Original articles

Naked lives: women with HIV/AIDS in the

situation of gender violence
Vidas nuas: mulheres com HIV/aids em situação de
violência de gênero

Roger Flores Ceccona Abstract

https://orcid.org/0000-0002-0846-1376
E-mail: [email protected] In patriarchal societies of peripheral countries,
Stela Nazareth Meneghelb women suffer the effects of social and gender
https://orcid.org/0000-0002-7219-7178 exclusion, which exposes them to the acquisition of
E-mail: [email protected] HIV, and which remain after becoming ill. The aim
Lupicinio Íñiguez-Ruedac of this paper is to explore the experiences of gender
https://orcid.org/0000-0002-1936-9428 violence in the trajectory of women living with
E-mail: [email protected] HIV. We conducted a qualitative study in which
61 women victims of gender violence registered
a
Universidade Federal de Santa Catarina. Escola de Saúde in a Specialized Care Service for HIV/AIDS in a
Coletiva. Departamento de Ciências da Saúde. Araranguá,
SC, Brasil.
municipality in the interior of Rio Grande do Sul
were interviewed, through a critical analysis of
b
Universidade Federal do Rio Grande do Sul. Mestrado
Profissional em Saúde da Família. Departamento de Saúde the discourse of the narratives produced by these
Coletiva. Porto Alegre, RS, Brasil. women. All interviewees reported having suffered
c
Universitat Autònoma de Barcelona. Departament de Psicología violations of rights throughout their lives, due to
Social. Barcelona, España. historical processes of exclusion, limitations in
access to school, work, health services, and security.
In health services, the care provided is based on a
biopolitical medical model capable of postponing
death, but not care for them fully. We denominate
these women’s trajectories as “naked lives,” a
concept of the philosopher Giorgio Agamben,
considering that they are considered devalued and
superfluous in society, marked by violence and HIV.
Keywords: Women; HIV; Aids; Violence; Gender.

Correspondence
Roger Flores Ceccon
Universidade Federal de Santa Catarina. Rod. Governador Jorge
Lacerda, 3.201, Urussanguinha. Araranguá, SC, Brasil. CEP 88906-072.

DOI 10.1590/S0104-12902020170575 Saúde Soc. São Paulo, v.29, n.4, e170575, 2020 1
Resumo Introduction
Em sociedades patriarcais de países periféricos, This study, based on narratives produced by
as mulheres sofrem os efeitos da exclusão social women with HIV/AIDS, seeks to understand how
e de gênero, que as expõe à aquisição do HIV e que social and gender inequalities and health practices
permanecem após o adoecimento. O objetivo deste can be central to the production of marginalized
estudo foi explorar as experiências de violência lives, devoid of rights and possibilities. Thus, we
de gênero na trajetória de mulheres que vivem refer to women who are on the other side of the line,
com HIV. É um estudo qualitativo em que foram a situation of current capitalism that Boaventura de
entrevistadas 61 mulheres vítimas de violência de Souza Santos delimits as radical limits that divide
gênero cadastradas em um Serviço Especializado the population into two groups: one on this side
em HIV/aids de um município do interior do Rio of the line and another on the other side, in which
Grande do Sul. Foi realizada análise crítica do whoever belongs there disappears as a reality,
discurso das narrativas produzidas por essas becoming non-existent, irrelevant, and excluded
mulheres. Todas as entrevistadas relataram ter (Santos, 2002, 2006, 2007).
sofrido violações de direitos ao longo da vida, devido For the female group, this exclusion was
a processos históricos de exclusão, limitações no aggravated with the advent of contemporary
acesso à escola, ao trabalho, a serviços de saúde neoliberal globalization, which seeks the “non-State”
e à segurança. Nos serviços de saúde, o cuidado or the “State of non-law,” in which governors comply
prestado pauta-se no modelo médico biopolítico with international economic orders, to increase
capaz de postergar a morte, mas não de atendê-las profit. In this model, the female domination and
com integralidade. Denominamos as trajetórias exploitation process is accentuated (Saffioti, 2001).
dessas mulheres de vidas nuas, conceito do Women continue to be the object of economic and
filósofo Giorgio Agamben, tendo em vista que sexual exploitation in the domestic and public
são consideradas desvalorizadas e supérfluas na markets (Pateman, 1993). The State is an agent of
sociedade, marcadas pelas violências e pelo HIV. exclusion, representing the interests of those who
Palavras-chave: Mulheres; HIV; Aids; Violência; hold economic power, and the inclusion of all as
Gênero. having rights does not matter to capital, because it
is not a source of profits (Rocha, 1999).
The lives of women are neglected in favor of their
preservation, since abyssal lines delimit borders
and spaces of death, resulting from care only for
the rights of the “universals.” This occurs when the
State withdraws from social regulation and public
services are privatized or cease to exist, increasing
inequalities and violence (Atkinson; Blandy, 2008;
Glon, 2005; Santos, 2002, 2006, 2007).
Violence is one of the means of control and
subjection used by patriarchy and is triggered
when there are failures in the imposition of
power hierarchies in the female domination
and exploitation system (Okareh et al., 2015;
Schraiber; Barros; Castilho, 2010). The multiple
forms of violence, including physical or sexual
abuse, coercion, threats, and non-guarantee of
rights, accentuate women’s vulnerability to HIV/
AIDS, as many have been infected through sexual

