Universal Access to HIV prevention, treatment and care: assessing the inclusion of human rights in international and national strategic plans

Abstract

Rhetorical acknowledgment of the value of human rights for the AIDS response continues, yet practical application of human rights principles to national efforts appears to be increasingly deficient. We assess the ways in which international and national strategic plans and other core documents take into account the commitments made by countries to uphold human rights in their efforts towards achieving Universal Access. Key documents from the Joint United Nations Programme on HIV and AIDS (UNAIDS), the World Health Organization (WHO), the World Bank, the Global Fund to Fight AIDS, TB and Malaria (GFATM) and the US President’s Emergency Plan for AIDS Relief (PEPFAR) were reviewed along with 14 national HIV strategic plans chosen for their illustration of the diversity of HIV epidemic patterns, levels of income and geographical location. Whereas human rights concepts overwhelmingly appeared in both international and national strategic documents, their translation into actionable terms or monitoring frameworks was weak, unspecific or absent. Future work should analyse strategic plans, plans of operation, budgets and actual implementation so that full advantage can be taken, not only of the moral and legal value of human rights, but also their instrumental value for achieving Universal Access.

Vulnerability in the context of HIV and syphilis infection in a population of men who have sex with men (MSM) in Salvador, Bahia State, Brazil

“…This reality has been identified in RDS studies with MSM in other countries 29,31 and is a serious factor associated with violence and barriers to health services. The literature also reports stigma and discrimination and their association with risky sexual practices for HIV infection and other STI, especially in stigmatized populations 12,14,38 .…”

“…However, in the context of the HIV/AIDS epidemic, the concept bears a close relationship to human rights, having appeared in the literature since the 1990s 11 . Individual and group vulnerability to HIV/AIDS partly reflects the stigma, prejudice, criminalization, and disrespect for human rights 12,13 , which in many countries hinder progress with policies for prevention and timely access to health services for diagnosis and treatment of HIV and other STI 12,13,14 . In MSM, this reality has been confirmed by various international and national agencies and institutions 4,12,13 .…”

“…That is, the various dimensions of vulnerabilities (social, individual, and programmatic) 10,11,14 converge in sociocultural and political-institutional aspects, individual characteristics, experiences, interactions, subjectivities, and personal histories 15 , as well as the characteristics of the social networks to which these individuals belong 1,16 .…”

Intervenção em adesão baseada na abordagem construcionista do cuidado: perspectiva dos profissionais de saúde

“…Este artigo discutirá uma proposta de intervenção, nomeada de "Abordagem Construcionista do Cuidado em Adesão" (ACCA), fundamentada em outro campo teórico: na noção de "Cuidado" 2 (Ayres, 2001(Ayres, , 2004 e em uma abordagem psicossocial de inspiração construcionista (Paiva, 2012b), ambas desenvolvidas no quadro dos direitos humanos em saúde que tem distinguido a chamada "resposta brasileira à Aids" (Berkman, Garcia, Munoz-Laboy, Paiva, & Parker, 2005;Gruskin & Tarantola, 2008;Kalichman & Diniz, 2009).…”

Psicología en la salud: Sociopsicológica o psicosocial? La innovación en el contexto de la respuesta brasilera al SIDA

“…Es intuitivo reconocer que estas acciones dependen en gran medida de los enfoques psicosociales que, como veremos, se inspiran en la tradición de las humanidades y de las ciencias sociales aplicadas, especialmente con relación a la enfermedad y la sexualidad y a las prácticas de salud basadas en los derechos humanos (Gruskin & Tarantola, 2008Kalichman & Diniz, 2009;Kerrigan et al, 2013;Nunn et al, 2009;Paiva, 2002Paiva, , 2008Paiva, , 2012a. Como es articulado en varios artículos de este suplemento, las prác-ticas psicopedagógico y el asesoramiento en las frentes para el SIDA de la respuesta más efi caces en Brasil aseguran la formación continua de los profesionales de diversos sectores (salud, educación, justicia, asistencia social, en las empresas), invistieron para entender y mitigar el proceso de estigmatización y discriminación, valorando las interacciones entre profesional-paciente y servicio-cliente para apoyar la adherencia a la medicación y el uso de condones, con resultados comparables a los países más ricos del hemisferio norte.…”