Loading
Buscar en Drogas México

   

Consolidated guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations :: Drogas México
trisección

Salud

Ilustración Farmacológica Vol.1 No. 1
Consolidated guidelines on HIV Prevention, Diagnosis, Treatment and Ca
Reflexiones Críticas sobre la Encuesta Nacional de Adicciones (ENAs) en Mé


Directrices para prevención, diagnóstico, tratamiento y cuidado de VIH en poblaciones clave Capítulo 5: Critical Enablers (facultadores críticos) 5.1 Law and policy (ley y políticas) pág. 90 5.1.1 Legal barriers (barreras legales) pág. 90 5.1.2 Critical enablers (facultadores críticos) pág. 90 5.2...
JUL
11
2 0 1 4

0 comentarios


Consolidated guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations

Organización Mundial de la Salud OMS

Viernes 11 de julio de 2014 (31/07/14)
Organización Mundial de la Salud OMS ver en apps.who.int

Directrices para prevención, diagnóstico, tratamiento y cuidado de VIH en poblaciones clave



Capítulo 5: Critical Enablers (facultadores críticos)
5.1 Law and policy (ley y políticas) pág. 90
5.1.1 Legal barriers (barreras legales) pág. 90
5.1.2 Critical enablers (facultadores críticos) pág. 90
5.2 Stigma and discrimination 96
5.2.1 Barriers 96
5.2.2 Critical enablers 96
5.3 Community empowerment 100
5.3.1 Barriers 100
5.3.2 Critical enablers 100
5.4 Violence 105
5.4.1 Barriers 105
5.4.2 Critical enablers 105



HIV epidemics, particularly among key populations, continue to be fuelled by stigma anddiscrimination, gender inequality, violence, lack of community empowerment, violationsof human rights, and laws and policies criminalizing drug use and diverse forms ofgender identity and sexuality. These socio-structural factors limit access to HIV services,constrain how these services are delivered and diminish their effectiveness.

Thus, it is important to understand the varied political, geographic and social contextsin which key populations live and where HIV services for them are delivered. It alsoneeds to be recognized that each key population group is heterogeneous, and effectiveprogrammes must account for this diversity.

Despite the challenges of marginalization, criminalization of the behaviour of certainkey populations and in some settings direct human rights abuses, it remains necessaryand feasible to deliver HIV-related services and to do so in ways that protect thesafety and well-being of people from key populations and of service providers. Health-care providers have an ethical obligation to care for and treat people impartially andequitably. Programmes and countries can ensure confidentiality of services, facilitateaccess by people from key populations to mainstream health services, improve quality,train and sensitize health-care providers, and reduce stigma and discrimination. Assafety allows, people from key populations should be encouraged and supported toparticipate in designing and delivering HIV prevention and response efforts. Despitelegislative restrictions people from key populations in most countries persevere, stillfinding ways of acting in association to provide support, and they may also be reachedonline and through regional networks.

Integrating HIV and related health services into primary health care can contribute toincreased and more equitable access to HIV services for key populations. To increase theeffectiveness of HIV services in primary health care, health-care providers will benefitfrom understanding gender identity and the diversity of sexual behaviours and identities,as well as drug use and dependence, and how to address these when providing services.

The health sector can take action to change the attitudes and behaviours of health-careproviders to reduce stigma and discrimination, particularly that relating to homophobia,transphobia, sex work and drug use. Health-care workers should be given the necessaryresources, training and support to provide services to key populations. At the sametime, health-care providers should be held accountable when they fail to meet standardsbased on professional ethics and internationally agreed human rights principles(1).

Monitoring and evaluation is important to ensure not only technical quality and impactof services but also the spirit in which they are provided and, thus, their acceptability topeople from key populations.

“Critical enablers”, as used in this document, means strategies, activities andapproaches that aim to improve the accessibility, acceptability, uptake, equitablecoverage, quality, effectiveness and efficiency of HIV interventions and services.Enablers operate at many levels – individual, community, institutional, societaland national, regional and global. They are crucial to implementing comprehensiveHIV programmes for key populations in all epidemic contexts. Critical enablersaim to overcome major barriers to service uptake, including social exclusion andmarginalization, criminalization, stigma and inequity. If left unaddressed, such barrierswill undermine the provision of HIV services, especially for key populations (2).

The barriers and critical enablers outlined in this chapter apply to both adults andadolescents in key populations. For adolescents from key populations, these factors maybe further exacerbated by their rapid physical and mental development and complexpsychosocial and socioeconomic vulnerabilities. Also, adolescents from key populationsexperience socio-structural barriers to services, notably policy and legal barriers related toage of consent. Those close to people from key populations, including partners and children,also can experience stigma and discrimination and so face the same difficulties in access toservices. Thus, including dependents in the provision of HIV services can be important.The health sector has an important role to play, but successful implementation of criticalenablers requires collaboration across different sectors, such as health, justice, housing,welfare and labour. It also requires multiple partners from government, civil society and the private sector. Full involvement of key populations and people living with HIV also is crucial(3, 4).

This chapter outlines a range of barriers that compromise access to appropriateand good-quality HIV services for key populations, identifies critical enablers toovercome these barriers (as illustrated in Fig. 5.1) and makes a number of good-practice recommendations. These good practice recommendations are based on earlierWHO documents addressing key populations. While these barriers and enablers areinterrelated, we attempt to discuss each individually.

fig. 5.1

critical enablers for key populations

1. Reviewing laws, policies and practices (includes decriminalization & age of consent)
2. Reducing stigma and discrimination
4. Preventing violence
3. Empowering the community

Successful implementation of critical enablers requires collaboration across different sectors.

ver en apps.who.int


estás viendo:
Consolidated guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations
volver arriba
DOCUMENTACIÓN ONU


comentarios
Entrar para agregar comentario:
entrar


DrogasMexico.org es un proyecto de Convivencia y Espacio Público AC y el Colectivo por una Política Integral hacia las Drogas AC.
Agradecemos el apoyo de Open Society Foundation, Angelica Foundation y Tides Foundation