HIV/AIDS in Latin America

HIV/AIDS has been a public health concern for Latin America due to a remaining prevalence of the disease.[1] In 2018 an estimated 2.2 million people had HIV in Latin America and the Caribbean, making the HIV prevalence rate approximately 0.4% in Latin America.[1]

Some demographic groups in Latin America have higher prevalence rates for HIV/ AIDS including men who have sex with men having a prevalence rate of 10.6%, and transgender women having one of the highest rates within the population with a prevalence rate of 17.7%.[2] Female sex workers and drug users also have higher prevalence for the disease than the general population (4.9% and 1%-49.7% respectively).[2]

One aspect that has contributed to the higher prevalence of HIV/AIDS in LGBTQIA+ groups in Latin America is the concept of homophobia.[1] Homophobia in Latin America has historically affected HIV service provision through under reported data and less priority through government programs.[3]

Antiretroviral treatment coverage has been high, with AIDS related deaths decreasing between 2007 to 2017 by 12%, although the rate of new infections has not seen a large decrease.[1] The cost of antiretroviral medicines remain a barrier for some in Latin America, as well as country wide shortages of medicines and condoms.[4] In 2017 77% of Latin Americans with HIV were aware of their HIV status.[4]

The prevention of HIV/AIDS in Latin America among groups with a higher prevalence such as men who have sex with men and transgender women, has been aided with educational outreach, condom distribution, and LGBTQIA+ friendly clinics.[5] Other main prevention methods include condom availability, education and outreach, HIV awareness, and mother-to-child transmission prevention.[1]

Origin and epidemiology of HIV/AIDS in Latin America

The first documented reporting of what would come to be known as HIV/AIDS happened in June 1981.[6] In September of 1982, AIDS is given its name and a case definition for the very first time.[7] Specific details on the origin of HIV/AIDS in Latin America are lacking, but in 1983, the first known HIV cases in Latin America were confirmed in Mexico and Haiti in the form of the HIV-1.[8] Blood screening in Mexico was scare in the early 1990s, which contributed to 63% of female AIDS cases stemming from blood transfusions.[9] Currently, the prevalence rate of HIV/AIDS in Latin America is highest in Belize (2%), Honduras (1.9%), Panama (1.54%) and  Guatemala (1.4%).[10] Since 2000, the prevalence of HIV/AIDS in the Caribbean has been highest in Haiti (5.2%), the Bahamas (4.1%), and the Dominican Republic (2.8%).[10]

Prevention of HIV/AIDS infections

In order to prevent and slow the transmission rates within the Latin American population public health initiatives need to target vulnerable populations.[11] Providing treatment, education, and health services that are stigma-free and accessible to vulnerable populations is key to combating the prevalence of HIV/AIDS in Latin America.[1] Another common barrier in accessing health services among transgender women is a mistrust of the health system as a whole from past discrimination towards this community within the health system.[2]

Prevention practices and methods

To prevent transmission between individuals, safe sex practices and treatment using antiretroviral treatment is a necessary public health intervention. Within Latin America as of 2018, 62% of those that are aware of their positive HIV status are currently on antiretroviral therapy, and of those individuals only 55% of them are virally suppressed, and carry an undetectable load. This accounts for 29% of the entire HIV positive community in Latin America.[1]

Practices to prevent transmission of HIV/AIDS

  • Engaging in less risky sexual behavior[12]
  • Correctly using barrier methods (male condoms and dental damns)[12]
  • Getting tested for HIV/AIDS and getting treated with antiretroviral therapy[12]
  • Taking preventative medicines for high risk populations, like post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) [12]
  • Not using or injecting drugs [12]

These safe sex practices reduce the risk of contracting HIV/AIDS. Many of these treatments are not widely available and accessible to vulnerable populations within Latin America.[11] In order to successfully implement these prevention methods the stigma and discrimination surrounding vulnerable populations needs to be addressed within the present health systems in Latin America.[11]

Public health initiatives

Within Latin America there are many barriers to prevention methods, including late diagnostic testing of patients, lack of testing centers in rural communities, and the stigma/discrimination within the HIV positive population.[11]