Saúde Soc. São Paulo, v.29, n.4, e170575, 2020 2

violence (Jewkes et al., 2010). On the other hand, it possible to broaden the understanding of the
the acquisition of HIV increases the possibility women’s life context and to highlight elements
of violence, both in conjugal relationships, when that are invisible in the daily life of services
they reveal the diagnosis to the partner and are and health care directed at them. Furthermore,
blamed for the acquisition of the disease, and in it recognizes the importance of listening and
societal relationships, when they suffer prejudices, narratives as a rescue of the narrator’s memory
discrimination, and social rejection (Carvalhaes; and voice (Marre, 1991).
Teixeira Filho, 2012; Santos et al., 2009; Villela; The research participants were heard in 2013
Barbosa, 2017). Violence, therefore, coexists with at the Specialized Care Service for STD/HIV/
the HIV/AIDS condition, although it is not possible AIDS (SAE) in a medium-sized city in the interior
to establish a cause and effect relationship, even of Rio Grande do Sul, which, at the time of the
though one in seven infections could be prevented survey, ranked 5th in Brazil in cases of HIV/AIDS.
if women were not subjected to violence or were not The choice for the location considered the high
in power inequality in relationships (Jewkes et al., incidence of the disease (Brasil, 2014).
2010). Besides, individual, programmatic, and social The study is part of a larger study in which,
conditions contribute to increasing the vulnerability in the quantitative stage, 160 women who lived
of women (Ayres, 2008). with HIV/AIDS participated (Ceccon; Meneghel;
The use of the gender category, within a perspective Hirakata, 2014). When evidencing the high
of the theory of patriarchy (Pateman, 1993; Saffioti, prevalence of violence (75%), women who reported
2001) to investigate the lives of women with HIV/AIDS having suffered gender violence were asked to
who suffer violence, implies recognizing them as freely narrate their life stories. Thus, 61 women
subordinate, dominated, and exploited subjects since over the age of 18, who lived with HIV/AIDS and
the social guarantee of its integrity is conditioned to were registered with the SAE, were heard. They
male tutelage. The patriarchy playbook imposes on spoke spontaneously about their life trajectories,
women passivity, formalism, and silence as a “screen reporting feelings related to living with HIV/AIDS
in front of the public,” cemented by the myth of and violence, based on the triggering question: “Tell
romantic love. Women are socialized to seek a partner, me your life and talk about HIV and the violence
to yield to male sexual desire, regardless of what they you have suffered.”
want. However, those who acquire HIV/AIDS are seen The narratives allow us to understand how
as promiscuous and sexually reckless. Thus, in sexist people construct explanations for their own
and conservative contexts, there is an exacerbation of experiences and the contexts in which they are
prejudice, stigma, and social rejection of women who inserted (Mishler, 1986, 1999, 2002; Ochs; Lisa,
do not behave according to the canons of patriarchy. 2001; Riessman, 2008). The material obtained
Besides, health services, in most cases, focus their in the interviews was transcribed and organized
practices only on the biological aspects of AIDS and according to two thematic categories: gender,
clinical care, with no concern with the integrality defined a priori, and naked life, which emerged
of care and with psychosocial problems that affect from the analysis of the material, being a concept
women (Gottert et al ., 2016; Marcondes Filho, 2001). developed by Giorgio Agamben (2004) to describe
The aim of this study was to explore the the process of necropolitics undertaken by
experiences of gender violence in the trajectory of governments in the current stage of capitalism,
women living with HIV. by leaving certain population groups absolutely
excluded and unprotected.
Methodological strategies The understanding of the narratives was based on
the critical discourse analysis, aiming to show how the
This is a qualitative study in which narratives discursive practices are related to the socio-political
of women with HIV/AIDS who were victims of structures of power and domination in society.
gender violence were heard. The narrative made The narrative discourse was understood as a social

