Author:
Divino Flavia,Nacher Mathieu,Pereira Rafael dos Santos,Peiter Paulo
Abstract
The HIV care cascade spans from diagnosis to patient linkage and retention in health services for treatment. Brazil has made substantial efforts to optimize the cascade of care. However, despite these advances, there are striking regional differences and difficulties from testing to treatment, particularly in the north and northeast regions, often reflecting social inequalities. Oiapoque, a highly affected city in the state of Amapá, shares its borders with an overseas European territory—French Guiana. The objective of this study was to get a clearer picture of the different components of the HIV care cascade in the municipality of Oiapoque. The study was exploratory and qualitative, involving the mapping of health structures in the research area and interviews with the responsible healthcare professionals working in the municipality. Patients are vulnerable at several levels, including mobility limitations, mismatched information that affects the linkage and retention of treatment, an absence of infectious disease doctors, an absence of user autonomy, missed appointments, dropouts, and abandonment of care. We found that the five recommended steps in the continuum of care for people living with HIV all had weak points or were non-existent or unavailable. These results will be fundamental to rethink the municipality's actions and the strategies of the Unified Health System SUS for the HIV epidemic in these border regions of the Amazon.
Subject
Public Health, Environmental and Occupational Health
Reference17 articles.
1. Ministério da saúde. Prevenção combinada do HIV Secr;Vigilância em Saúde do Ministério da Saúde,2017
2. Date Mismatch at the Wayback Machine. 2015-03-19. Tabela 1.4 - Taxa de fecundidade total, taxa bruta de natalidade, taxa bruta de mortalidade, taxa de mortalidade infantil e esperança de vida ao nascer, por sexo, segundo as Grandes Regiões e Unidades da Federação,2022
3. Ministério da Saúde,2019
4. Oiapoque, aqui começa o Brasil: a fronteira em construção e os desafios do Desenvolvimento Regional / Oiapoque, [the city where it begins Brazil: the frontier in construction and Regional Development's challenges];de Almeida;Redes,2016