Family health teams strategy for HIV/AIDS/STI prevention and care

Background: The Brazilian AIDS Program has been considered a successful model for other countries. However, the number of new AIDS cases is now increasing among poor people, women and youngsters . In this context, a model based on the family health teams has a high potential to promote and deliver health care. The scope of this project is the maintenance of a sustained response to STI/HIV/AIDS prevention, care and treatment in deprived areas of large cities in Brazil.
Methods: With funding donated by Johnson and Johnson, Associação Saúde da Família (ASF) implemented a capacity building project to integrate HIV/AIDS/STD and reproductive health related activities into primary care in regions of two large cities in Brazil, São Paulo and  Fortaleza. Over half million people with an average monthly family income of US$ 320 live in each of these regions. Family Health Teams were trained to offer STI/HIV/AIDS prevention care and treatment door-to-door and at Primary Care Health Units. This project was initially replicated to the city of Fortaleza and is planned to be expanded to other regions.
Results: From January 2005 to December 2007 an estimated number of 8 million door to door were systematically and repeatedly made to women, men and adolescents by trained Health Community Agents. During the intervention approximately 2.5 million condom units were distributed, 33,099 people were vaccinated for Hepatitis B, and approximately 10,000 people were tested for HIV and syphilis. A noticeable decrease in the incidence of unwanted pregnancies among adolescents was observed as well as a substantial increase in the diagnosis and treatment of STIs.
Conclusions: The present strategy is a viable model for implementation of large scale HIV/AIDS/STI prevention and care, which can be expanded to other cities and communities in Brazil, and should be considered as a potential model for the developing world.