Saúde Soc. São Paulo, v.29, n.4, e170575, 2020 3

practice that constitutes reality and how social actors city where I live, no one wants to know about me,
are built for performance and resistance (Mishler, not my family, not a health clinic or the police. Then
1986, 1999, 2002; Ochs; Lisa, 2001; Riessman, 2008). came HIV. When I thought there could be no more
The research respected the recommendations of suffering, I got AIDS. It’s a joke, right? I didn’t even
the Declaration of Helsinki (AMM, 1964) and was know what that was. I found out in pregnancy and
conducted according to Resolution No. 196/1996 I despaired, I thought I was going to die. My life is
of the National Health Council (Brasil, 1996). The over. It was supposed to be a good time, my daughter
study is part of a doctoral thesis presented to the coming into the world, but it was awful. He already
Postgraduate Program in Nursing at the Federal had AIDS before I met him, and he never told me.
University of Rio Grande do Sul, and the project was My life was over. (female, 26 years old, poor, black)
approved by the Research Committee and by the
Research Ethics Committee under number 22209. The women interviewed reported having
suffered rights violations throughout their lives,
Results and discussion mainly limitations on access to school, work, health
services, and security. They live in a city where
Gender and violence: the lives of women with poverty and social exclusion have intensified in
HIV/AIDS recent years, in a context of growth and wealth
of agribusiness, undertaken by regional elites.
The narratives produced by women showed Financial and social power is perpetuated for
female itineraries marked by unequal power generations among a few families, aggravating
relations that occur in a class-based society, which social inequalities (Campos, 2011).
is racist and patriarchal. Violence was understood The fact that the women interviewed reported
as any act that results or is likely to lead to physical, restricted or non-existent access to housing,
sexual, psychological, or suffering for women, education, food, income, and protection throughout
including the threat of such acts, coercion, or their lives shows the situation of political, legal, and
arbitrary deprivation of liberty in a public or private social unprotection determined by the absenteeism
environment (WHO; UNODC; Unaids, 2012). of the State and the predatory performance of
It became evident that the women interviewed are non-state agents (Santos, 2006). State absenteeism
on the other side of the line (Santos, 2006), included can be considered in situations where the services are
in the modern sub-humanity in which the excluded only symbolic, not guaranteeing the implementation
live, those who are not even considered candidates for of protective measures, or exist with such scarcity
social inclusion since the current stage of capitalism that they fail to achieve minimum coverage, such
separates groups by apartheid. Thus, these poor, black, as temporary shelters for women in situations of
uneducated, prostitutes and women with HIV/AIDS violence or the insufficient number of professionals
are inserted in the sub-humanity destined to sacrifice in the SAEs.
(Santos, 2006), with another humanity composed The AIDS epidemic in Brazil affects a large
of included individuals considered universal, number of women and poor, dispossessed,
represented by white and rich heterosexual men. It voiceless, and powerless people who are on the
is not a matter of deviations from alleged normality, other end of the line. In addition, institutions
but of being placed in a marginalized place, due to broadcast increasingly authoritarian and
poverty, skin color, low education, less valued jobs, conservative speeches, which include mandatory
and the disease that causes abjection (Veiga-Neto, heterosexuality and threats to women’s sexual
2011), as shown below: and reproductive rights, such as non-access to
HIV prophylaxis after sexual violence, increasing
I’ve suffered my whole life. I’ve lived on the street, female vulnerability (Carvalho; Piccinini, 2008).
never went to school, I don’t even have anything to The social determination of health/disease
eat. My ex-husband raped me my whole life. In the is replaced by the attribution of individual

