RESUMEN
Los presentes lineamientos son el resultado de un proceso de análisis, elaboración y consulta en el cual se tomó en cuenta información sobre los diferentes métodos de notificación asistida, y los pasos que deben llevarse a cabo, partiendo de las consideraciones realizadas por la OMS y el trabajo de diversos organismos de cooperación, los que se adaptaron a la realidad nacional. Estos Lineamientos contienen los principios rectores propuestos por la OMS, los métodos de notificación asistida de parejas o contactos sexuales, etapas de la implementación de la notificación asistida, herramientas utilizadas, forma de priorizar a las personas en mayor riesgo, además un sistema de monitoreo y evaluación del proceso de trabajo
These guidelines are the result of a process of analysis, development and consultation in which information on the different methods of assisted notification was taken into account, and the steps that must be carried out, based on the considerations made by the WHO and the work of various cooperation organizations, which adapted to the national reality. These Guidelines contain the guiding principles proposed by the WHO, the methods of assisted notification of partners or sexual contacts, stages of the implementation of assisted notification, tools used, how to prioritize people at highest risk, as well as a monitoring system and work process evaluation
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El SalvadorRESUMEN
Este documento prioriza 32 indicadores del Plan Estratégico Nacional Multisectorial de VIH e ITS 2022-2026, a los cuales se dará vigilancia y evaluación durante el período. El Salvador ha priorizado sus acciones enfocadas en poblaciones clave, personas con VIH, para este quinquenio, se ha enfocado en estrategias de prevención, diagnóstico, atención profundizando el enfoque en el alcance de las metas
This document prioritizes 32 indicators of the National Multisector Strategic Plan for HIV and STIs 2022-2026, which will be monitored and evaluated during the period. El Salvador has prioritized its actions focused on key populations, people with HIV, for this five-year period, it has focused on prevention, diagnosis, and care strategies, deepening the focus on achieving the goals
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Programación de Servicios de Salud , El Salvador , InfeccionesRESUMEN
El Ministerio de Salud, promueve el ejercicio del derecho humano a la salud, por lo anterior es importante redimensionar la Estrategia nacional de información, educación y comunicación para el cambio de comportamiento (IEC/CC), con el objetivo de que el personal de salud disponga de procesos sistemáticos para la promoción de la salud con enfoque de las determinantes sociales de la salud y comportamientos saludables que pudieran ser adaptados y adoptados según el perfil epidemiológico local, las prioridades de salud y los recursos humanos, materiales y financieros disponibles. Con base a lo anterior la Unidad de programa de ITS/VIH/sida, incorpora el abordaje de ITS/VIH a la Estrategia nacional de IEC/CC del MINSAL, dirigida hacia poblaciones de mayor vulnerabilidad, definidas en este documento como audiencia primaria siendo estas: adolescentes, trabajadores(as) sexuales, poblaciones clave, personas con capacidades especiales, personas privadas de libertad, población móvil y población de uniformados, con el fin de mejorar la salud en correspondencia a las estrategias planteadas
The Ministry of Health promotes the exercise of the human right to health, therefore it is important to resize the National Information, Education and Communication Strategy for Behavior Change (IEC/CC), with the objective that health personnel have systematic processes for health promotion with a focus on the social determinants of health and healthy behaviors that could be adapted and adopted according to the local epidemiological profile, health priorities and available human, material and financial resources. Based on the above, the STI/HIV/AIDS Program Unit incorporates the STI/HIV approach into the National IEC/CC Strategy of the MINSAL, aimed at the most vulnerable populations, defined in this document as the primary audience, these being : adolescents, sex workers, key populations, people with special abilities, people deprived of liberty, mobile population and uniformed population, in order to improve health in accordance with the proposed strategies
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El SalvadorRESUMEN
La consejería es reconocida a nivel mundial como una estrategia importante que contribuye a la educación y prevención de riesgos contra la infección por ITS/VIH, se reconoce que no basta con transmitir el conocimiento de manera mecánica, sino que es necesario sensibilizar y dialogar con las personas que acuden a los servicios de salud, sobre la importancia del autocuidado, contribuyendo a la toma de decisiones de cada usuario para que mejoren su calidad de vida. A través de los presentes lineamientos se pretende unificar y fortalecer los procedimientos en el área de consejería
Counseling is recognized worldwide as an important strategy that contributes to education and risk prevention against STI/HIV infection. It is recognized that it is not enough to transmit knowledge mechanically, but it is necessary to raise awareness and dialogue with people who go to health services, about the importance of self-care, contributing to the decision-making of each user to improve their quality of life. Through these guidelines it is intended to unify and strengthen the procedures in the area of counseling
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El SalvadorRESUMEN
El Plan Estratégico Nacional Multisectorial de VIH e ITS 2022-2027 (PENM 2022-2027) es el resultado directo de la evaluación de medio término del PENM 2022-2026, enriquecido con perspectivas clave del "Análisis de la Respuesta del Sector Salud al VIH en El Salvador" realizado por la Organización Panamericana de la Salud (OPS) en diciembre de 2023. Además, se ha fundamentado en herramientas metodológicas actualizadas, como la "Lista de verificación y lista de referencia para el desarrollo y revisión de un plan estratégico nacional de respuesta al VIH" de ONUSIDA (2023), con el objetivo de complementar y alinear nuestras acciones con las directrices, recomendaciones y estrategias más recientes propuestas por ONUSIDA
