title: [Health in the prison system: representations and practices by prison guards in Rio de Janeiro, Brazil].
abstract: The role of prison guards in limiting access to health services by inmates and the impact of their representations on daily health practices were investigated through an action-research program. The program aimed to produce knowledge and improve the guards' involvement in tuberculosis and HIV/AIDS control by raising their awareness. Developed in three prisons and two hospitals, the study included individual interviews and group discussions and showed that representations of health and illness, risk hierarchy, and preventive strategies are related to actors' status in the prison's social organization, the conflicts and tensions between them, and the sense of group belonging that reinforces identities and antagonisms. Such representations have a major influence on the guards' daily practices and inmates' access to health services. The denial of inmates' right to health and their limited autonomy contributed to the implementation of essentially prescriptive health actions. The guards' awareness of their own health representations and practices may contribute to the deconstruction of stereotypes and increase their involvement in prevention and care. Further, improvement of inmates' health depends on changes in prison conditions.
authors: Superintendência de Saúde, Secretaria de Estado de Administração Penitenciária do Rio de Janeiro, Rio de Janeiro, Brasil. vilmadiuana@gmail.com
authors: Vilma
authors: V
authors: Diuana
authors: Dominique
authors: D
authors: Lhuilier
authors: Alexandra Roma
authors: AR
authors: Sánchez
authors: Gilles
authors: G
authors: Amado
authors: Leopoldina
authors: L
authors: Araújo
authors: Ana Maria
authors: AM
authors: Duarte
authors: Mônica
authors: M
authors: Garcia
authors: Eliane
authors: E
authors: Milanez
authors: Luciene
authors: L
authors: Poubel
authors: Elizabeth
authors: E
authors: Romano
authors: Bernard
authors: B
authors: Larouzé
mesh_terms: D001938:Brazil; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000209:etiology*; D028701:Patient Rights; D011329:Prisoners; D011330:Prisons; D036301:Qualitative Research; D012938:Social Perception; D012940:Social Problems; D014376:Tuberculosis / Q000517:prevention & control*; D000078329:Workforce