Saúde Soc. São Paulo, v.29, n.4, e170575, 2020 4

responsibility, and sexually transmitted diseases wash, cook, mop, and take care of them. […] I
are seen as the result of morally objectionable couldn’t study. I can barely read. I was beaten
behaviors. Thus, women with HIV/AIDS are like an animal by my father and my brothers.
considered transgressive and promiscuous, with With canes, splinters of wood, and whatever
no empathy for them and no social commotion they found around. My mother was also beaten.
with their deaths (Sontag, 1989). Nobody ever took care of me. My uncle had been
The patriarchal, capitalist and racist ideology abusing me since I was six years old. He ran his
in force in society divides and separates, excludes, finger and tongue over my vagina and my anus.
and limits access to rights, focusing mainly He took my hand and put it on his cock. But he
on the most vulnerable in terms of economic never penetrated. When I cried, he told me to shut
condition, gender, and race. It is empowered in up and not tell anyone, otherwise, he would kill
politically democratic societies in its formal, me. This went on for five years, and I still suffer
yet authoritarian, conservative, violent, and from it today. (woman, 50 years old, white, poor)
exclusionary mechanisms in practice (Ceccon,
2016). This ideology is also configured as a state Women reported that physical and sexual
of exception that operates using violence as a aggressions were frequent in childhood, a situation
mechanism of control, discipline, and submission, that forced them to secrecy, constituting family
and the naturalization and trivialization of practices, a place where violence is used to correct,
violence, in addition to blaming the victims discipline, and submit (Garbin; Queiroz; Rovida,
themselves, a fact that hinders their confrontation 2012; Santos, 2002). Furthermore, in the family,
(Santos, 2002; Segato, 2007). This mechanism the hierarchy and obedience of the family group
maintains the abyssal line between women who are directed to the male figure, characteristics
will be protected and cared for and those whose naturalized and legitimized by the patriarchal
lives are eliminable, invisible, and disposable. system (Narvaz; Koller, 2004).
They constitute precarious lives, such as the In adulthood, they continued to suffer
interviewed black and poor women who acquired psychological, physical, sexual, and patrimonial
HIV/AIDS and whose only certainty, after abuse by men who were parents, brothers,
diagnosis, is that “life is over.” boyfriends, husbands, partners, bosses, or pimps.
The subordination/exploitation of women Violence, as a fundamental part of the patriarchal
through violence is part of the current phase of social mandate, is a condition for the reproduction
capitalism, denominated as “apocalyptic,” whose of unequal relations, with positions marked by
lives are tie to a “politics of violence” (Segato, hierarchical distancing. This means that violence
2003). This situation, observed in the study, was plays a necessary role in the reproduction of the
considered a marker of gender inequality, in which symbolic economy of power and gender inequality
women with HIV/AIDS reported having suffered, (Segato, 2003). The reports of violence, present
throughout their lives, assaults of various types, in all life stories, indicate how much this fact is
perpetrated by people who fulfilled the function of part of the process of subordination of women
care, such as family members, parents, brothers, with HIV/AIDS:
husbands, companions, boyfriends, and even bosses
and strangers. The trajectories are constituted by He threatened me with death, called me a bitch,
violations of rights that resulted in violence and said I fucked anyone. He was rude and stupid.
acquisition of HIV: […] I’ve never been beaten so much in my life.
Every day, I was beaten. After we got married, he
Since I was a child, I was sacrificed by my family became a demon: he used to hurl me against the
and had to work early. I was adopted by many wall, hit me on the head, knock me down. I had
people and always returned. It was a house with a black eye and a sore head. When I managed to
10 brothers, and I, the eldest, had to clean, please, get rid of him, I became a hooker. It was the way

