Serviço-escola de psicologia da Unifesp: campos de estágio, ações e especificidades / UNIFESP's psychology service-school: internship field, actions, and specificities / Serviço-escola de psicologia de la Unifesp: campos de prácticas profesionales, acciones y especificidades

O Serviço-Escola de Psicologia (SEP) da Unifesp foi constituído com o intuito de transcender o tradicional funcionamento das clínicas-escola, superando a atomização da Psicologia em áreas e oferecendo serviços integrados à rede. Isso possibilita uma formação interdisciplinar, pluralista, generalista, não tecnicista, crítica, permitindo a compreensão e atuação do psicólogo em diversos contextos socioculturais. O objetivo do artigo é descrever, avaliar e problematizar as ações do SEP da Unifesp, em relação à oferta de campos de estágio e ações desenvolvidas neles. É um estudo transversal, baseado em metodologia predominantemente quantitativa e descritiva. O levantamento de dados foi realizado por meio de dois questionários online respondidos por todos os supervisores. Os dados quantitativos foram submetidos à análise estatística descritiva. Os resultados evidenciaram maior incidência das ações no município de Santos e, em menor grau, em outros municípios da Baixada Santista e na cidade de São Paulo. A maioria das atividades de estágios não se limita ao espaço físico de atendimento clínico do Serviço-Escola, ocorrendo junto às instituições públicas ou às instituições ligadas ao terceiro setor na região, relacionadas, direta ou indiretamente, com a promoção de políticas públicas. A pluralidade de recursos utilizados (grupos, atendimento individual, acompanhamento terapêutico, oficinas, matriciamento, entre outros) revela uma ampliação do repertório de competências e habilidades. A variedade de oferta de projetos e campos de estágio, públicos-alvo atendidos, assim como a diversidade e flexibilidade de ações e estratégias desenvolvidas, apontam um movimento de congruência em relação às diretrizes curriculares nacionais e ao inovador Projeto Pedagógico do curso.(AU)

UNIFESP's Psychology Service-School (SEP) was founded with the objective of going beyond the traditional functioning of school-clinics, overcoming the atomization of Psychology in areas and offering services integrated to the network. This enables an interdisciplinary, pluralist, generalist, non-technicist, and critical training, allowing psychologists' understanding and action in different sociocultural contexts. This article aims to describe, evaluate, and discuss the actions of UNIFESP's SEP regarding the offer of internship fields and the actions developed in those fields. It is a cross-sectional study, based on a predominantly descriptive and quantitative methodology. The data was surveyed with two online questionnaires answered by all supervisors. Quantitative data were submitted to descriptive statistical analysis. The results showed a higher incidence of actions in the municipality of Santos and, to a lesser extent, in other municipalities of the Baixada Santista and in the city of São Paulo. Most internship activities are not limited to the physical space of the service-school's clinical care and take place alongside public institutions or institutions linked to the third sector in the area, directly or indirectly related to the promotion of public policies. The plurality of resources (groups, personal care, therapeutic monitoring, workshops, matrix support, among others) reveals an expansion of competences and skills repertoire. The variety of projects and internship fields offers, of target audiences served, as well as the diversity and flexibility of the developed actions and strategies point to a congruence movement relating to national curricular guidelines and to the innovative pedagogical project of the course.(AU)

