VIH-Sida, Inequidades en Salud y COVID-19: Impactos y Desafíos

Abstract

The objective of this research is to review the various impacts of Covid-19 on HIV-AIDS, identifying focal problems, to finally propose what are the challenges to face and what approaches and measures are most relevant from the proposals found in the academic literature. and scientific. The epidemiological data from Colombia were not encouraging prior to the Covid-19 pandemic. As a developing country, its mortality figures present an increase of almost 50%, between 2015 and 2019. It is important that in terms of public health policies, the focus on direct interventions to the Social Determinants of Health (DSS) to counteract socio-sanitary inequities, without losing sight of the double relationship between economic development and health development, or bilateral relationship that accounts for the loop between negative impacts on health and the socioeconomic status of the PLHIV. Among the impacts on health services for PLHIV, the limitation of access, the decrease in guarantees such as testing, the timely start of ART, the stoppage of sexual and reproductive education programs, which are reflected in the increase in the figures of IPHIV, of health complications, of sexual practices without prevention and the interruption of ART. HIV-related stigma, discrimination, criminalization and inequalities remain stark and persistent in times of Covid-19. All of the above, in turn, affects mental health and the prevalence of psychiatric comorbidities in PLHIV, who have a significantly higher prevalence (four times more) than the general population. The magnitude of the impacts of Covid-19 on HIV-AIDS and, in general, on public health systems, demands coordinated regional and global governance, not disjointed and in dispute. The adoption of the syndemic model proposed by Singer, which contemplates the co-presence and articulation of two or more diseases or epidemic outbreaks simultaneously with social, cultural, political and/or economic factors, would be favorable. The contribution of this proposal opens the door to mixed and multidimensional studies that integrate quantitative epidemiology and qualitative data adapted to specific contexts.