Saúde Soc. São Paulo, v.29, n.4, e170575, 2020 5

 I found to survive because I had never studied The practice of prostitution is, most of the
or worked in my life. I was dependent on him for time, carried out in territories where the law
everything. I ended up suffering more. (woman, of the strongest and violence prevails, where
30 years old, black, poor) gangs, dealers, pimps, male escorts, and hustlers
prevail, which subject women to violence, abuse,
Violence works as a punishment against women and exploitation. As users pay for sex, they feel
who have left their place, from subordinate and entitled to use the paid body according to their
tutored positions in a status system. This place wishes, making them objects of violence and
shows the signs of female sociability and sexuality, even death, in addition to causing a high risk of
governed by the needs and interests of men, and contracting HIV/AIDS, since many men reject
the simple movement of women in a position that condom use or withdraw it during sexual practice
is not intended for them in the hierarchy puts into (Lipszyc, 2003). At the same time, prostitution
question the male position in this structure, based operates in places of production of affections and
on status as a value in the system of relationships. cultural, academic, and political products. It is
Violence is used to discipline and control, and the carried over and built by people with subjectivities
act of punishing and depriving women of vitality that do not fit into cohesive constructions of
is also a moralizing gesture. This social mandate “groups,” let alone “risk groups” (Guimarães;
is not aimed at a specific woman, but at a generic Merchán-Hamann, 2005).
woman, since her subjection is necessary for the The rights of women, often nonexistent or
rapist’s symbolic economy and for the balance of confiscated as a result of patriarchy, make them,
the gender order to remain intact. Generic women instead of being citizens, subservient to men in all
are those who are subject to the feminine role, areas of life, in the form of submission or because
whose fixed itinerary in the structure reinforces they have a body capable of being sanctioned with
the need for violence marked by gender inequality violence whenever it breaks the rules. They are
(Segato, 2003). subjected to the patriarchal and capitalist system,
A group of women interviewed only found excluded, victims of violence as a corrective practice,
the possibility of survival in prostitution. This deprived of rights, citizenship, and reduced to
activity, which, in past times, was managed by precarious and unprotected lives. Furthermore,
women themselves, has now been appropriated compared to other job options, prostitution can be
by the Mafia patriarchy, making them need to pay understood as an effective way to guarantee these
for the “protection” of pimps and hustlers, which women a sufficient amount of money not only
means an increase in exploitation. Currently, the to survive but to rehearse a socioeconomic rise
sex market and the sexual exploitation of women (Blanchette; Silva, 2009).
is one of the most profitable sectors worldwide.
In this market, prostitutes are given the status The production of naked lives
of sexual objects, which can be easily discarded
when they become ill, rebel, or grow old, and it Social inequalities and gender-based violence
is maintained continuously by the entry of poor can be considered one of the modus operandi to
young people, minority ethnicities, migrants, maintain patriarchal capitalism, exclude and
and those from countries at war or war conflicts, reduce women to “naked life,” a concept proposed
where they are the target of human trafficking, by Agamben (2004) to refer to unprotected subjects,
drugs and commercial sexual exploitation whose lives are expendable. Poor, black, and HIV-
(Carcedo, 2010). Among the factors that lead young infected women become deprived of possibilities
women to prostitution are poverty, family abuse, since the protection mechanisms used by the
pregnancies without resources in traditional dominant groups in society are not available to
societies, and the lack of social and financial them. However, these lives are not eliminated
support networks (Ribeiro; Oliveira, 2011). in clearly observable acts, but their survival is