El Serviço-Escola de Psicologia (SEP) de la Unifesp (Universidade Federal de São Paulo, Brasil) buscó trascender el funcionamiento tradicional de las clínicas universitarias, superar la atomización de la Psicología en áreas y ofrecer servicios integrados a la red. Esto permite una formación interdisciplinar, pluralista, generalista, sin tecnicismos, crítica, lo que posibilita a los/las psicólogos/as comprender y actuar en diferentes contextos socioculturales. Este artículo pretendió describir, evaluar y problematizar las acciones del SEP Unifesp respecto a la oferta de campos de prácticas profesionales y acciones desarrolladas. Es un estudio transversal, con metodología predominantemente cuantitativa y descriptiva. Los datos se recolectaron de dos cuestionarios en línea respondidos por los/las supervisores/as. Se les aplicaron un análisis estadístico descriptivo. Hubo más acciones en la ciudad de Santos (Brasil) que en otros municipios de la región metropolitana de la Baixada Santista y en la ciudad de São Paulo. La mayoría de las prácticas profesionales no se limita a la atención clínica del SEP, ocurriendo en instituciones públicas o vinculadas al tercer sector en la región, directa o indirectamente, relacionadas con la promoción de políticas públicas. La pluralidad de recursos (grupos, atención individual, acompañamiento terapéutico, talleres, soporte matricial, entre otros) revela un amplio repertorio de competencias y habilidades. La variada oferta de proyectos y campos para prácticas profesionales, los públicos destinatarios atendidos, así como la diversidad y flexibilidad de acciones y estrategias desarrolladas apuntan a una congruencia respecto a los lineamientos curriculares nacionales y al innovador proyecto pedagógico del curso.(AU)

Respeto por la autonomía individual y el beneficio colectivo: argumentación a favor de la vacunación obligatoria contra el SARS-CoV-2 para el personal de la salud / Respect for individual autonomy and a collective benefit: Arguments in favor of compulsory SARS-CoV-2 vaccination among health care professionals

Con la llegada de las vacunas contra el SARS-CoV-2, un nuevo aspecto a tener en cuenta en la pandemia es el rechazo a la vacunación. Como la recepción de la vacuna, es voluntaria, se plantea cómo abordar la situación de los miembros del equipo de salud que la rechazan. Se exponen argumentos bioéticos de diversas corrientes: el deontologismo kantiano y lo conceptos de universalidad, humanidad y autonomía; el utilitarismo de Mill, con la autoprotección como único fin por el cual la humanidad está habilitada para interferir con la libertad de acción de sus miembros; el principismo de Beauchamp y Childress y los conceptos de beneficencia y autonomía; el principio de oportunidad de Varo Baena; y el principio de solidaridad, derivado de la ética de los derechos humanos. Se incluyen aportes de filósofos contemporáneos como Roberto Espósito, Jean-Luc Nancy y Alberto Giubilini. Se exponen dos contrargumentos: el de no maleficencia y el de contraproducencia. Por último, se plantea que, dado que el bien común (la salud pública, en este caso) es el determinante íntimo y último de la libertad individual e igual para todos, está por encima del beneficio individual

With the development of SARS-CoV-2 vaccines, a new aspect to be taken into consideration in the midst of the pandemic is vaccine refusal. Since vaccination is voluntary, it is necessary to deal with the fact that some health care team members refuse to receive it. Here I put forward different bioethical arguments: Kantian deontology and the principles of universalizability, humanity, and autonomy; Mill's utilitarianism, with self-protection as the sole end for which humankind is authorized to interfere with its members' freedom of action; Beauchamp and Childress' principlism and the concepts of beneficence and autonomy; Varo Baena's principle of opportunity; and the principle of solidarity resulting from the ethics of human rights. The contributions of contemporary philosophers like Roberto Espósito, Jean-Luc Nancy, and Alberto Giubilini are also included. Two counter-arguments are presented: nonmaleficence and counter-production. Lastly, I suggest that, since common good (in this case, public health) is the intimate and final determining factor of individual freedom and is the same for all, it is above any individual benefit.

