RESUMO
The outlook for elimination of the scourge of cervical cancer is bright, because we now have the tools to achieve this goal. In recent years human papillomavirus (HPV) vaccination in high-income countries has resulted in dramatic decreases in HPV infection and associated cervical disease. If all countries with a substantial burden of disease introduce the vaccine nationally, we can protect the vast majority of women and girls most at risk. For women who are beyond the vaccination target age, progress has been made in screening and treatment for cervical precancer, but we must accelerate this momentum to reduce incidence and mortality worldwide to the very low rates found in wealthier countries. Human and financial resources must be increased and directed to programs that follow best practices and reach all women, including the marginalized or disadvantaged. Seven key actions are recommended. Now is the time for action at national, regional, and global levels.
Assuntos
Vacinação em Massa , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/provisão & distribuição , Neoplasias do Colo do Útero/prevenção & controle , Feminino , Saúde Global , Implementação de Plano de Saúde , Humanos , Saúde da MulherAssuntos
Erradicação de Doenças , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Sífilis/transmissão , Fármacos Anti-HIV/uso terapêutico , Feminino , Infecções por HIV/prevenção & controle , Humanos , Gravidez , Cuidado Pré-Natal , Sífilis/prevenção & controle , Tailândia , Zidovudina/uso terapêuticoAssuntos
Democracia , Saúde Global , França , Política de Saúde , Direitos Humanos , Humanos , Cobertura Universal do Seguro de SaúdeAssuntos
Síndrome da Imunodeficiência Adquirida/prevenção & controle , Saúde Global , Síndrome da Imunodeficiência Adquirida/economia , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/transmissão , Pesquisa Biomédica/métodos , Epidemias , Medicina Baseada em Evidências/métodos , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Participação do PacienteRESUMO
The women, men, and transgender people who sell sex globally have disproportionate risks and burdens of HIV in countries of low, middle, and high income, and in concentrated and generalised epidemic contexts. The greatest HIV burdens continue to be in African female sex workers. Worldwide, sex workers still face reduced access to needed HIV prevention, treatment, and care services. Legal environments, policies, police practices, absence of funding for research and HIV programmes, human rights violations, and stigma and discrimination continue to challenge sex workers' abilities to protect themselves, their families, and their sexual partners from HIV. These realities must change to realise the benefits of advances in HIV prevention and treatment and to achieve global control of the HIV pandemic. Effective combination prevention and treatment approaches are feasible, can be tailored for cultural competence, can be cost-saving, and can help to address the unmet needs of sex workers and their communities in ways that uphold their human rights. To address HIV in sex workers will need sustained community engagement and empowerment, continued research, political will, structural and policy reform, and innovative programmes. But such actions can and must be achieved for sex worker communities everywhere.