Saúde Soc. São Paulo, v.29, n.4, e170575, 2020 6

rendered unsustainable, and the State, in its Most of the time, women are infected for not
governance mechanisms, is the entity that lets having adequate protection, for male refusal to
them die (Agamben, 2004; Reihling, 2010). use condoms, for suffering sexual abuse, rape,
Although letting women with HIV/AIDS die is commercial sexual exploitation, or even in the
not a deliberate act of power, biopolitical actions course of dating and conjugal relations (Ceccon;
operate through mechanisms of coercion and Meneghel; Hirakata, 2014). The sexual morality of
control related to subtle practices that require society reinforces “the myth of romantic love,” in
the participation of women themselves (Reihling, which women must satisfy men at the expense of
2010). Even if their lives are reduced to “naked their sexual and reproductive autonomy (Santos
lives,” forms of intervention need not necessarily et al., 2014).
occur through direct interventions. They can The large number of women still infected
take place through the lack of efficient forms of by HIV in Brazil is an indication that there is a
protection, and, in the case of the disease, the female contingent without autonomy to protect
non-availability of prevention, care, and health themselves, to use condoms and to refuse
care mechanisms that consider women in full and unwanted sex, acquiring HIV/AIDS early, although
have a significant expression in the population, currently, the epidemic has increased again among
through public policies, not being reduced to men, especially homosexuals and in urban centers.
specific actions (Douglas, 1976). However, in relation to women, it is still men who
The instances capable of determining the decide when, and how sex will be done. Therefore,
limit between protected life and “naked life,” gender inequalities maintained by patriarchy
politicizing the phenomenon of life by including are conditions that, by subjecting and making
it or excluding it from the legal sphere, are part women vulnerable, contribute to the production
of the biopolitical regime, which has the power of leftover, superfluous, and expendable lives
to protect or discard the lives of these women. (Saffioti, 2001).
In this way, the state of exception, in which The trivialization of life also occurs when health
“naked life” is simultaneously excluded from the services focus only on the clinical care of AIDS,
legal order and imprisoned in it, constitutes the ignoring the inequalities, violence, and suffering
contemporary rule and the hidden foundation of that affect them, thus breaking with the principle
the sovereign organization of political bodies in of integral care. Thus, the health sector provides, as
the West (Foucault, 1976). a State, fragmented and partial care, which fails to
The narratives produced by women show meet the needs of users in its entirety:
that the State also does not guarantee sexual
and reproductive rights, including access to Here at SAE, when I found out, they supported me.
contraceptive practices and HIV prevention drugs But they just wanted to know about medicines,
in the face of rape or guaranteed abortion provided consultations, and tests. The other misfortunes
for by law, according to the excerpt: of life I had to deal with alone. I was beaten by
my husband, I had no money to live, my son was
I went to live with an aunt because I didn’t have a in prison. I didn’t even have the money to take a
job. It was also there that I suffered my first rape. bus. I was unemployed. Those who work here do
I was at home and I was abused by my cousin, not have time to know if you are beaten, if you
who was 10 years older and much stronger. I cried, are hungry, if you suffer. (woman, 36, black, poor)
tried to kick, struggled. He took off my shorts and
panties. After a while, he released me. He came on The care practices offered to women who have
me. I was hurt, black and blue, with sore arms. I the virus are centered on biomedical interventions
didn’t look for a hospital or a police station. I never through early diagnosis, clinical consultations,
had a partner who wanted to use a condom. (female, periodic exams to monitor CD4 and viral load levels,
black, 41 years old) and supply of medication. There is not always

Saúde Soc. São Paulo, v.29, n.4, e170575, 2020 7

non-judgmental and qualified listening, with the with equitable and universal policies (Seffner;
necessary time and the proper ambiance. These Parker, 2016).
actions, by not including biopsychosocial aspects, This situation can be made invisible by the
constitute a fragmented biomedical practice neutrality discourse of the clinical and biomedical
restricted to the medicalization of life. Even so, model, which is not concerned with the desires and
these actions, which do not respect the principle social, psychological, and affective needs of women
of integrality, are not carried out in the same way (Reihling, 2010). On many occasions, due to the
for all women, with others that, due to difficulties precariousness of their lives, they do not consider
in access or adherence, or even due to obstacles AIDS as a problem and do not realize the limitations
encountered due to race, ethnicity, class, sexual of the care practices offered by the service.
orientation or job insertion will receive unfair
treatment, with discrimination and impairment Then AIDS came. But you know, I suffered so much
in treatment adherence, many of them needing in my life that this disease didn’t seem like much
to live with disabling opportunistic diseases, and to me. The SAE is for me to take my medication and
others dying precociously (Ceccon; Meneghel; do my exams. And this is fine with me. As for that,
Hirakata, 2014). everything is fine. The problem is the other things
Getting someone to live just with the supply of in my life that no one even asks about. And this is
medication, treatment, and tests are not enough my life: AIDS and beatings. So I already left SAE
considering the precariousness of women’s lives. and then I had to go back dozens of times. (woman,
The care of life goes beyond what is prescribed in 32 years old, black, poor)
the offerings of the health sector and definitely
enters the field of politics. And AIDS remains one The abandonment of care offered by the service
of the diseases that most have a political interface. was reported by several women and many others
Medicalization is unable to solve a series of who were on the service register and have already
questions derived from it, having to exercise other abandoned it. In Brazil, there is a lot of evasion of
ways of responding to the disease, understood in users in SAEs, and the services do not carry out an
its necessarily social face, although without giving active search, considering them as “archive,” whose
up pharmaceutical advances (Paiva et al., 2015), death is already contained in the metaphor. In turn,
although, at the present historical moment, even the services face difficulties, with incomplete teams
that is at risk. of professionals, creating work overload and making
Following the strategy of offering treatment it difficult to offer collective activities (Schraiber;
and not facing the political side of AIDS D’Oliveira; Couto, 2009).
establishes two action fronts that do not lead to In relation to gender-based violence that affects
the same objective. They represent counterpoints: women, the health sector is part of the coping
one makes you live, another lets you die. One network, but services are not yet concerned with
speech advocates for testing and treating, identifying these situations, limiting themselves
another denies equal rights. It is necessary to to treating injuries. Professionals, in most services,
ensure the autonomy of subjects, regardless of including SAEs, are limited to inquiring about
race, gender, and social class to face the disease, the materiality of violence, doing little to change
and this implies designing possible futures it, and women with HIV/AIDS are faced with the
for these lives because life’s viability is also a low resolution of the institutions that are part
project of happiness. It is necessary to talk about of the network to confront and prevent violence.
sex, rescue the erotic, promote access to human The mechanisms used to curb aggression are also
rights, and build a world of equal opportunities inefficient, as noted in this study, in which many of
between people. AIDS indicates, above all, the the interviewees had sought out the police to report
precariousness of life – naked life – and is, the same aggressors who continued to victimize them
therefore, a political problem that can be solved (Meneghel; Hirakata 2011; Meneghel; Iñiguez, 2007).

