Detener el VIH entre los grupos de población con más riesgo

Aunque hay algunos individuos y grupos que afirman que “no hay evidencia de que la prevención funciona”, el hecho es que existen abundantes pruebas sobre la eficacia y efectividad de las medidas específicas y enfoques para reducir la . Su aplicación es más urgente entre la mayoría de los grupos con mayor riego. Entre ellos, los de los hombres que tienen sexo con otros hombres, personas transgénero, trabajadores sexuales y usuarios de drogas han sido seriamente afectados y aún siguen teniendo mayores probabilidades de infectarse con el VIH (y otras ), de ahí su denominación genérica como “Poblaciones en mayor riesgo “(o ).

Además de los factores de comportamiento que aumentan las probabilidades de entrar en contacto con el agente infeccioso, las PEMAR tienen una vulnerabilidad aumentada, que se asocia con las actitudes sociales negativas, la intolerancia, el fanatismo y la discriminación que los enajenan de los servicios de salud y educación.

En consecuencia, la tasa de infección puede alcanzar proporciones alarmantes entre los miembros de estas poblaciones. Por ejemplo, algunas encuestas serológicas indican que la incidencia entre los hombres que tienen sexo con hombres () puede ser de 5 a 25 veces mayor que en la población general en algunas ciudades de América Latina. Además, entre las personas transexuales el impacto de la epidemia es enorme. Incluso si los estudios epidemiológicos que documenta el impacto entre las personas transexuales son limitados, los existentes apuntan a un gran rango de la prevalencia (de 8 a 68%). Esta es sólo una de las muchas cargas transportadas por una población que está sujeta a desprecio, acoso, malos tratos y la violencia. (No olvidar que la combinación de Alcohol y Drogas aumentan el riesgo)

Las condiciones de salud en general de estas poblaciones puede y debe ser transformado y un punto ideal de entrada es la prevención y atención de la infección por VIH entre los miembros de estos grupos y poblaciones.

Para asegurar la máxima eficacia en la ejecución de las intervenciones es necesario ubicarlos dentro de entornos de apoyo. Por otra parte, es necesario que se articule con las intervenciones estructurales conducentes a promover y mantener los cambios y, para articular las respuestas en un marco de salud pública y no meramente clínico.

La Organización Mundial de la Salud () acaba de lanzar una serie de recomendaciones bajo el título: “Prevención y Tratamiento de VIH y otras infecciones de transmisión sexual entre hombres que tienen sexo con hombres y los transexuales: Recomendaciones para un enfoque de salud pública. 2011 “.

Este documento es el producto de dos años de consultas entre expertos y representantes de organizaciones de la sociedad civil, otros organismos y programas y las partes interesadas. El proceso se inició en septiembre de 2008 durante una consulta en la sede de la OMS en Ginebra. Consultas similares tuvieron lugar en otras regiones de la OMS. En las Américas la primera se llevó a cabo en Acapulco, México en noviembre de 2008 y la segunda en Panamá en junio de 2009. Bajo el liderazgo de la , una herramienta de referencia se desarrolló: el “Proyecto para la prestación de atención a los hombres gay y otros hombres que tienen sexo con hombres”.

El proceso global continua, mientras tanto, y una amplia consulta se celebró en Beijing en septiembre de 2010. El producto final es el conjunto de recomendaciones para el uso por parte de funcionarios de salud pública, los administradores de VIH / ITS, los proveedores de salud y organizaciones de la sociedad civil.

Este conjunto de recomendaciones se basa en un análisis exhaustivo de la literatura revisada por expertos sobre la eficacia y efectividad de los métodos y enfoques específicos para prevenir la transmisión sexual del VIH y otros patógenos de transmisión sexual. Los principios generales que enmarcan las recomendaciones son la protección de los derechos humanos y la prevención de cualquier forma de discriminación en los servicios de salud. Entonces, las acciones específicas que deben llevarse a cabo se agrupan de la siguiente manera:

* prevención de la transmisión sexual del VIH

* la atención integral de la infección por el VIH

* las intervenciones conductuales (incluyendo la educación).

Estas recomendaciones han tenido en cuenta la relevancia cultural y la aceptación potencial de las acciones propuestas.

La Organización Mundial de la Salud también está realizando un proceso similar al documento de recomendaciones para prevenir las ITS entre las . Una consulta a nivel mundial se llevará a cabo en la región de las Américas y la Secretaría de la OPS brindará respaldo técnico y administrativo ha esta iniciativa.


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