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About the Authors:
Tamara Flys
* E-mail: [email protected]
Affiliation: Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
Rosalba González
Affiliation: Gorgas Memorial Institute, Panama City, Panama
Omar Sued
Current address: Fundación Huésped, Buenos Aires, Argentina
Affiliation: Pan American Health Organization, Washington, D.C., United States of America
Juana Suarez Conejero
Affiliation: Pan American Health Organization, Consultant, Washington, D.C., United States of America
Edgar Kestler
Affiliation: Centro de Investigación Epidemiológica en Salud Sexual y Reproductiva (CIESAR), Guatemala
Nestor Sosa
Affiliation: Gorgas Memorial Institute, Panama City, Panama
Jane McKenzie-White
Affiliation: Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
Irma Irene Monzón
Affiliation: Centro de Investigación Epidemiológica en Salud Sexual y Reproductiva (CIESAR), Guatemala
Carmen-Rosa Torres
Affiliation: U.S. Department of Health and Human Services (HHS), Washington, D.C., United States of America
Kathleen Page
Affiliation: Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
Introduction
Central America, which consists of Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama, has been particularly affected by the rapidly spreading HIV epidemic in Latin America. Four of the countries with the highest prevalence rates in Latin America are in Central America and 200,000 people live with HIV/AIDS in the region [1]. Despite PAHO recommendations for universal HIV screening of pregnant women, only 52% of pregnant women were HIV-tested in Latin America and the Caribbean [2], [3] and only 36% of pregnant women diagnosed with HIV received antiretroviral therapy for the prevention of HIV mother-to-child transmission (PMTCT) in 2007 [3]. Lack of integration of HIV care into primary medical care in Central America leads to lost opportunities for HIV diagnosis and treatment, especially for rural or marginalized populations that may not have easy access to specialized HIV care at referral centers. This affects quality and access to care and long term prognosis of HIV-infected individuals.
Although guidelines are developed and discussed between national authorities and HIV experts, many training activities target doctors at specialized care clinics or hospitals [4], whereas training programs designed to facilitate the implementation of these recommendations by primary health care workers (HCWs) at the community level are limited. Many training programs fail to bridge the theoretical approach (e.g., National and International Guidelines and Protocols) to the realities on the ground, however...