Saúde Soc. São Paulo, v.29, n.4, e170575, 2020 8

 To overcome situations of violence, society the human guinea pig for medical experiments; the
must deconstruct the ideological mechanisms patient in a deep coma kept alive by technological
that maintain hierarchies of power between the means; survivors in refugee camps; suspects linked
sexes (Meneghel et al., 2013), but the patriarchy to terrorism or illegal immigration, detained and
continues to use these mechanisms to maintain held incommunicado; the inhabitants of ghettos
the situation of submission/exploitation of these and slums on the outskirts of large cities, especially
women, whose trajectories have been marked by so in cases where the confrontation between two
many inequities that they can only be considered sovereign forces, the police, and organized crime,
as naked lives. generates a space of indistinction in which naked
It is not possible to think of the State without lives are discarded. This process occurs when a
relating it to the figure of the homo sacer, the woman, a citizen and a holder of rights, starts to
one whose life is sacrificable – such as that of be considered a life that does not deserve to be
women with HIV/AIDS in this study – so that as lived, whose elimination through negligence or
long as there is a sovereign power, there will be even murder is simply filed or forgotten without
naked life exposed to abandonment and death. punishment (Agamben, 2004).
The one who has power and who can sacrifice
anyone without restrictions is sovereign is, while Final remarks
the homo sacer is the one who can have his life
without possibilities and be eliminated without In this study, we extended the condition of
constituting a homicide. This is the treatment of naked life, formulated by Agamben, to women with
the State for the poor and excluded classes, for HIV/AIDS, poor and black women, who reported
those who live in the slums and apartheid regions paths crossed by violence, exclusion, exploitation,
of large cities. This is the treatment offered and gender inequalities. Not all women with
to those on the other end of the line. One of the HIV/AIDS can be included in this condition, and
ways to operationalize this regime is to limit the Brazil remained, until 2016, a reference for HIV/
distribution of resources and social equipment, AIDS, investing billions of reais in medicines and
making universal access to rights guaranteed in a network of services to carry out diagnosis,
by the Constitution not for everyone, in such a treatment, and monitoring of patients. However,
way that a portion of the population is left to die when the focus of HIV/AIDS care focuses only on
(Agamben, 2004; Santos, 2002, 2007). clinical aspects when the principles of integrality
If the state of exception has become the norm in and equity are broken when the life situation is so
the contemporary world, there should be no surprise precarious that AIDS becomes a secondary problem,
with the rise of totalitarianism, with the existence and when the patients leave the service, these
of extermination camps and refugees, with the women may be in the condition of mere “naked
increasing number of slums, with the ostensible life.” Killable, superfluous, and disposable life.
presence in the territories of paramilitary groups,
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Authors’ contributions
All the authors conceived and designed the project, analyzed and
interpreted the data, wrote the article, carried out its critical review
and approved the published version.

Received: 03/05/2018
Resubmitted: 06/22/2020
Approved: 07/31/2020

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