Havana: Oxfam Joint Progam in Cuba, 2008. 46 p.
This paper discusses the Cuban approach to HIV, which like the nation's public health system, is founded on the principal that health is a human right. In practice, this translates into a continuum of care through universal access to primary, secondary, and tertiary health services, government commitment to equalizing and improving social determinants, and scientific research and development aimed at advancing population health. Constitutional rights, including job and housing guarantees and anti-discrimination laws, also play a role. Free, equitable access to care, a robust national biotechnology capability, and an educated citizenry with confidence in the public health system have helped contain the epidemic on the island. Other components of the Cuban strategy as it has evolved over time include: sexual education program beginning in grade school for the entire population; a targeted, pro-active prevention program including free and subsidized condom distribution, HIV screening for pregnant women and blood donors, outreach to more vulnerable groups, and confidential hotlines; aggressive and systematic education program about the epidemiological, social, psychological, and biological aspects of HIV and AIDS designed for different populations (women, youth, men who have sex with men, transvestites, prisoners, people engaging in transactional sex, etc); free and anonymous HIV testing for those requesting it; free anti-retroviral treatment for all who need it; government-provided high nutrition diet for people with HIV and AIDS; wide range of counseling services for persons with HIV and those affected by it, including accompaniment, counseling, support, information, and sharing of experiences; national support network for people with HIV or AIDS, their families, friends and co-workers, including dedicated chapters by and for women, transvestites and transsexuals, and men who have sex with men; systematic safe sex education for targeted groups including women, transvestites and transsexuals without regard to sexual orientation, and men who have sex with men; participation of people with HIV or AIDS in program design, implementation, and evaluation including outreach, prevention, counseling, and capacity building; training of human resources in health, including sensitivity and clinical training for doctors, dentists, and other health professionals attending people with HIV; and coordinating work between sectors so that all parts of society are helping forge a response to the epidemic. In short, Cuba's experience has shown that government will combined with an integrated, rights-based approach can positively affect outcomes for preventing HIV and provide a healthy, dignified life for people with HIV or AIDS. That such results are possible in a small, low-income country like Cuba represents a learning opportunity for other nations - particularly in the Global South - seeking to forge relevant strategies to address the HIV/AIDS crisis.
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