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Biography

Bernardino Geraldo Alves Souto was graduated in medicine at Federal University of Juiz de Fora, Minas Gerais, Brazil, in 1987. Received his master's degree in 2002 and Ph.D. in 2006, in Infectious Diseases and Tropical Medicine, at Federal University of Minas Gerais, Brazil. Specialist in Intensive Care Medicine, Clinical Medicine/Internal Medicine and Epidemiology. Professor of the Department of Medicine of the Federal University of São Carlos, São Paulo, Brazil. Practices general integral medicine and is attending physician at Specialized Care Service in STD/HIV/Aids of São Carlos, São Paulo, Brazil. As researcher, mainly investigates the epidemiology of HIV infection, and the psychological and social issues related to people living with this virus.

Abstract

The Brazilian Program for the Control of HIV/Aids is efficient in relation to its epidemiological and logistical purposes, but allows the influence of social inequalities on vulnerability to HIV infection and clinical progression of Aids, faces difficulties to improve the therapeutic adhesion and early diagnosis and does not provides person-centered broadened care. Prioritizes the disease, the specialist care and the epidemiological results through centralized management and standardized actions. Its advantages are the logistical and operational control stringent of the assistance and epidemiological surveillance, and the disadvantages are the low equity and the offer of an authoritative and little humanized individual care. Achieves operational efficiency, but does not cover the subjective and existential aspects of life with HIV, which influence the therapeutic adhesion, the early diagnosis, the general health and the wellbeing of people living with this virus. Regarding therapeutic adhesion and early diagnosis, this limit may compromise the effectiveness and sustainability of the Programme; regarding psychological and social wellbeing of people, may lose the opportunity of to subtract human suffering, of aggregating personal value to the subject and of ensuring access in accurate measure of need. To overcome these limits is proposed that assistance be offered within the hierarchical model how it organizes the Health System in Brazil, which considers the ability of the primary attention of intersectoral conection of the assistance and provision of an expanded and integral care focused on person without losing the advantages of vertical programmatic action.

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