Latin America still not faced a large-scale AIDS epidemic

Although the risk patterns that favor the expansion of HIV are very widespread, the majority of the countries of Latin America have still not faced a large-scale AIDS epidemic, according to a publication by the Pan American Health Organization and the World Bank.

But recent trends indicate that if the countries of Latin America do not take adequate prevention measures promptly, the incidence of the disease could hit epidemic proportions, the book notes.

Effective interventions can still prevent HIV from turning into a health catastrophe, as has occurred elsewhere in the world and even in some Caribbean islands. This analysis is the central theme of the Spanish version of HIV/AIDS in Latin American Countries: The Challenges Ahead, published by the Pan American Health Organization (PAHO) and the World Bank.

The study, conducted in 17 Latin American countries encompasses all parts of the AIDS problem: epidemiological surveillance, effective interventions, persistent problems, and national and international responses to the epidemic.

"The most recent studies indicate that the prevalence of HIV among pregnant women is 2 percent or higher in six countries: Bahamas, Belize, Guyana, Haiti, Dominican Republic, and Trinidad and Tobago. In contrast, the majority of the other countries of the region show a concentrated epidemic, particularly in the Southern Cone, where Brazil has the greatest number of people who live with HIV/AIDS", says the prologue by Dr. Mirta Roses, director of PAHO.

Although the book notes that there is significant underreporting of cases, the best estimates of PAHO, UNAIDS and WHO indicate that in Latin America there are some 1.4 million people living with HIV/AIDS. During 2001, 130,000 adults and children contracted the infection and 80,000 people died because of AIDS.

The so-called feminization of the epidemic is shown by the increasingly equal proportion of men and women with AIDS, and by the growing rates of HIV infection in pregnant women and children, the book notes. The ever-growing numbers of cases of AIDS and HIV infection among women 20 to 29 years old indicate that adolescents are at high risk, it says.

"In most countries we see all the mechanisms of transmission, as well as risk behaviors such as early sexual initiation, unprotected sex with multiple partners, and injectable drugs used with contaminated syringes," according to Roses.

"Many countries have substantially improved the resources allocated to the struggle against HIV/AIDS. Alliances and successful projects with access to the Global Fund against AIDS have tripled existing resources. However, stigma, discrimination and gender inequalities that weaken women’s ability to negotiate continue to be the greatest impediments," Roses said.

Research shows that the level of knowledge and information is sufficiently appropriate, but, "We are not seeing behavioral change toward sexual practices of lower risk," she said. The challenge is to ensure that AIDS does not continue to devastate generations in the most productive stages of the life cycle, which could threaten the important achievements in life expectancy and quality of life that have been hit in recent decades in the region, she added.

The authors of the book, Anabela García Abreu, Isabel Noguer, and Karen Cogwill conclude that Latin America has the infrastructure and the knowledge necessary for coping with the epidemic efficiently and effectively, if the required resources are provided. "The needs vary and, as a result, it is important to adapt the interventions to respond to the profile and the capacity of each country," they say.

International organizations and programs are in position to increase regional or subregional interventions in concrete areas, and "Cooperation will lead to multiple benefits from effective interventions, as well as positive costs-benefits, " they conclude.

The XV International AIDS Conference in Bangkok highlighted the need for joining efforts globally to fight the epidemic. Latin America, with PAHO at the forefront, has been leading efforts to expand access to antiretroviral therapy for the people who live with the virus, in line with global initiatives.

PAHO was established in 1902 and is the oldest public health organization in the world. It serves as the Regional Office of the World Health Organization and works on with all the countries of the Americas to improve the health and quality of life of their inhabitants.

http://www.paho.org