Dimensión social del VIH y respuesta estatal / Social dimensión of HIV and state response

La infección por VIH está fuertemente condicionada por factores sociales. Dos de los mayores obstáculos a la respuesta a la infección son el estigma y la discriminación que todavía se asocian con ella. El proceso de estigmatización se produce a través de conductores individuales y facilitadores estructurales que se entrelazan con estigmas superpuestos. El estigma tiene diversas manifestaciones y produce complejas consecuencias que influyen negativamente en la prevención, diagnóstico, tratamiento y calidad de vida. Este artículo revisa estos aspectos, así como las evidencias de estigma existentes en España. La respuesta frente a la infección por VIH requiere un firme compromiso político. Sin embargo, los avances alcanzados en España se han ralentizado a causa de la crisis económica y la falta de liderazgo de las instituciones. Para alcanzar los objetivos internacionales, es necesario colocar al VIH en primera línea de la agenda política

HIV infection is strongly conditioned by social factors. Two of the most significant obstacles in the response to HIV is the stigma and the discrimination that is still associated with it. The stigmatization process occurs through individual drivers and structural facilitators that interweave with overlapping stigmas. These stig-mas manifest in several forms and lead to complex consequences that negatively influence prevention, diagnosis, treatment and quality of life. This article reviews these issues and the evidence of stigma in Spain. The response to HIV requires a strong political commitment. However, the economic crisis and the lack of leadership from institutions have slowed down the progress achieved in Spain. HIV must be placed at the forefront of the political agenda in order to achieve international goals

Prevención primaria / Primary prevention

La infección por VIH no está controlada en España. Se requieren nuevas estrategias para prevenir la transmisión, especialmente en los colectivos en que tiene mayor incidencia, mediante intervenciones combinadas. El diagnóstico precoz de la infección y el inicio de tratamiento es la estrategia más eficiente, que deben estar acompañados por intervenciones que promuevan cambios de conductas. Este tipo de campañas no solo se deben dirigir a la población general, sino que también es necesario llegar a grupos poblacionales clave de forma más específica. Las intervenciones biomédicas, como la profilaxis preexposición, utilizan una combinación de medios para reducir el riesgo de adquirir el VIH y suelen estar acompañadas por intervenciones conductuales. La influencia de factores estructurales y de justicia social, y la defensa de los derechos de las personas con VIH tienen importantes repercusiones en las estrategias de prevención. Las intervenciones estructurales tratan de incidir en estos factores y reducir la vulnerabilidad a la infección por VIH

HIV infection is still not controlled in Spain. New HIV infection prevention strategies are required, especially in populations of higher incidence, by means of combined interventions. Early diagnosis and treatment of HIV-infected individuals is the most cost-effective strategy to control the epidemic, including interventions designed to motivate behavioural changes. These types of campaigns must not only be directed to the general population through mass channels, but also to key populations through more specific channels and messages. Biomedical interventions like pre-exposure prophylaxis, uses a combination of biomedical tools to reduce the risk of HIV acquisition, and are usually accompanied of behavioural interventions. The influence of structural factors, social justice and defending the rights of people living with HIV have a significant impact on prevention strategies. Structural interventions are designed to influence these factors that make some individuals or populations more vulnerable to HIV infection

Social dimensión of HIV and state response. / Dimensión social del VIH y respuesta estatal.

HIV infection is strongly conditioned by social factors. Two of the most significant obstacles in the response to HIV is the stigma and the discrimination that is still associated with it. The stigmatization process occurs through individual drivers and structural facilitators that interweave with overlapping stigmas. These stig-mas manifest in several forms and lead to complex consequences that negatively influence prevention, diagnosis, treatment and quality of life. This article reviews these issues and the evidence of stigma in Spain. The response to HIV requires a strong political commitment. However, the economic crisis and the lack of leadership from institutions have slowed down the progress achieved in Spain. HIV must be placed at the forefront of the political agenda in order to achieve international goals.

Primary prevention. / Prevención primaria.

HIV infection is still not controlled in Spain. New HIV infection prevention strategies are required, especially in populations of higher incidence, by means of combined interventions. Early diagnosis and treatment of HIV-infected individuals is the most cost-effective strategy to control the epidemic, including interventions designed to motivate behavioural changes. These types of campaigns must not only be directed to the general population through mass channels, but also to key populations through more specific channels and messages. Biomedical interventions like pre-exposure prophylaxis, uses a combination of biomedical tools to reduce the risk of HIV acquisition, and are usually accompanied of behavioural interventions. The influence of structural factors, social justice and defending the rights of people living with HIV have a significant impact on prevention strategies. Structural interventions are designed to influence these factors that make some individuals or populations more vulnerable to HIV infection.