ABSTRACT OBJECTIVE: To assess the determinants of embedded implementation research (EIR) conduct in seven Latin American and Caribbean countries. METHODS: This qualitative interpretative study conducted and analyzed 14 semi-structured interviews based on a grounded theory approach using Atlas-ti© 7.5.7. We grouped the conditions appointed by interviewees as determinants of EIR conduct into six domains. RESULTS: The participation of high-level engaged decision makers as research co-producers is an important EIR determinant that fosters research use. Nevertheless, EIR faces challenges such as dealing with key personnel changes and fluctuating political contexts. CONCLUSIONS: Despite its limitations, EIR is effective in creating a sense of ownership of research results among implementers, which helps bridge the gap between research and decision-making in health systems.

ABSTRACT OBJECTIVE: To assess the determinants of embedded implementation research (EIR) conduct in seven Latin American and Caribbean countries. METHODS: This qualitative interpretative study conducted and analyzed 14 semi-structured interviews based on a grounded theory approach using Atlas-ti© 7.5.7. We grouped the conditions appointed by interviewees as determinants of EIR conduct into six domains. RESULTS: The participation of high-level engaged decision makers as research co-producers is an important EIR determinant that fosters research use. Nevertheless, EIR faces challenges such as dealing with key personnel changes and fluctuating political contexts. CONCLUSIONS: Despite its limitations, EIR is effective in creating a sense of ownership of research results among implementers, which helps bridge the gap between research and decision-making in health systems.

Objective. To describe a political mapping on discrimination and homophobia associated to human immunodeficiency virus (HIV) in the context of public institutions in Mexico. Materials and methods. The political mapping was conducted in six Mexican states. Stakeholders who were involved in HIV actions from public and private sectors were included. Semistructured interviews were applied to explore homophobia and discrimination associated with HIV. Information was systematized using the Policy Maker software, which is a good support for analyzing health policies. Results. Discriminatory and homophobic practices in the public domain occurred, damaging people´s integrity via insults, derision and hate crimes. Most stakeholders expressed a supportive position to prevent discrimination and homophobia and some of them had great influence on policy-making decisions. It was found that state policy frameworks are less specific in addressing these issues. Conclusions. Homophobia and discrimination associated to HIV are still considered problematic in Mexico. Homophobia is a very sensitive issue that requires further attention. Also, an actual execution of governmental authority requires greater enforcement of laws against discrimination and homophobia.

Objetivo. Presentar un mapeo político sobre discriminación y homofobia asociadas con la epidemia del virus de la inmunodeficiencia humana (VIH) en entornos institucionales públicos. Material y métodos. Se realizó un mapeo político con actores clave en seis estados de México, a quienes se les aplicó una entrevista semiestructurada para explorar la discriminación y homofobia asociadas con el VIH. La información se sistematizó mediante matrices de contenido por categorías y el software PolicyMaker. Resultados. Se documentaron prácticas discriminatorias y homofóbicas lesivas a la integridad como la denostación, la burla y los crímenes de odio. La mayoría de actores se manifestaron en contra de la discriminación y la homofobia; algunos de ellos influyeron de manera importante en la formulación de políticas para prevenir la discriminación y la homofobia. Sin embargo, los marcos normativos estatales fueron poco específicos. Conclusiones. Son persistentes las prácticas discriminatorias y la homofobia asociadas con el VIH, por lo cual se requiere mayor atención en los estados y es necesario impulsar políticas para prevenirlas, así como la observancia del cumplimiento de las leyes estatales.

Objective. To describe a political mapping on discrimination and homophobia associated to human immunodeficiency virus (HIV) in the context of public institutions in Mexico. Materials and methods. The political mapping was conducted in six Mexican states. Stakeholders who were involved in HIV actions from public and private sectors were included. Semistructured interviews were applied to explore homophobia and discrimination associated with HIV. Information was systematized using the Policy Maker software, which is a good support for analyzing health policies. Results. Discriminatory and homophobic practices in the public domain occurred, damaging people´s integrity via insults, derision and hate crimes. Most stakeholders expressed a supportive position to prevent discrimination and homophobia and some of them had great influence on policy-making decisions. It was found that state policy frameworks are less specific in addressing these issues. Conclusions. Homophobia and discrimination associated to HIV are still considered problematic in Mexico. Homophobia is a very sensitive issue that requires further attention. Also, an actual execution of governmental authority requires greater enforcement of laws against discrimination and homophobia.

