+ users remained underrepresented. Barriers to access included institutional prejudice, lack of professional preparedness, and a narrow biomedical focus on HIV/aids. Facilitators involved social support networks, and the search for inclusive spaces. Research gaps persist, particularly regarding dissident gender identities. CONCLUSION: Strengthening inclusive policies, diversifying scientific production, and integrating sexual and gender diversity into professional training are essential to promoting equity and improving health outcomes.

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