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Revelación del estatus de VIH

La revelación de la condición de ser VIH+ es un asunto complejo, delicado y muy personal. Se trata de hablar sobre una enfermedad estigmatizada, transmisible y potencialmente mortal. Las decisiones al respecto no sólo son personales sino que varían según la edad, la situación, el contexto y la pareja, y pueden cambiar durante el transcurso del tiempo y según las experiencias de la persona. Históricamente, los mensajes de salud pública han exhortado la revelación del estatus de VIH a toda pareja sexual y de drogas. En la realidad, algunas personas VIH+ tal vez prefieran no revelar su estatus por varios motivos: temor al rechazo o daño, sentimientos de culpabilidad, el deseo de mantenerlo en secreto, creer que al protegerse durante el acto sexual ya no es necesario revelarla, fatalismo, la percepción de normas comunitarias en contra de la revelación y creer que los otros tienen la responsabilidad de protegerse. Esta hoja se centra en la revelación del estatus de VIH dentro del contexto sexual. Comentar y revelar el estatus de VIH es una vía de doble sentido. Ya sea correcto o no, la mayoría de las personas creen que cuando una persona se sabe VIH+ entonces le incumbe informar a su pareja, y a los consejeros se les anima a ayudarles en este proceso. Además, en algunas áreas las leyes requieren la revelación del estatus de VIH+ antes de iniciar el contacto sexual. Sin embargo, ambos integrantes de la pareja deben compartir la responsabilidad de conocer su propia condición, de revelarla cuando lo estimen importante y de preguntar a su pareja sobre la condición del otro si desean enterarse. La mayoría de las personas VIH+ revelan su estatus a algunas pero no a todas sus parejas, amistades y familiares. Generalmente, entre más tiempo se viva con el VIH, más fácil se hace aceptar y revelar dicha estatus. La revelación del estatus de VIH a parejas sexuales es más común en las relaciones románticas de largo plazo que en las casuales (aventuras de una noche, parejas anónimas, sesiones grupales, etc.). La revelación también varía según la percepción del estatus de VIH de las parejas, el nivel de riesgo de VIH de los actos sexuales, el sentido de responsabilidad de proteger a las parejas (responsabilidad personal vs. compartida) y el consumo de alcohol o drogas.

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Dangerous Inhibitions: How America Is Letting AIDS Become an Epidemic of the Young

This monograph was produced as part of the Marketing HIV Prevention project, a collaborative project between the Center for AIDS Prevention Studies at the University of California, San Francisco (Thomas J. Coates, , Director) and the Harvard AIDS Institute (Richard Marlink, MD, Executive Director). We would like to thank SmithKline Beecham Consumer Health Care, makers of OraSure, for its unrestricted grant in support of the Marketing HIV Prevention project. We would also like to acknowledge the support of the Office of AIDS, National Institute of Mental Health, National Institutes of Health, for its ongoing support of the Center for AIDS Prevention Studies under grant number MH42459. The author would like to thank Thomas Coates and Mario Cooper for their significant contributions to this report. I am also indebted to several colleagues who reviewed earlier drafts of the paper, including: Paula Brewer, James Colgrove, Peggy Dolcini, Kevin Filocamo, Katherine Haynes-Sanstad, Lisa Heft, Susan Kegeles, Clark Moore, Ric Marlink, Maureen Michaels, James Riggs, Mark Steitz, Jeff Stryker, and Steve Wakefield. And thanks to Susan Lausten for the design and layout of this piece.
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Collaborative HIV Prevention Research in Minority Communities

HIV has spread dramatically in minority communities, with African Americans currently being five times as likely as whites to contract HIV, and the disproportion continues to increase. Historically, few minority investigators have been funded by the NIH. Culturally appropriate measurements and methods are needed to successfully involve respondents and accurately measure their beliefs, values, and behaviors. Investigators who are members of minority groups often have more access to the minority community and more credibility within that community. In addition, they may have a greater understanding of the cultural issues that could influence behavior, and they often have language fluency
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Report Back from the MSM IDU Forum

This forum grew out of an interest in having dialogues between researchers, providers and community members (these categories are not mutually exclusive groups). This would serve the dual purpose of giving research legs so that it can inform programs and helping ensure that program and life experience inform research studies. Another factor for calling this meeting was the high prevalence of HIV among men who have sex with men and are also injection drug users (MSM IDUs). In San Francisco, the prevalence of HIV among MSM IDUs is 35%. MSM IDUs make up 9% of the cumulative AIDS cases in California, and 6% of the cumulative AIDS cases in the US. Currently, the San Francisco Community Planning Group has listed MSM IDUs as a top priority for prevention programs and funding. Despite the high prevalence rates and interest in serving this population, there are few services, limited infrastructure and scant research specifically addressing MSM IDUs. Most of the funding is divided between MSM-specific and IDU-specific, as well divided between care and prevention, HIV+ and HIV-. As a result of this first informal meeting, CAPS is providing this Report Back on the forum, and a roster of participants to encourage ongoing discussion and networking among service providers, researchers and others working with MSM IDUs. NOTE: The ground rules of this meeting were that specific comments were not attributed to specific people. This Report is intended to be a summary of the different views and ideas from the forum; not every point made is included. This Report is not a consensus.
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HIV Counseling and Testing Developing Countries

In developing countries where health resources are severely limited, debate continues regarding the relative amount that should be spent on HIV counseling and testing. While HIV counseling and testing has been promoted as effective for prevention, few controlled studies have been conducted.The Voluntary HIV Counseling and Testing Efficacy study was a randomized clinical trial of the effectiveness of HIV counseling and testing for the prevention of new HIV infections. The study was conducted at three sites: Nairobi, Kenya; Dar-Es- Salaam, Tanzania; and Port-of-Spain, Trinidad. (posted 9/98)