The Brazilian experience in promoting early diagnosis of HIV
R.M.M. Ribeiro, L.D.A. Inocêncio
Ministry of Health - Brazil, Aids and STD Department, Brasília, Brazil
Issues: The increased access to early detection of HIV in Brazil.
Description: An estimated 255 thousand people in Brazil are infected by HIV but have never taken the test. Ministry of Health figures show that in 1998 only 24% of the population had been tested and in 2008 the figure was 36.5%. Furthermore, 34.9% of patients that were diagnosed HIV positive and never previously treated, came to the services clinics with their immunological systems already jeopardized.
Lessons learned: Brazil has a concentrated-type epidemic and great heterogeneity due to its vast area and demographic and cultural diversity. In that context several policies and actions have been carried out:a) Political-administrative decentralisation of government laboratories in networks with a hierarchy based on levels of complexity.b) Participation of the community and civil society in social control.c) Social mobilisation by means of “You Gotta Know” projects (“Fique Sabendo”) to stimulate people to know their serological status. Health actions offer information, condoms and testing. Religious barriers in the catholic social welfare movements have been overcome and parades celebrating sexual diversity are supported.d) The offer of diagnostic tests has increased tenfold over the last decade. In 2008, 4,659,610 HIV tests were performed.e) Investment has been made in national production of rapid tests. In 2009 2,446,380 rapid tests were distributed, 28% more than in the previous year.f) The last revision of the testing algorithm norm took in new methodologies like using molecular biology for early diagnosis in children exposed to infection and reducing the steps involved, leading to financial savings.
Next steps: Success and continuity of the Brazilian response to AIDS depend on learning from experience. Meeting the challenges means intensifying good practices, systematising what has been learned from them and transforming them into permanent strategic health actions.
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