it is consider the accessibility of health care and stigmatizing processes as a dimension of a complex problem that deserves to be analyzed at different levels: one macro context, one of meta procesess and one of micro procesess. the health care practices should be read in the articulation of these two categories and in the interweaving of these three levels of analysis. stigmatization processes not necesary become barriers to access to the health system. stigma can also operate as a facilitator of access whith the inclusion of these subjects in targeted policies. we should inquire not only for access barriers that exist for these population, but still what are the characteristics of accessibility to health care in this specific population? many of the practices that take place with this population are held in a logic of victimization that continues aiming madness.