[Community-based intervention to control STD/AIDS in the Amazon region, Brazil].
OBJECTIVE
To describe a case study of community-based intervention, developed in a constructionist-emancipatory framework to control STD/AIDS.


METHODS
Descriptive study developed in the town of Manacapuru, in the state of Amazonas, from 1997 to 2004, focusing on procedures designed in collaboration with government agents, health professionals and the community. Data on the dynamics of prostitution and condom sales in this town, preventive practices and STD/AIDS care and process assessment were collected. Actions targeting STD prevention and care in the public healthcare system, a testing center, an epidemiological surveillance system and sex workers' qualification were established concomitantly.


RESULTS
It was observed the strengthening of sex workers as peer educators and their legitimization as citizens and health agents in projects involving transvestites, homosexuals and students. There was an increase in condom sales in town, as well as in condom use among sex workers; reduction in bacterial STD; and stabilization of the incidence of HIV/AIDS infections and congenital syphilis. The sustainability of the intervention program studied, organized within the sphere of action of the Sistema Unico de Saúde (National Health System), was promoted by a political pact, which guaranteed headquarters and municipal law-regulated budget, as well as by the constant debate over the process and program results.


CONCLUSIONS
The study strengthened the notion that effective control of STD/AIDS depends on a synergic approach that combines interventions on individual (biological-behavioral), sociocultural and programmatic levels.
Benzaken
Adele Schwartz
AS
Fundação de Dermatologia Tropical e Venereologia Alfredo da Matta, Manaus, AM, Brasil. adele@vivax.com.br
Galbán Garcia
Enrique
E
Sardinha
José Carlos Gomes
JC
Pedrosa
Valderiza Lourenço
VL
Paiva
Vera
V
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control / Q000635:transmission; D001938:Brazil; D019058:Community Networks; D003256:Community Participation; D017280:Condoms / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006266:Health Education / Q000379:methods*; D006293:Health Promotion; D006801:Humans; D008297:Male; D011287:Prejudice; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000517:prevention & control* / Q000635:transmission; D012931:Social Environment; D014931:Women, Working