[Aporophobia in primary health care: perceptions of healthcare providers about prejudice against the poor].

Aporophobia compromises access to and the quality of care at health services. Health professionals of the Family Health Strategy (FHS) play a central role in ensuring universal, comprehensive, equitable health care. The aim of the present study was to understand perceptions about aporophobia among higher-level FHS professionals. A sequential, explanatory, mixed-methods study was conducted with 96 FHS professionals in Fortaleza, Ceará State, Brazil. In the first stage, quantitative data were collected using the Attitudes Towards the Homeless Questionnaire. In the qualitative phase, 10 professionals were interviewed based on the scores they received on the questionnaire (lowest and highest quintiles). The data were analyzed using the IraMuTeq software and included similarity analysis interpreted in light of the theories of philosopher Adela Cortina. Significant associations were found between aporophobia and both skin color (p = 0.022) and employment status (p = 0.008). The qualitative content was categorized into four classes: poverty-related causes; manifestations of aporophobia and its stereotypes; comprehensive care for vulnerable groups; and humanization and adaptation in care. The perceptions of the professionals ranged from humanized practices to subtle or even explicit prejudices, revealing challenges in the assurance of equity in care. These results underscore the need for ongoing training of healthcare providers of the FHS, the inclusion of discussions on the social determinants of health at higher education institutions, and the strengthening of intersectoral collaboration to ensure more humanized and inclusive care.