Objetivo. Presentar un mapeo político sobre discriminación y homofobia asociadas con la epidemia del virus de la inmunodeficiencia humana (VIH) en entornos institucionales públicos. Material y métodos. Se realizó un mapeo político con actores clave en seis estados de México, a quienes se les aplicó una entrevista semiestructurada para explorar la discriminación y homofobia asociadas con el VIH. La información se sistematizó mediante matrices de contenido por categorías y el software PolicyMaker. Resultados. Se documentaron prácticas discriminatorias y homofóbicas lesivas a la integridad como la denostación, la burla y los crímenes de odio. La mayoría de actores se manifestaron en contra de la discriminación y la homofobia; algunos de ellos influyeron de manera importante en la formulación de políticas para prevenir la discriminación y la homofobia. Sin embargo, los marcos normativos estatales fueron poco específicos. Conclusiones. Son persistentes las prácticas discriminatorias y la homofobia asociadas con el VIH, por lo cual se requiere mayor atención en los estados y es necesario impulsar políticas para prevenirlas, así como la observancia del cumplimiento de las leyes estatales.

OBJECTIVE: To analyze the profile of care for sexually transmitted infections (STIs) in health centers in border areas of Central America during 2007-2010. MATERIALS AND METHODS: Cross-sectional study in a sample of 3 357 patients. Doctors were trained and medicines, condoms and HIV testing (basic package of care [BPC]) were supplied. Sample was characterized according to sociodemographic variables. Factors associated with the probability of receiving the BPC were identified. RESULTS: Sixty six percent were 25-59 years old, and 93.2% were women. The most frequently diagnosed syndrome was vaginal discharge associated with candidiasis, bacterial vaginosis, trichomoniasis and gonorrhea. Sixty six percent of prescriptions were adhered to the international recommendations. Only 10% received the complete BPC.The likelihood of receiving it was lower in women. CONCLUSIONS: It is not enough to increase service delivery capacity to change care practices. These are deeply rooted in the sociocultural context. Highlights gendered medical practices that adversely affect the profile of care.

OBJETIVO: Analizar el perfil de atención por infecciones de transmisión sexual (ITS) en centros de salud de zonas fronterizas de Centroamérica durante el periodo 2007-2010. MATERIAL Y MÉTODOS: Estudio transversal en una muestra de 3 357 pacientes. Se capacitaron médicos y se suministraron medicamentos, condones y pruebas de VIH (paquete básico de atención [PBA]). Se analizaron las características sociodemográficas de los participantes y su asociación a la recepción del PBA. RESULTADOS: De la muestra, 66.0% tuvo de 25 a 59 años, 93.2% era mujer. El síndrome más frecuente fue el flujo vaginal asociado con candidiasis, vaginosis bacteriana, trichomoniasis y gonorrea. De las prescripciones, 60% siguió recomendaciones internacionales. Sólo 10.2% recibió el PBA. La probabilidad de recibirlo fue menor en mujeres. CONCLUSIONES: No basta con incrementar las capacidades de provisión de servicios para modificar las prácticas de atención. Éstas se encuentran enraizadas en el contexto sociocultural. Destacan prácticas médicas diferenciadas por género que influyen negativamente en la atención.

OBJECTIVE: To analyze the profile of care for sexually transmitted infections (STIs) in health centers in border areas of Central America during 2007-2010. MATERIALS AND METHODS: Cross-sectional study in a sample of 3 357 patients. Doctors were trained and medicines, condoms and HIV testing (basic package of care [BPC]) were supplied. Sample was characterized according to sociodemographic variables. Factors associated with the probability of receiving the BPC were identified. RESULTS: Sixty six percent were 25-59 years old, and 93.2% were women. The most frequently diagnosed syndrome was vaginal discharge associated with candidiasis, bacterial vaginosis, trichomoniasis and gonorrhea. Sixty six percent of prescriptions were adhered to the international recommendations. Only 10% received the complete BPC.The likelihood of receiving it was lower in women. CONCLUSIONS: It is not enough to increase service delivery capacity to change care practices. These are deeply rooted in the sociocultural context. Highlights gendered medical practices that adversely affect the profile of care.

OBJETIVO: Analizar el perfil de atención por infecciones de transmisión sexual (ITS) en centros de salud de zonas fronterizas de Centroamérica durante el periodo 2007-2010. MATERIAL Y MÉTODOS: Estudio transversal en una muestra de 3 357 pacientes. Se capacitaron médicos y se suministraron medicamentos, condones y pruebas de VIH (paquete básico de atención [PBA]). Se analizaron las características sociodemográficas de los participantes y su asociación a la recepción del PBA. RESULTADOS: De la muestra, 66.0% tuvo de 25 a 59 años, 93.2% era mujer. El síndrome más frecuente fue el flujo vaginal asociado con candidiasis, vaginosis bacteriana, trichomoniasis y gonorrea. De las prescripciones, 60% siguió recomendaciones internacionales. Sólo 10.2% recibió el PBA. La probabilidad de recibirlo fue menor en mujeres. CONCLUSIONES: No basta con incrementar las capacidades de provisión de servicios para modificar las prácticas de atención. Éstas se encuentran enraizadas en el contexto sociocultural. Destacan prácticas médicas diferenciadas por género que influyen negativamente en la atención.