Std/Aidsstd/Aids of Sao Paulo City Health Department February 2002, Brazil
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STD/AIDSSTD/AIDS OF SAO PAULO CITY HEALTH DEPARTMENT FEBRUARY 2002, BRAZIL Quem teve a idéia de cortar o “tempo em fatias, ao que se The priorities in deu o nome de ano, foi 2001 um indivíduo genial. Industrializou a esperança, follow in fazendo-a funcionar no limite da exaustão. Doze meses dão para qualquer ser humano se cansar e entregar os pontos. Aí 2002 entra o milagre da renovação e tudo começa outra vez, com Integration into the Universal Health outro número e outra vontade Care System (SUS) de acreditar que daqui para diante vai ser diferente”. Humanization of services Carlos Drummond de Andrade ” Emphasis on Prevention STD/AIDS OF SAO PAULO CITY HEALTH DEPARTMENT Celso Pacheco Photos: Minute Thought Considerations uring the first year of Marta Su- Such program is undermined by a po- Such view regards the answer to AIDS plicy’s mandate, the work litical proposal that considers the HIV epidemic to rely on an effective public done by the STD/AIDS of Sao and AIDS epidemic one of the main health care system, so as SUS. It is, thus, DPaulo City Health Department problems of public health. Also, it a political proposal that bears in mind concerned the physical remodeling and views people’s dedication and collec- partnership and autonomy, decentrali- the reorganization of health services, tive work force as crucial impetus for zation and partnership as the main an- through new perspectives and attitude. the fight against STDs and HIV/AIDS. swers to life. 1 institucional_eng1.p65 1 28/6/2002, 01:41 AIDS in the City of Sao Paulo It has been rising in the suburbs among heterosexuals, women and injected drug users. ao Paulo scored 46.889 HIV infected infected man and women. Since 1997, this persons, a number accumulated since rate had kept steady in a 2 to 1 status; how- Surveillance 1980, 45.456 of which are adults and ever, in 2001 it became less than that 2 to 1 S 1.433 children. The growth in AIDS basis. Since HIV treatment resources avail- Work rate in the City of Sao Paulo was of able have improved, thank to the anti-AIDS 40.48 notified infections in 100 thousand in- cocktail, a stabilization trend among adults Improving the Epidemic habitants (number of notifications of the in- has been noticed: about four thousand in- Surveillance System is crucial fection in 1998 for the resident population). fections notified per year, consistently con- to a straight prevention plot and According to a ranking of the 96 ad- trolled in 1996, 97, 98 and 99. On the other ministrative districts in Sao Paulo, some in the fight against HIV/AIDS hand, there has been a fall by 30% in the and other STDs deserve special attention among the 10 first number of notifications among children, in districts in numbers of notified infection. spite of the notification of 70 new cases of In 2001 Health Surveillance Centers República, Santa Cecília and Bela Vista (in Mother to Child HIV transmission per year. were organized and technicians were the downtown area), Jabaquara and Sapo- Concerning exposition, the last five trained according to the Health Ministry pemba (in the Southeast area), Brasilândia, years have shown a predominance of policies. HIV and STD surveillance has Cachoeirinha, Santana and Freguesia do Ó heterosexuals (34.6%), men who have been reinforced through the standardiza- (in the northern area), Pirituba (in the West- sexual intercourse with other men tion of procedures and because of detailed ern area) and Campo Limpo (in the South- (23.6%), and injected drug users (14%). data scheming on STD/AIDS services. ern area). Such ranking reveals a change in There has been an “aging” in the aver- Among the health care staff, a sur- the profile of HIV infection in the city, age age of new AIDS patients in the last veillance of accidents during work which has been moving towards the sub- 5 years. Among men, the average 25-29 hours when handling biological mate- urbs because of epidemic trends among year old group shifted to a 30-39 age rial was accomplished last year. More- injected drug users and heterosexuals. group. Among women, this shift was over, the control of mother to child HIV from a 25-29 age group up to a 25-34 transmission has been improved, which What really changes age group. Finally, after a dramatic fall agrees that a child aged less than 18 by 52% at the introduction of the cock- months born to an HIV-infected moth- Among adults, there has been a signifi- tail, the rate of AIDS was estabilized at er will be categorized for surveillance cant decrease concerning the rate of HIV 1.400 deads per year in the last 3 years. purposes as not infected with HIV. The surveillance group is preparing an epi- demiological bulletin for April 2002. Highlighted practice The work in STD/AIDS in the city should consider service based researches ork in STD/AIDS means to tion of a Committee Human Research. produce