Características del servicio social para profesionales médicos en los estados andinos / Characteristics of compulsory service programs for medical professionals in the Andean states

INTRODUCCIÓN: Se ha estudiado poco sobre el impacto de los programas de servicio social en salud en el desarrollo profesional de médicos de los Estados Andinos (Argentina, Bolivia, Chile, Colombia, Ecuador, Perú y Venezuela), programas cuya finalidad es incrementar los recursos humanos en salud en zonas rurales y remotas. OBJETIVO: Describir la normativa de los programas de servicio social para profesionales médicos de los Estados Andinos. MÉTODOS: Se realizó una revisión bibliográfica de documentos normativos concernientes al servicio social para profesionales médicos en sitios web de gobiernos de los Estados Andinos, con la finalidad de obtener información la condición de servicio, financiamiento del programa/remuneraciones y modos de adjudicación. Adicionalmente, se empleó el motor de búsqueda PubMed para complementar la información sobre servicios sociales obligatorios en estos países. RESULTADOS: El servicio social para profesionales médicos está establecido bajo un marco normativo en todos los Estados Andinos, a excepción de Argentina, donde no existe este programa. Los participantes perciben una remuneración, salvo en Bolivia, donde el servicio es realizado por estudiantes. Los sistemas de adjudicación para estos programas son heterogéneos, siendo que en algunos Estados Andinos existe asignación de plazas según criterios meritocráticos. La participación en programas sociales en salud condiciona el ejercicio profesional (Ecuador, Colombia y Venezuela) y el poder realizar una especialización (Chile y Perú). CONCLUSIONES: Se requiere estudiar del impacto de estos programas en el desarrollo profesional del participante, con el objetivo de implementar estrategias de mejora adecuadas a sus contextos particulares.

INTRODUCTION: There are few studies on the impact of social service programs on health in the professional development of doctors in the Andean States (Argentina, Bolivia, Chile, Colombia, Ecuador, Peru, and Venezuela). The purpose of these programs is to increase the availability of human resources in health in rural and remote areas. OBJECTIVE: To describe the regulations of social service programs for medical professionals in the Andean countries. METHODS: We carried out a bibliographic review of normative documents concerning the social service for medical professionals using websites of governments of the Andean States as data sources. We sought to obtain information regarding service conditions, funding of these programs­including remunerations, and means of program allocation. Additionally, we used PubMed/MEDLINE to find complementary information on mandatory social services in these countries. RESULTS: Social service for medical professionals is established under a regulatory framework in all the Andean countries, except for Argentina, where this program does not exist. Participants receive remuneration (except in Bolivia, where students perform the service). The allocation systems used for these programs are heterogeneous, and in some Andean countries, the allocation is merit-based. Participation in social programs influences later professional opportunities (Ecuador, Colombia, and Venezuela) and the ability to specialize (Chile and Peru). CONCLUSIONS: It is necessary to study the impact of these programs on the professional development of the participants to design and implement quality improvement strategies tailored to each context.

O psicólogo no acompanhamento de adolescentes que cumprem medidas socioeducativas: seria possível uma escuta analítica? / The psychologist following adolescents in their compliance of socio-educational measures: would analytical listening be possible?

O objetivo deste artigo é discutir sobre o trabalho do psicólogo no campo das Medidas Socioeducativas (MSE), especificamente no da Liberdade Assistida (LA). Por meio de uma discussão teórica acerca de conceitos psicanalíticos ‒ como o desamparo ‒, é possível pensar nas atitudes antissociais e na delinquência como manifestações da angústia na adolescência. De acordo com o pressuposto de Laurent (2007), a implicação do sujeito com o seu sintoma e a abordagem do vínculo formado entre psicólogo e adolescente se efetivam como auxílio para mudanças subjetivas na vida do jovem, pensando-se nos impasses que o interpelam, sem recorrer aos caminhos da violência. Considera-se que a LA possa constituir-se como um espaço de estímulo ao protagonismo do jovem e como um meio de o profissional da assistência social conhecer o adolescente e a sua realidade, contribuindo para a ruptura de preconceitos. Além disso, pode-se pensar em políticas públicas adequadas às necessidades deste público.

The objective of this article is to discuss about the work of the psychologist in the field of Socio-Educational Measures, specifically Probation. Through theoretical discussion on psychoanalytic concepts ‒ such as helplessness ‒, it is possible to think about antisocial attitudes and delinquency as manifestations of anguish in adolescence. According to Laurent's (2007) assumption, the subject's implication with his symptom and the approach of the bond formed between psychologist and adolescent are effective in aiding to subjective changes in the life of the youngster, when considering the impasses that challenge him, without resorting to the ways of violence. It is considered that Probation may become a space for stimulating the young person's protagonism and as a way for the social assistant to get to know the adolescent and his reality, contributing to shatter prejudices. Additionally, it is possible to think of public policies adequate to the needs of this public.