Recently in Bahamas, Brazil, El Salvador, Jamaica, Peru, and Trinidad and Tobago self tests were made available, and have the potential to increase testing in at-risk populations.[13] However the accessibility and affordability of the tests is under scrutiny from public health professionals.[1] Other public health initiatives include education regarding safe sex practice use and condom availability. Programs in Mexico and Brazil that aimed to prevent mother-to-child transmission (PMTCT) is an important initiative that has been relatively successful at reducing the prevalence of HIV/AIDS in this population from 16.7% in 2010 to 10.4% in 2017.[14][1]

See also

References
  1. "HIV and AIDS in Latin America the Caribbean regional overview". Avert. 2015-07-21. Retrieved 2019-11-17.
  2. García, Patricia J; Bayer, Angela; Cárcamo, César P (June 2014). "The Changing Face of HIV in Latin America and the Caribbean". Current HIV/AIDS Reports. 11 (2): 146–157. doi:10.1007/s11904-014-0204-1. ISSN 1548-3568. PMC 4136548. PMID 24824881.
  3. "Homophobia and HIV". Avert. 2015-07-20. Retrieved 2019-11-17.
  4. "Miles to go—closing gaps, breaking barriers, righting injustices". www.unaids.org. Retrieved 2019-11-17.
  5. Silva-Santisteban, Alfonso; Eng, Shirley; de la Iglesia, Gabriela; Falistocco, Carlos; Mazin, Rafael (2016-07-17). "HIV prevention among transgender women in Latin America: implementation, gaps and challenges". Journal of the International AIDS Society. 19 (3Suppl 2): 20799. doi:10.7448/IAS.19.3.20799. ISSN 1758-2652. PMC 4949309. PMID 27431470.
  6. "A Timeline of HIV and AIDS". HIV.gov. 2016-05-11. Retrieved 2019-11-18.
  7. "Current Trends Update on Acquired Immune Deficiency Syndrome (AIDS) --United States". www.cdc.gov. Retrieved 2019-11-18.
  8. del Rio, Carlos; Sepúlveda, Jaime (Summer 2002). "AIDS in Mexico: lessons learned and implications for developing countries". AIDS. 16 (11): 1445–1447. doi:10.1097/00002030-200207260-00001. PMID 12131182.
  9. Kimball, A M; Berkley, S; Ngugi, E; Gayle, H (May 1995). "International Aspects of the AIDS/HIV Epidemic". Annual Review of Public Health. 16 (1): 253–282. doi:10.1146/annurev.pu.16.050195.001345. ISSN 0163-7525. PMID 7639874.
  10. Morison, Linda (2001-09-01). "The global epidemiology of HIV/AIDS". British Medical Bulletin. 58 (1): 7–18. doi:10.1093/bmb/58.1.7. ISSN 0007-1420.
  11. dos Santos, Monika ML; Kruger, Pieter; Mellors, Shaun E.; Wolvaardt, Gustaaf; van der Ryst, Elna (2014-01-27). "An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: the People Living with HIV Stigma Index". BMC Public Health. 14 (1): 80. doi:10.1186/1471-2458-14-80. ISSN 1471-2458. PMC 3909177. PMID 24461042.
  12. "Prevention | HIV Basics | HIV/AIDS | CDC". www.cdc.gov. 2019-12-02. Retrieved 2019-12-05.
  13. Volk, Jonathan E; Lippman, Sheri A; Grinsztejn, Beatriz; Lama, Javier R; Fernandes, Nilo M; Gonzales, Pedro; Hessol, Nancy A; Buchbinder, Susan (2016-06-01). "Acceptability and feasibility of HIV self-testing among men who have sex with men in Peru and Brazil". International Journal of STD & AIDS. 27 (7): 531–536. doi:10.1177/0956462415586676. ISSN 0956-4624. PMC 4643427. PMID 25971262.
  14. Rely, Kely; Bertozzi, Stefano M.; Avila-Figueroa, Carlos; Guijarro, Maria Teresa (2003-09-01). "Cost-effectiveness of strategies to reduce mother-to-child HIV transmission in Mexico, a low-prevalence setting". Health Policy and Planning. 18 (3): 290–298. doi:10.1093/heapol/czg035. ISSN 0268-1080. PMID 12917270.
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