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AIDS at the region
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The epidemic in Latin America

Approximately 1.9 million adults and children in Latin America and the Caribbean were living with HIV/AIDS at the end of 2001-1.5 million people in Latin America and 420 000 in the Caribbean. The total figure includes the 200 000 people who acquired the virus in 2001.

The estimated 100 000 AIDS deaths in 2001 have further increased the ranks of children orphaned by the epidemic. Some 330 000 of the orphans are living in Latin America (fully 130 000 of them in Brazil) and 250 000 in the Caribbean (fully 200 000 of them in Haiti).

Twelve countries in this region (including the Dominican Republic and Haiti, and several Central American countries), have an estimated HIV prevalence of 1% or more. In these areas, the epidemic is firmly rooted in the wider population and is driven primarily by transmission through heterosexual intercourse.

Leading cause of death

HIV/AIDS is now the leading cause of death in some countries of the Caribbean Basin, where adult prevalence rates are surpassed only by the rates experienced in sub-Saharan Africa. Haiti´s life expectancy in 2000-2005 is nearly six years less than it would have been in the absence of the AIDS epidemic. In the Bahamas and Guyana, the number of deaths among 15-34-year-olds is about 2.5 times higher than it would have been in the absence of AIDS.

Worst affected are Haiti and the Bahamas, where adult HIV prevalence rates are more than 6% and 3.5%, respectively. Recent surveillance data indicate a relatively stable HIV prevalence rate of 2.5% among the adult population of the Dominican Republic, following the increases seen there in the 1990s.

Among the factors that help drive the spread of HIV is the combination of unequal socioeconomic development and high population mobility, as Central America shows. There, the epidemic is worsening
and is concentrated chiefly among socially marginalized populations.

Vulnerable populations

Population mobility (spurred by high rates of unemployment and poverty) is emerging as a significant factor in the epidemic´s growth. Central America´s geographic position also makes it an important transit zone for people moving between the rest of the region and North American countries. Appropriately, protecting vulnerable populations on the move, including adolescent girls and young women, is now the focus of a regional initiative in Central America.

In Mexico, adult HIV prevalence in the wider population is still well under 1%, but prevalence rates are much higher in specific population groups in some parts of the country-up to 6% among injecting drug users and 15% among men who have sex with men. The epidemic has been spreading mainly through these modes of transmission.

Relatively low national HIV prevalence rates in most South and Central American countries mask the fact that the epidemic is already firmly lodged among specific population groups. There is significant overlap between injecting drug users and men who have sex with men, especially in Brazil and the southern cone countries, where injecting drug use is a growing social phenomenon. Injecting drug use is also a major route of HIV transmission in Argentina, Chile and Uruguay.

Brazil´s prevention programmes for injecting drug users have resulted in a substantial decline of HIV prevalence among this population group in several large metropolitan areas. In addition, a national survey showed that condom use among injecting drug users rose from 42% in 1999 to 65% in 2000-another indication that Brazil´s sustained education and prevention efforts are bearing fruit.

Treatment and care success

Latin American and Caribbean countries have made significant advances in access to treatment and care. Of 24 countries in the region surveyed in 2001, 11 have policies, regulations or laws that guarantee access to antiretroviral therapy.

At the end of 2001, approximately 170 000 people across the region were receiving antiretroviral treatment-including 105 000 in Brazil, where prevention efforts are complemented with an extensive treatment and care programme that guarantees State-funded antiretroviral therapy for those living with HIV/AIDS.

By reducing HIV/AIDS-related morbidity, Brazil´s treatment and care programme is estimated to have avoided 234 000 hospitalizations in 1996-2000.

This report was originally published by UNAIDS.


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