AIDS around world - Latin America

The HIV epidemic in Latin America is highly diverse. Most transmission in Central American countries and countries on the Caribbean coast occurs through sex between men and women. Brazil, too, is experiencing a major heterosexual epidemic, but there are also very high rates of infection among men who have sex with men and injecting drug users. In Mexico, Argentina, and Colombia, HIV infection is also confined largely to these sub-populations. The Andean countries are currently among those least affected by HIV infection, although risky behaviour has been recorded in many groups.

Around 1.7 million people are living with HIV in Latin America. In 2004, around 95,000 people died of AIDS and an estimated 240,000 people were newly infected.

The countries with the highest prevalence rates in the region tend to be found on the Caribbean side of the continent. Over 7% of pregnant women in urban Guyana tested positive for HIV in 1996. Strikingly, the rates in pregnant women were similar to those in patients attending clinics for sexually transmitted diseases (STDs) – one would have expected them to be lower.

In Honduras, Guatemala and Belize there is also a fast-growing epidemic, with HIV prevalence rates among adults in the general population between 1 and 2%. In 1994, less than 1% of pregnant women using antenatal services in Belize District tested positive for HIV, while one year later the prevalence rate had risen to 2.5%, the rate in one health centre, in Port Loyola, hitting 4.8%. Much of the problem is concentrated in teenagers, suggesting that the worst is still to come.

Heterosexual transmission of HIV is rarer in other countries of Central America . In Costa Rica, for example, HIV is transmitted mainly during unprotected sex between men. In this country, as in many other parts of Latin America, there is little systematic surveillance for HIV among groups with high risk behaviour, but studies among men who have sex with men in Costa Rica showed infection rates of 10-16% as long ago as 1993.
In Mexico, too, HIV has affected mainly men who have sex with men, more than 14% of whom are currently infected. HIV rates among pregnant women, however, are extremely low. Data from a programme to reduce the transmission of HIV from mothers to infants suggest that less than one in every 1,000 women of childbearing age is infected. Even among female sex workers in Mexico, the prevalence rate is well under 1%.

Awareness raising amoung young people in Mexico

A low prevalence of HIV infection among heterosexuals is the norm in the Andean region, at least in the countries for which data are available. For example, Argentina has typically high rates of HIV infection among injecting drug users and men who have sex with men, but a relatively low prevalence of 0.4% among pregnant women.

One of the defining features of the Latin American epidemic is that several populous countries, including Argentina, Brazil, Cuba and Mexico, are attempting to provide antiretroviral therapy for all people infected with HIV. The governments of these countries have invested and encouraged

local pharmaceutical manufacturers to produce generic copies of expensive patented medicines. This allows them to distribute drugs to a much greater proportion of their population that they would otherwise be able to help.

Coverage still varies widely, but these efforts are having a definite impact. While they are improving both the length and the quality of people's lives, they are also increasing the proportion of people living with HIV, and thus HIV prevalence figures. Nevertheless, some concern has been voiced over the risk that HIV prevention activities may suffer if too much effort and money is devoted to providing treatment.