Fatores associados à interrupção do tratamento para HIV de mulheres trans e travestis em uma unidade de saúde em Manaus, Amazonas : um estudo qualitativo

Abstract

Transgender women and travestis living with HIV experience contexts of social exclusion, stigma, and institutional barriers that undermine access to and continuity of antiretroviral therapy (ART). Understanding the causes of treatment interruption in this population is essential for developing equitable public policies and comprehensive care strategies. Objective: To identify factors associated with antiretroviral treatment interruption among transgender women and travestis living with HIV/AIDS in a reference unit in Manaus, Amazonas. Method: A descriptive qualitative study conducted between January and August 2025 with three participants selected through the Medication Logistics Control System (SICLOM). Data were collected through semi-structured interviews, analyzed using Braun and Clarke’s thematic analysis, and organized with support from MAXQDA software. Results: The narratives revealed multiple factors related to ART discontinuation, including unstable housing, transportation difficulties, lack of identification documents, substance use, and institutional barriers marked by transphobia. Inadequate communication of the diagnosis and disrespect for the use of social names were identified as factors contributing to disengagement from services.

Conversely, the presence of community support networks and friendships was essential for re- engaging in care. Conclusion: Treatment interruption among transgender women and travestis

results from a set of structural and symbolic vulnerabilities reinforced by social inequality and institutional transphobia. Therefore, comprehensive care requires moving beyond restricted biomedical practices and addressing the inequalities that undermine the dignity and autonomy of these women.