Rechazo de los padres a la vacunación obligatoria en Chile. Desafíos éticos y jurídicos / Parental refusal to mandatory vaccination in Chile. Ethical and legal challenges

Resumen: Este artículo se presenta como una reflexión ética y jurídica acerca de la tendencia actual de los pa dres a rechazar la vacunación de sus hijos en un régimen jurídico que establece la obligatoriedad de determinadas vacunas. Se analizan los principales argumentos que los padres usan para rechazar las vacunaciones obligatorias, y, en concreto: el temor a los efectos negativos que la vacunación pueda provocar en el menor; la violación del "derecho a la autonomía"; las creencias religiosas o pseudo- filosóficas; la resistencia a la intervención del Estado en asuntos personales o familiares. De esto, nace un necesario análisis ético sobre la vacunación infantil. Finalmente, se discute la responsabilidad de los padres y del Estado (autoridad sanitaria) en el cuidado de los menores de edad. La vacunación es un beneficio tanto para el inoculado como para la comunidad, la mejor política preventiva. Al mismo tiempo, se configura como un caso complejo que demanda un debate profundo, cuyo fin debe ser el tránsito desde un aparente conflicto entre los padres y el Estado, a una convergencia por el cuidado de los menores de edad. En otros términos, se recalca el hecho de que los padres, más allá del cum plimiento de un deber normativo heterogéneo, deben actuar motivados por la adhesión voluntaria al bien del hijo y de la comunidad.

Abstract: This article is an ethical and legal reflection about the current trend of parents to refuse vaccination of their children under a legal regime that establishes mandatory use of certain vaccines. We analyze the main arguments used by parents to refuse obligatory vaccination, i.e., the fear of the negative effects that vaccination may have on the child; the violation of the "right to autonomy"; religious or pseudo-philosophical beliefs; and the resistance to the State intervention in personal or family mat ters. Therefore, this statement implies a necessary ethical analysis of childhood vaccination. Finally, it will be discussed the responsibility of parents and the State -the health authority- in the care of mi nors. Vaccination is a benefit for both the inoculated and the community, the best preventive policy. At the same time, it is considered a complex case that demands a profound debate, whose purpose should be the transition from an apparent conflict between parents and the State, to convergence for the care of minors. In other words, it is emphasized the fact that parents, beyond the fulfillment of a heterogeneous normative duty, must act motivated by voluntary adherence to the best interest of the child and the community.

Declaración del Comité Consultivo de Inmunizaciones de Sociedad Chilena de Infectología en relación a los cuestionamientos de las vacunas y su obligatoriedad / Statement from the Immunization Committee of the Chilean Infectious Diseases Society in reference to vaccine refusal and mandatory policy on vaccination

Resumen A pesar del enorme impacto de las vacunas en la salud de la población, éstas han sido y son objeto de cuestionamientos por grupos que las consideran innecesarias o inseguras y argumentan que las personas tienen el derecho a decidir sobre si éstas deben ser administradas o no. Sin embargo, el uso de vacunas tiene connotaciones distintas a otras decisiones en salud, ya que no vacunar impacta no sólo al individuo, sino también a la comunidad que lo rodea. El inmunizar a un alto porcentaje de la población permite limitar la circulación de los agentes infecciosos, logrando la llamada inmunidad comunitaria que protege a los no vacunados por razones médicas o porque son muy pequeños. Por esta razón muchos países han definido las vacunas como obligatorias. Como Comité Consultivo de Inmunizaciones nos parece que esta estrategia es correcta; sin embargo, debe ser acompañada por una política de educación de la población y personal de salud sobre los beneficios y riesgos reales de las vacunas. Así mismo es necesario introducir mejoras en el sistema de notificación de reacciones adversas a vacunas haciéndolo más accesible. Adicionalmente, se debe dar respuesta oportuna a los afectados por supuestas o reales reacciones a vacunas, y en los casos de eventos adversos graves efectivamente asociados a vacunas. entregar cobertura económica y acompañamiento. Finalmente, es esencial la coordinación entre los diferentes actores y comunicadores para transmitir mensajes que generen confianza y respondan a las inquietudes de la población de hoy en día.

