Gender, sexuality, and the prevention of sexually transmissible diseases: a Brazilian study of clinical practice.

Epidemiological tendencies in the spread of HIV/AIDS in Brazil demonstrate the increasing importance of heterosexual transmission to women who are not included in those traditional categories of 'risk' which have so far guided research and attempts at prevention. While more attention is now being given to other STDs as part of HIV prevention, this same view of 'risk' prevails, as does a tendency to rely on strictly quantitative indicators and conceptions which treat health care workers' beliefs and attitudes as individual phenomena. This study, an examination of clinical practices of STD management in gynecological and antenatal programs in public health posts in Rio de Janeiro, reveals the mutually-reinforcing relationship between gender norms in sexuality and gynecological clinical practices, which results in the reproduction of both gender hierarchy and vulnerability to infection by all STDs.