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Optimización de la atención del VIH y la prestación de servicios: hacer más con menos
1The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia. mboyd@kirby.unsw.edu.au
Lancet (London, England)
|July 26, 2012
Resumen
Los esfuerzos mundiales para proporcionar acceso universal a la atención del VIH/SIDA se enfrentan a desafíos. Esta revisión examina la optimización de la entrega del tratamiento del VIH en los países de bajos ingresos para cumplir con los objetivos globales.
Área de la Ciencia:
- Salud Global La salud global.
- Enfermedades infecciosas Enfermedades infecciosas.
- Política de salud pública Política de salud pública.
Sus antecedentes:
- El acceso universal a la atención del VIH y la terapia antirretroviral (TAR) ha sido testigo de una colaboración internacional sin precedentes.
- La recesión económica mundial y el cambio en las prioridades de los donantes amenazan el objetivo de las Naciones Unidas para 2015 de que 15 millones de personas reciban tratamiento contra el VIH/SIDA.
- La evidencia muestra que el tratamiento contra el VIH reduce la infecciosidad, lo que refuerza la lógica de un acceso generalizado.
Objetivo del estudio:
- Revisar críticamente los éxitos y desafíos de las iniciativas globales de atención del VIH.
- Examinar estrategias para optimizar la prestación de atención del VIH y el tratamiento antirretroviral en países de ingresos bajos y medios (PIBM).
Principales métodos:
- Revisión crítica de la literatura existente y los datos del programa sobre la prestación de atención al VIH.
- Análisis de cuatro áreas clave: estrategia de tratamiento, dosificación de fármacos, monitoreo y prestación de servicios.
- Centrarse en la implementación en entornos de recursos limitados.
Principales resultados:
- Si bien se han logrado avances significativos, lograr el acceso universal para 2015 se ve amenazado por las prioridades financieras y de salud en competencia.
- Los esfuerzos de optimización en los LMIC son cruciales para la atención sostenible y efectiva del VIH.
- Las áreas clave para mejorar incluyen estrategias de tratamiento, dosificación de medicamentos, monitoreo de pacientes y modelos generales de prestación de servicios.
Conclusiones:
- Sostener y optimizar la prestación de atención del VIH en los LMIC es fundamental para cumplir con los objetivos globales de tratamiento.
- Abordar los desafíos en la estrategia de tratamiento, la dosificación, el monitoreo y la prestación de servicios es esencial para el progreso continuo en la lucha contra la epidemia de VIH / SIDA.
- La colaboración internacional debe adaptarse a los actuales desafíos de salud mundial para garantizar el acceso continuo a la terapia antirretroviral que salva vidas.
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