Although vaccines have had a tremendous impact in public health they are questioned by certain groups that consider them unnecessary or unsafe and argue in favor of the right to decide to be vaccinated or not. However vaccines must have special considerations because unlike other medical decisions, not vaccinating has consequences not only for the individual but also for other members of the community. Immunizing a high proportion of the population limits the circulation of an infectious agent attaining what is called herd immunity that protects the susceptible members of the group. For this reason many countries consider vaccination mandatory as a responsibility of every citizen. This committee agrees with this view but thinks other strategies should be implemented as well, such as special educational efforts for the public and parents addressing benefits and real risks of vaccinating. Also health care professionals should be trained in vaccines. The notification system for adverse events currently available should be improved and be more accessible. Persons truly affected by adverse events due to vaccination should receive on time responses and be offered psychological and financial support. Finally all stakeholders should make coordinated efforts to work together to deliver messages that answer concerns on vaccines and bring confidence back to the public.

Ingestão de folato nos períodos pré e pós-fortificação mandatória: estudo de base populacional em São Paulo, Brasil / Folic acid intake before and after mandatory fortification: a population-based study in São Paulo, Brazil / Ingesta de folatos en la prefortificación o posfortificación: estudio de base poblacional en São Paulo, Brasil

Analisou-se a ingestão de folato nos períodos pré e pós-fortificação. Os dados dietéticos foram coletados por recordatório de 24 horas (R24h) no Inquérito de Saúde de São Paulo (ISA-Capital) em 2003 e 2007/2008, estratificando-se a população segundo fase da vida e sexo. Utilizaram-se os valores de recomendação: necessidade média estimada (EAR) e nível máximo de ingestão tolerada (UL) e o método "EAR como ponto de corte" para estimar a inadequação da ingestão. Houve redução na prevalência de inadequação da ingestão de folato em todos os estratos, com destaque para os adolescentes e adultos do sexo masculino, de 72% para < 1% e de 76% para 6%, mas nas mulheres adultas a inadequação permaneceu elevada (38%). Antes da fortificação, o feijão foi o alimento que mais contribuiu para a ingestão de folato; após, o maior contribuinte passou a ser o pão, porém o feijão permaneceu importante. A fortificação foi bem-sucedida (aumentou a ingestão dentro de níveis seguros), porém, gera preocupação a elevada proporção no grupo alvo, mulheres adultas, que não atingem a recomendação para ingestão de folato.

This study analyzed folic acid intake before and since mandatory fortification. Dietary data were collected by 24-hour recall in a health survey in São Paulo (ISA-Capital) in 2003 and 2007-2008, stratifying the population according to life stage and gender. Estimated average requirement (EAR) and tolerable upper intake level (UL) were used to assess intake. Prevalence of inadequate folic acid intake decreased in all groups, especially adolescents and adult males (72% to < 1% and 76% to 6%, respectively) but remained high in adult women (38%). Beans were the main source of folic acid before fortification. With fortification, bread became the main source, but beans remained important. Fortification was successful (increased intake within safe levels), but it raised concerns about the high proportion in the target group (adult women) who still fail to meet the recommended intake.

