Indigenous populations in Brazil: challenges to accessing STD/HIV/AIDS actions
Brazilian Ministry of Health, Brazilian STD/AIDS Program, Brasilia/DF, Brazil
Issues: The accumulated total of registered AIDS cases among indigenous populations is 634. Various factors influence the vulnerability of this population to STD/HIV/AIDS: pauperisation, moving to the cities, land tenure conflicts, abusive consumption of alcohol and problems of access to health services. There are 528,603 indigenous people belonging to 220 ethnic groups speaking more than 180 different languages.
Description: Data from surveys among Brazilian military service conscripts in the 17 to 20 age group show that 77.8% of indigenous conscripts were sexually active, 38.1% of them had initiated their sexual lives before they were 15 and 90%knew that using condoms reduced the risk of HIV transmission. 41.5% of indigenous conscripts referred to regular condom use with stable partners and 67.5% declared having used a condom during their last sexual intercourse. Actions directed at controlling STDs and AIDS implanted in the Health Services Network have been executed according to the response capacity of local services in the 34 Special Indigenous Health Districts (DSEI) and the corresponding network of specialised reference services for diagnosis and treatment.
Lessons learned: Monitoring done in 2007 showed that 31 DSEI made condoms available on a regular basis, 26 stated that they adopt a syndrome-based approach to STDs and provided testing for HIV and Syphilis and 22 special DSEI registered that they undertook actions to prevent vertical transmission of HIV and Syphilis. It was noted that indigenous health management was not efficiently shared with the municipal or state spheres of the National Health Service - SUS.
Next steps: Expanding and qualifying actions for controlling STD/HIV/AIDS in the 34 Special Indigenous Health Districts articulating them with the Reference Services Network is a priority to guarantee the effectiveness of a national response that reduces risks.
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