The National Multisector Strategic Plan for HIV and STIs 2022-2027 (PENM 2022-2027) is the direct result of the mid-term evaluation of the PENM 2022-2026, enriched with key perspectives of the Analysis of the Health Sector Response to HIV in El Salvador carried out by the Pan American Health Organization (PAHO) in December 2023. In addition, it has been based on updated methodological tools, such as the "Checklist and list of reference for the development and review of a national strategic HIV response plan" of UNAIDS (2023), with the aim of complementing and aligning our actions with the guidelines, most recent recommendations and strategies proposed by UNAIDS
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Programación de Servicios de Salud , El SalvadorRESUMEN
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Summary In the past, the epidemic of Acquired Immune Deficiency Syndrome (AIDS) was not conceived originally as a public health problem, and was attributed instead to individuals enacting social roles related to lifestyles considered as transgressions from hegemonic sexuality (heterosexual, reproductive and monogamous). The epidemiological analysis was upheld by clinical notions which reinforced the stigma of population groups historically discriminated, such as homosexuals and the Afro-American population. The study of the epidemic based on the concept of risk gave rice to the category of groups at risk, so that the phenomenon was explained from a moral point of view, as it also became apparent that the deaths associated with AIDS were a consequence of sexual preferences. This then impeded the analysis of the epidemic from the standpoint of the structural components of public health. Once it was possible to isolate and identify the Human Immune Deficiency virus (HIV) as the causal agent of AIDS, the epidemiology ceased referring to risk groups and incorporated the notion of risk practices. Even though, in the beginning potential infection with HIV by means of bodily fluids, such as blood, semen, and uterine cervical fluid was recognized, the clinical discourse still reinforced the stigmatization of infected people. The only innovation was the invention of the sexual worker as a new likely victim of the epidemic. At this moment, epidemiology recognizes the importance of speaking about contexts of risk instead of groups or practices at risk. Notwithstanding, the global dynamics of the epidemic tends to reinforce the idea that migrants are a new group at risk. This implies going backwards in the conceptual thinking of HIV/ AIDS because it suggests that migrants are a new hazard for public health, just like homosexuals and commercial sex workers. The mobile populations play a role in the transmission of HIV, especially in regions where international borders are shared between countries with unequal economies. For this, it is necessary to consider that the infections of HIV exist in cultural, political, and economical contexts. In this kind of regions, the epidemic can not be analyzed thinking of migrants as the responsible actors in the prevalence growth. The human traffic and the sexual aggressions, for example, are social phenomena linked to the structural conditions of the geographical stations of the mobile populations. In addition, it is necessary to consider that the worldwide dynamics of poverty and migration are produced as a result of disintegration of rural economies (disasters, wars, structural poverty). The relation between migration and poverty can be focused as that of contexts of sexual violence and discrimination. This point of view allows for the exploration of the conditions of HIV/STD infection among persons whose dignity is less respected. The relationship between international clandestine migration and HIV/AIDS has been studied scarcely. With the aim of proposing a different epistemological focus for this problem, in this article we reflect on the possibility of analyzing the notion of vulnerability placing it in a category which takes into account the historical, cultural, social and economic contexts. We propose to analyze vulnerability as a condition that may be transformed in space and time, and that is socially diverse because of this. From this, it follows that vulnerability is acquired in the process of interaction between migrants and the societies through which they move in transit. In this sense, vulnerability can be expressed as a way of being and living, linked to social roles and the course of the personal lives of the people who accompany migrants at the time of their territorial migration. Thus vulnerability is modified according to the historical and social conditions of their places of origin, the places they pass through, and the places of their destination, but also varies according to age, sex, education and social norms which direct sexual identity, as well as the reasons migrants have for displacing themselves. This perspective also permits us to observe that in ethnographic terms, vulnerability can be studied by taking into account the social capital of the clandestine migrant which, when translated into terms of their access to social networks in the places of origin, transit and destination, may either bring them nearer to or further away from situations of isolation, depression and sexual violence. The concept of vulnerability that we propose allows for the explanation of the ruralization of the HIV/AIDS epidemic as a phenomenon related to four socio-historic aspects: poverty, disintegration of agricultural zones, sexual violence and clandestine migration to the United States. We also suggest to include the fact that the HIV/AIDS epidemic occurs in contexts where the violation of human rights is associated with sexual aggression, which can also cause new HIV/STD. For this reason, the impact of poverty acquires a specific influence on this process presenting itself as the way of life of the migrant who transfers him-herself without documents and without authorization and who is especially fragile because he/she faces circumstances in which he/she has no social power. We thus consider that in order to understand in depth the phenomenon concerning the vulnerability of populations who move without legal papers, it is necessary to include both the life histories of the individuals and a study of the social context in which these take place, as a mean of analyzing their vulnerability. The objective of this essay consists in demonstrating the instrumental potential of the concept of vulnerability and its methodological implications for the study of international clandestine migration, as well as sexual aggressions as indicators of violation of human rights and infection with HIV/STD, respectively.