Decentralization of HIV and Syphilis Diagnosis: Access Strategy in the Primary Health Care Level of La Plata (2024-2026)

Estrategia de acceso en el primer nivel de atención de La Plata (2024-2026) 

Abstract

This report presents the implementation strategy for rapid HIV and syphilis testing in the municipality of La Plata during the 2024-2026 period. This strategy was developed in a context marked by a rise in Sexually Transmitted Infections (STIs) and significant defunding of national sexual health policies. Following the framework of National Law 27.675, which mandates a comprehensive response based on Primary Health Care (PHC), the municipal Health Secretariat established the Directorate of Comprehensive Care (DCI) and joined the provincial Five-Year Health Plan to reverse the discontinuity of previous prevention efforts.

The methodology utilizes a mixed-design approach, combining a qualitative historical-processual reconstruction of the strategy's implementation with a quantitative analysis of testing data reported through the SISA/SNVS system. The strategy focused on training interdisciplinary teams in technical procedures and pre- and post-test counseling from a human rights and gender perspective. Additionally, it established a supply management circuit to ensure the steady distribution of dual rapid tests and penicillin across local centers. A fundamental component involved building health networks and "protected appointments" to guarantee diagnostic confirmation and timely treatment within the second level of care.

Results show that by establishing 16 testing centers in Primary Health Care Centers (CAPS), the municipality achieved a 226% increase in rapid testing during 2025 compared to the average of the previous three years. In conclusion, diagnostic decentralization has proven to be an effective tool for removing barriers to access, positioning the first level of care as a strategic gateway for ensuring the right to health and continuous care for the population.