Vulnerabilities and decentralization of operations for attention to HIV/AIDS for Primary Health Care. Northeast, Brazil, 2019 ; Vulnerabilidades y descentralización de acciones de atención al VIH/SIDA para la Atención Primaria de Salud. Noreste, Brasil, 2019 ; Vulnerabilidades e descentralização das ações de cuidado ao HIV/AIDS para a Atenção Primária à Saúde. Nordeste, Brasil, 2019

Objective. To characterize the decentralization of operations for attention to HIV/Aids to Primary Health Care (PHC), taking the individual, social, and programmatic components of vulnerability as analytical references. Methods. A qualitative study was carried out based on interviews with persons who live with HIV/Aids in municipalities of a health region in the Northeast of Brazil. Results. Insufficient information on infection limits the perception of individual vulnerability and delays the search for a diagnosis. Factors related to gender, race, and sexual orientation increase social vulnerability, and the stigma of discrimination also influences the use of health services. On the programmatic dimension, users recognized limitations in the organization and infrastructure of the PHC, difficulties in transfer to specialized services at the regional headquarters, and fragmentation between levels of attention. These limitations were more severe in the interior and rural areas. Longitudinal connections with specialized services are strong. Conclusions. An intermediate route is suggested for the decentralization of HIV/Aids care, shared between specialized services and the PHCs. To achieve that, investments in PHC improvements and interprofessional communication strategies in the health region are essential. ; Objetivo. Caracterizar la descentralización de las acciones de atención del VIH/Sida hacia la Atención Primaria de Salud (APS) tomando como referencia de análisis los componentes individuales, sociales y programáticos de vulnerabilidad. Métodos. Se realizó un estudio cualitativo basado en entrevistas con personas que viven con VIH/Sida en municipios de una región sanitaria al interior del Nordeste de Brasil. Resultados. Los resultados indican que la información insuficiente sobre la infección limitó la percepción de vulnerabilidad individual y retrasó la búsqueda de diagnóstico. Los factores relacionados con género, raza y orientación sexual incrementan la vulnerabilidad social, y los asociados al estigma y ...