Se analizó la ingesta de folato en los periodos de pre- y posfortificación. Los datos dietéticos se recogieron mediante un recordatorio de 24 horas en la Encuesta de Salud de São Paulo (ISA-Capital) en 2003 y 2007/2008, estratificando la población según etapa de la vida y sexo. Se utilizaron los valores de recomendación: necesidad media estimada (EAR) y la ingesta máxima tolerable (UL) y el método "EAR como punto de corte" para estimar la ingesta inadecuada. Se observó una reducción en la prevalencia de ingesta inadecuada de folato en todos los grupos, especialmente en los adolescentes y adultos varones, de un 72% a < 1% y de un 76% a un 6%, no obstante, en las mujeres adultas, la inadecuación seguía siendo alta (38%). Antes de la fortificación, los frijoles son el alimento que más contribuye a la ingesta de folato, después es el pan el que también constituye una fuente de folato, pese a que los frijoles siguen siendo los más importantes. La fortificación fue exitosa (aumento de la ingesta dentro de niveles seguros), sin embargo, se plantea una preocupación por el alto porcentaje del grupo objetivo: mujeres adultas que no cumplen con la recomendación para la ingesta de ácido fólico.

Programa Intergral para el Control del Cáncer en Cuba: Cuidados del paciente al final de la vida / Integral Program for Cancer Control in Cuba: Patient Care at the end of life

Este libro se ha editado con el objetivo de desarrollar el componente estratégico de los cuidados al final de la vida desde la atención primaria de salud. Esperamos que junto a otros que forman parte del paquete educativo EDUCANCER, facilite a los directivos y técnicos, organizar un sistema de acciones que permita formar y optimizar recursos materiales, humanos y financieros, para mejorar los cuidados integrales de los pacientes al final de la vida...

La escuela media bajo el mandato de la obligatoriedad / Compulsory high school

El artículo se propone analizar cómo el mandato de la obligatoriedad escolar de la escuela media fijada por la actual ley educativa argentina pone en cuestión su histórico patrón de normalidad escolar atravesado por criterios de selección expulsiva. Para ello se abordará en primer lugar la reconstrucción de la matriz de origen de la escuela media para observar cómo se constituyó y bajo qué características dicho patrón. En segundo lugar, que estrategias políticas e institucionales se despliegan a nivel macro y micropolítico con el objetivo de introducir criterios más inclusivos, más excluyentes o una paradójica combinación de ambos. En este abordaje se encuentran presentes las oscilaciones constitutivas entre esa escuela preparatoria para el ingreso a la universidad o formadora para la inserción inmediata al mercado de trabajo. Dilema que abre el interrogante de ¿Incluir para qué? En otros términos, si incluir manteniendo esta dicotomía o si es posible pensar un modelo de escuela que prepare a la vez para ambas funciones, respetando la diversidad de los docentes, alumnos y sus familias que heterogeneizan y multiplican los sentidos de lo escolar.

Vaccine refusal; an obstacle to a polio-free world

To evaluate the pattern and reasons of reluctance/ refusal to polio vaccination with an aim to gain insights and learn lessons during Polio campaign. Setting: Polio campaign days during 2009 in Muzaffar Garah district between January to April 2009. Cross sectional survey. Survey done during intensive polio days during the three campaigns this year by detailed interview with parents, senior members of the family regarding reluctance to administer oral polio drops in the Muzaffar Garah district. Reasons and frequency of reluctance were documented. After counseling the WHO team managed to convince part of the reluctant population. The data was once again collected from the unconvinced population of parents who declined till the end. During the survey there were 404 reluctant parents.236 [58%] of these were convinced and the remaining stayed unvaccinated despite counseling. Amongst the group that showed initial reluctance. 132 [32.5%] refused to cooperate due to religious misconceptions. Of the confirmed deniers 116 [69%] belonged to a conservative religious group The most easy to convince group was the group demanding monitory benefits for cooperating in Polio campaign 13 [7%]. People refuse Polio vaccination due to misinformation /misconception especially on religious grounds. The die hard refusals were mostly linked to religious reasons. Education of religious leaders is the way forward to drive Polio to extinction

Human papilloma virus vaccination: should it be mandatory?