scientifically, to turn The participation of the profession- public the result of this produc- als of STD/AIDS of the city of Sao Pau- W tion and to act according to this lo in congresses and seminars were also produced scientific knowledge. It is what an accomplished objective. For example, technicians of the several municipal units in the IV Brazilian Congress of Preven- are trying to do everyday. Last year, a first tion of STD/AIDS, accomplished in Sep- team participated in a course of Basic tember of 2001 in Cuiabá, it was present- Research skills on AIDS in the School of ed 15 papers, which published their stud- Public Health of USP, systematizing its ies and a latter on summary of the de- practice in projects. At the same time, all bates to the whole team of STD/AIDS, of the studies that are being developed in in the seminar “Heats of Cuiabá”. STD/ the municipal services were gathered in a AIDS City of Sao Paulo was also present publication, the Inventory of Researches in several national and international sem- and Studies in STD and AIDS. STD/AIDS inars on Harm Reduction. To the XIV In- of Sao Paulo City Health Department also ternational Conference on AIDS, AIDS contributes with the Cogest (Coordination 2002, that will take place in Barcelona, The projects developed in the Course of of Decentralized Administration of the Methodology of Research are also part of the about 40 papers of the several areas were General Health Office), in the constitu- Inventory of Researches and Studies in DST/AIDS submitted. 2 institucional_eng1.p65 2 28/6/2002, 01:41 Perus STD/AIDS Anhanguera Tremembé Jaraguá Brasilândia of Sao Paulo City Health Department Cacho- eirinha Jaçanã Mandaqui Tucuruvi Pirituba Jardim Helena Freguesia Vila Medeiros Ermelino The STD/AIDS section has do Ó Matarazzo São São Casa Cangaíba Miguel Limão Santana Vila Domingos Verde Vila Itaim Paulista Vila Jacuí Curuça Vila Amália Ponte Rasa been remodeled in order to Jaguara Guilherme Lapa Barra Penha Vila Bom Funda Pan Leopoldina Retiro Santa follow the integration of the Tatuapé Itaquera Lajeado Cecília Belém Vila Matilde Artur Perdizes Repú- Brás Alvim Jaguaré Alto de blica Pinheiros Carrão Consolação Guaianazes city health care services Moóca Bela Cam- Cidade Líder Vista José Jardim Liber- buci Água Vila Bonifácio Butantã Pinheiros Paulista dade Rasa Formosa Aricanduva Rio Pequeno Parque do into the Universal Health Carmo Cidade Vila São Tiradentes Raposo Mariana Ipiranga Vila Lucas Care System (Sistema Tavares Morumbi Prudente Vila Sônia Itaim Moema Sapopemba São Mateus Bibi Iguatemi Saúde Único de Saúde – SUS) Vila Campo Sacomã São Rafael Andrade Belo Cursino Campo he improvement in HIV-infected and Limpo Santo Amaro Jabaquara STD patients’ life standards and the Capão Jardim prevention from HIV transmission Redondo São Luiz Campo Grande Cidade Ademar have been the main goals in the remod- Socorro Teling of health care services. This specialized Pedreira network of services provides full health assis- Jardim Ângela Cidade Dutra tance, and aims at the upgrading of city labo- ratories for diagnosis and at a complete super- vision of HIV/AIDS and other SDT infections. In 2001, an emergency call for medical staff enlarged the number of nurses and infec- Grajaú tious desease doctors, who have been official- Prevention and Aid Center on STD/AIDS ly hired in 2002. Moreover, an agreement be- Parelheiros tween the City of Sao Paulo STD/AIDS has CTA – Testing and Counseling Center on STD/AIDS granted supervision and monitoring services by members of the staff of the University of Medical Specialities Outpatient service Campinas (UNICAMP) in order to assist the SAE – Specialized Assistance Service on STD/AIDShealth service reorganization process. Nowadays, the 19 public services special- CR – Reference Center on STD/AIDS ized in STDs are distributed into four CTAs - Testing and Counseling Centers (Centros de Testagem e Aconselhamento), nine SAEs – Marsilac Specialized Assistance Service (Serviços de Assistência Especializada), three CRs – Ref- erence Centers (Centros de Referência), one CPA – Prevention and Aid Center, and two AEs – Medical Specialities Outpatient Service (Ambulatórios de Especialidades). Service Structure CTA – Testing and CR – Reference Center AE – Medical Specialities Counseling Center Center of prevention and aid supporting Outpatient Service Guidance, counseling, and HIV-testing STD/AIDS services. It carries out diagnosis, It assists various patients with different and will be furnished with a bigger and more center, specialized in the prevention and diseases, including STD and HIV- infected detection of sexually transmitted infections. complex lab, which will allow emergency patients. and HIV testing. SAE – Specialized CPA – Prevention and Aid Center All the STD/AIDS public Assistance Service It carries out prevention, testing and services distribute male and female condoms This center carries out prevention and counseling procedures.