Abstract and Introduction
Abstract
Background: This article provides a summary of the current status of the HIV/AIDS epidemic in Latin America, as well as an outline of the diverse responses to it.
Methods: A search of international databases (Pubmed and ISI-Web of Science), regional databases (Scielo and Lilacs), regional and national documents and UNAIDS reports. Data are presented according to subregion.
Results: In Mexico HIV remains concentrated among urban men who have sex with men (MSM), and has been growing among injecting drug users (IDU) and in rural areas in relation to migration. An increasing proportion of women among those affected is observed in all countries in Central America, the most affected region, as well as increasing the impact on other vulnerable groups, such as indigenous populations. The Andean Countries have urban epidemics concentrated among MSM. In Peru, non-traditional vulnerable populations were identified. In the Southern Cone heterosexual transmission became more relevant, probably in connection with IDU epidemics and is increasingly affecting lower income groups. Incidence rates have been declining since 2002 in Brazil, the first country to guarantee free, universal access to antiretrovirals, where one-third of drug-nave patients are still initiating treatment at an advanced stage. Generally, access to treatment has improved as a result of support from the Global Fund and other initiatives, but there are concerns regarding coverage, equity and sustainability.
Conclusions: HIV is still concentrated among MSM in Latin America. Non-traditional vulnerable groups such as migrants and lower income populations, usually considered part of the general population, deserve attention. Programmes confronting sexual exclusion are still needed. Access to treatment has improved over time, but inequalities persist.
Introduction
According to estimates from the United Nations Joint Programme on HIV/AIDS -- UNAIDS, as of December 2007, 33.2 (95% CI: 30.6-36.1) million people were living with HIV worldwide. Among them, ~1.6 (1.4-1.9) million or 5% of this total were living in Latin America. Overall, HIV prevalence among adults was 0.5% (0.4-0.6%) in Latin America.
This article reviews data from peer-reviewed papers and reports from international health agencies (e.g. UNAIDS, the World Health Organization -- WHO, and the Pan American Health Organization -- PAHO), with the aim of providing a summary of the current status of the pandemic in the region, as well as an outline of the responses to it.
Due to the strong heterogeneity of the epidemic in the region, data will be presented according to the major regional divisions, based on the sociogeographic, demographic and cultural characteristics of the subregions.
Comprehensive reviews have been published on specific countries, such as Brazil, Argentina, México and Costa Rica, as well as on specific populations, such as drug users and men who have sex with men (MSM), but no paper has addressed the epidemiology of HIV/AIDS in the region, since the publication of the review by Calleja et al. in 2002.