Cervical cancer is the second most common malignancy and a leading killer among women worldwide. Seventy percent of these cervical cancers are known to be caused by Human Papilloma Virus, which is transmitted primarily by sexual contact. The use of Human Papilloma Virus prophylactic vaccine among young adolescents, who have not been previously exposed to the infection, as primary prevention holds most promise for the prevention of this cervical cancer. Each year 80% of the 274,000 deaths caused by cervical cancer occur in developing nations like Nepal. Largest promise of this vaccine is in such countries where screening program is difficult to implement and maintain. However this also raises concerns and debates about the enduring effectiveness and the long term side effects of the vaccine, which are yet unknown. Garnering public trust and public acceptance is key to the success of any public health intervention. More research on the long term safety and efficacy on Human Papilloma Virus vaccine and dissemination of these findings is recommended to increase the acceptance of the program before making it a state mandate.

Bioethical considerations in neonatal screening: Japanese experiences.

Since 1979, at least 13,000 affected babies have been identified with one of the tested diseases. The outcome for patients is generally favorable if adequate treatment is given. Recently, ethical issues have arisen concerning whether or not written informed consent should be required, under what conditions the residual blood spot may be used for research purposes other than that originally designed, and whether or not the test is cost-effective. Mandatory screening seems acceptable under certain conditions, but parental education and opportunity for refusal should be part of the system. Refusal should be documented only after an attempt has been made to persuade parents to consent. Informed consent is necessary if there is uncertainty about the test's benefit to the child. Parents should be informed of the potential research value of the samples and assured that research results will not be linked to any particular/individual newborn. If identified or coded blood spots are used for research, IRB review and approval by IRB must occur. The net health care benefit from screening for six disorders in Japan was 0.25 billion yen ($2.2 million) per 100,000 screened newborns compared to $3.2 million for PKU and CH in the US for 100,000 screened newborns.

Evaluation of the concomitant use of two different EIA tests for HIV screening in blood banks

OBJECTIVE: In 1998, the Brazilian Ministry of Health made it mandatory for all blood banks in the country to screen donated blood for human immunodeficiency virus (HIV) concomitantly using two different enzyme immunoassay (EIA) tests. Concerned with the best use of available resources, our objective with this study was to evaluate the usefulness of conducting two EIA screening tests instead of just one. METHODS: We analyzed data from 1999 through 2001 obtained by testing 698 191 units of donated blood using two EIA HIV screening tests concomitantly at the Pro-Blood Foundation/Blood Center of Säo Paulo (Fundaçäo Pró-Sangue/Hemocentro de Säo Paulo), which is a major blood center in the city of Säo Paulo, Brazil. All samples reactive in at least one of the two EIA tests were submitted for confirmation by a Western blot (WB) test, and the persons who had donated those samples were also asked to return and provide a follow-up sample. RESULTS: Out of the 698 191 blood units that were donated, 2 718 of them (0.4 percent) had to be discarded because they were reactive to at least one of the EIA tests. There were two WB-positive donation samples that were reactive in only one HIV EIA screening test. On their follow-up samples, both donors tested WB-negative. These cases were considered false positive results at screening. Of the 2 718 donors who were asked to return and provide a follow-up sample, 1 576 of them (58 percent) did so. From these 1 576 persons, we found that there were two individuals who had been reactive to only one of the two EIA screening tests and who had also been negative on the WB at screening but who were fully seroconverted on the follow-up sample. We thus estimated that, in comparison to the use of a single EIA screening test, the use of two EIA screening tests would detect only one extra sample out of 410 700 units of blood. CONCLUSIONS: Our data do not support the use of two different, concomitant EIA screening tests for HIV. The great majority of HIV-positive donors have already seroconverted and will be detected using only a single EIA screening test. Only persons who are going through the process of seroconversion may be missed by using a single EIA test and detected using two EIAs for screening. To screen out these individuals and decrease the residual risk of HIV transmission from the blood donated in our center, the use of other techniques, such as nucleic acid testing (NAT) or a p24 antigen assay, would be more effective