Leonardo Arenas, AHF Chile Coordinator on Onusida Report: "In Chile we continue to work with strategies of 15 years ago"

On Monday, it was learned that OnuSida University has declared that Chile is among the 10 countries in the world with the highest magnitude increase, including countries such as Kuwait, Madagascar, Montenegro, Uzbekistan, Kazakhstan, Philippines or Slovakia.

The Institute of Public Health (ISP) has registered 5,206 new cases of HIV among the months of January and September of 2018, which is a 21% increase in the same period in 2017, when 4,304 were recorded. ISP registered 6361 cases of infection. The statistics complete the scenario in order to achieve the goals of the 2030 Agenda for Sustainable Development, which includes among its agreements reaching that day without AIDS. In fact, this Monday, the head of the HIV Department of the Ministry of Health, Ana Maria San Martín, received another criticism of the increase of infections caused by the delay in the implementation of the National Plan for the Prevention of HIV. Founded last May, it has only 254 family health centers – from the existing 500- with fast tests available.

The current situation in Chile is not very encouraging to achieve these goals for 12 years. Concancyerto talked with Leonardo Arias, Coordinator of AHF Chile, To know the keys of the report disseminated by Onusida, in a national and international reading.

1. The figures

According to Arenas, the figures in the report reveal that we already know 75% of people living with HIV worldwide. A fact that is possible to thank the continuous increase of campaigns that call to take the test and the extension of the service of testing, especially the introduction of the rapid tests. "The challenge is to reach the remaining 25%," he says. Following the global numbers, in Chile, the 25% gap at the global level represents some 25,000 people. "We have to increase new infections, get out and find them, and we need targeted interventions, reach key populations that take risk behaviors and where preventive articles do not arrive or do not want to take them," says Arenas. The right thing, he says, would be to reach some 15,000 people to achieve a first pillar of 90%.

Another significant data that the coordinator has shown is the increased number of people with suppressed viral load, that is, those who reduce the chances of transmitting HIV in an unprotected relationship by more than 90%.

Leonardo Arias

2. Expand the test

As far as Chile is concerned, Arias is concerned that access is given to rapid tests or rapid HIV testing for populations that have not yet arrived. "What is fundamental is that a modification to the HIV regulation recently comes out that restricts the use of rapid testing to health professionals," he says. On the other hand, according to him, the UNAIDS report recommends that the test be carried out by trained personnel of affected communities, civil society organizations and health professionals. Arenas receives that recommendation consider the 25,000 people in Chile who live with HIV and do not know it. "The important thing Targeted Strategies for Extension of Testing Led by Civil Society Organizations to Reach Churches Right, That in addition, they feel stigmatized and discriminated against the same health system, "says Arenas, otherwise," a backlash may occur, "he adds. Arenas announces that the modification of the HIV Regulation will appeal to the Constitutional Court.

Arenas exemplifies the possibilities of expanding the application of the test with the Peruvian experience. "Ahh Peru has a barge now in Ikvito, in the jungle, which runs through the different indigenous communities and offers medicines and tests, which is an example of the possibility that the test has to reach places where the established health system does not reach" , He says. "The Minister [de Salud, Emilio Santelices] He missed the way that was proposed at the beginning of his administration: we must expand the placement of the test, "he adds. In the view of the AHF coordinator, the limitation of applying the test only to health professionals has To do with "a certain Guilt Fear of losing control over the" and "limits the possibilities of applying the rapid test." However, for him, The role of civil society organizations is fundamentally because they fit key populations – cheerful world, men who have sex with men or trance women – and also to reduce the time between diagnosis and treatment.

Arenas recalls the initiative to sell the HIV self-test in the subway which was launched last August but had to be withdrawn. "Onusida's report takes the experiences of self-test and is one of the strategies for those who have a risk situation and do not go to the public or private system, and prefer to do it individually." Working in other countries, "Arenas Explained. In your opinion, "In Chile we continue to work with strategies of 15 years ago and in those things we can not match the world we like to compare, which is the most developed world"

3. Reduce time between diagnosis and treatment

Another point that highlights Leonardo Arenas is the need to reduce the time between the person's test and start treatment. According to the figures of AHF Chile, in our country that time is about four months on average in the public system. The organization, through the application of fast testing in open spaces and via Facebook or Web, has come to reduce it to 30 days and Arenas remembers that the Minister of Health, Emilio Santelices wants to reduce it to 20 days. "It should be a cultural change in the health system and adapt the new technologies to be able to advance, But we will be hesitant about what happens in the neighboring countries and not to mention the comparison with Europe, "he says.

4. Gap between diagnosis and care

Leonardo Arenas stressed that positive in Chile, the people in the treatment have high adhesion and high viral mass, but he shows that there is a gap between people diagnosed and those in care, those who are under treatment, and suppressed viral mass. "As new infections increase, we will have to increase the number of people under treatment and this requires a financial increase," he explained. According to Mental figures, in 2017, about 46,000 people were diagnosed, but not notified, which means that "There is a case between people who have gone to the sound system and who have been tested, but have not retired". The coordinator puts on the table the different options that the system has to reverse: call, send an email, or go to the house … "But if the person does not lie, this person is not notified and this is a problem Because the person should know their health situation. "In his view, what to do with" We do not apply the technologies that allow the immediate result. "Why do we applaud the test when we can apply the rapid test and provide the result 30 minutes? "He asks. "It's a waste of time and patients," he replies.

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