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Latin America
There are an estimated 1.5 million people living with HIV/AIDS in Latin America. UNAIDS estimates that 150,000 people were newly infected with HIV in 2002 and 60,000 people died due to AIDS in that year.
The majority of transmission in Central American countries and countries which line the Caribbean coast occurs through sex between men and women. Whilst Brazil is also experiencing a significant heterosexual epidemic, there are also high seroprevalence rates among men who have sex with men and injecting drug users..
By comparison, the HIV epidemic is largely confined to men who have sex with men and injecting drug users in Argentina, Mexico and Colombia. In Costa Rica, the epidemic almost entirely centres around men who have sex with men. Studies among men who have sex with men in Costa Rica suggest that seroprevalence rates were as high as 10-16% as long ago as 1993.
The worst affected countries are;
Brazil
There are an estimated 600,000 people living with HIV/AIDS. The government has embarked upon HIV prevention campaigns which have been credited with a fall in prevalence of HIV among injecting drug users in particular. This has been pursued with a strong commitment to health care and protecting the rights of people living with HIV. The government is committed to provide free antiretroviral therapy to all those who need it; an estimated 105,000 Brazilians were receiving antiretroviral treatment by the end of 2001. Since the introduction of this policy in 1996, AIDS deaths have almost halved. Opportunistic infections have declined by between 60-80% between 1996 and 1999.
Condom use among men who have sex with men increased dramatically between 1989 and 1995, rising from 34% to 69%. At the same time the proportion of men reporting anal sex in the past 6 months rose from 67% to 76%.
However in the more impoverished parts of Brazil, particularly the north-eastern region, it is claimed there are very few prevention activities and unprotected sex remains highly prevalent.
In Sao Paolo, the rate of new HIV infections among men who have sex with men was a steady 2% between 1994 and 1997.
Prevention programmes among injecting drug users have contributed to a substantial decline in HIV prevalence in this population in several large metropolitan areas.
In addition, a national survey in Brazil has shown increasing condom use among injecting drug users (from 42% in 1999 to 65% in 2000)—a sign that sustained education and prevention efforts are bearing fruit.
Mexico
There are an estimated 150,000 people living with HIV/AIDS, or 0.29% of the adult population. More than 14% of men who have sex with men are estimated to be HIV-positive. However, seroprevalence rates among female sex workers are estimated to be below 1% and data from a programme to reduce the transmission of HIV from mother to infants suggest that less than 1 in 1000 women of childbearing age is infected.
Argentina
There are an estimated 130,000 people living with HIV/AIDS, or 0.69% of the adult population. Injecting drug use is considered to be a principal means of transmission in Argentina as also in Chile and Uruguay.
Guyana
There are an estimated 15,000 people living with HIV/AIDS, or 3.01% of the adult population.
Studies among sex workers in the capital, Georgetown, suggest that around 46% of sex workers are HIV-positive.
Belize
There are an estimated 2400 people living with HIV/AIDS, or 2.01% of the adult population.
Honduras
There are an estimated 63,000 people living with HIV/AIDS, or 1.92% of the adult population.
Between one fifth and one tenth of sex workers are HIV-positive in various cities.
Panama
There are an estimated 24,000 people living with HIV/AIDS, or 1.54% of the adult population.
Guatemala
There are an estimated 73,000 people living with HIV/AIDS, or 1.38% of the adult population. Seroprevalence rates among pregnant women and sex workers are higher in the coastal cities and the capital than in more rural cities.
Access to treatments
Some countries in Latin America have begun to provide antiretroviral drugs to some inhabitants, and Brazil has been able to make treatment available to everyone who needs it. Local production and bulk purchasing of imported antiretrovirals has led to significant decreases in the programme's drug costs.
Chile and Venezuela and have been able to make antiretrovirals available to some people, whilst Cuba, Argentina, Costa Rica and Uruguay now guarantee free and universal access to anti-HIV drugs through the public sector.
An estimated 170 000 people (most of them in Brazil) were receiving antiretroviral therapy at the end of 2001.
References
HIV/AIDS Surveillance in Europe. European Centre for the Epidemiological Monitoring of AIDS. July 2000.
The Impending Catastrophe: A resource book on the emerging HIV/AIDS epidemic in South Africa.
The Progress of Nations 2000. UNICEF.
Report on the global HIV/AIDS epidemic. June 2000. UNAIDS.
AIDS epidemic update, December 2001. UNAIDS.