HIV/AIDS in Colombia

Last updated

With an estimated 120,000 people living with HIV/AIDS, the HIV/AIDS epidemic in Colombia is consistent with the epidemic in much of Latin America as a whole, both in terms of prevalence of infection and characteristics of transmission and affected populations. [1] Colombia has a relatively low rate of HIV infection at 0.4%. Certain groups, particularly men who have sex with men, bear the burden of significantly higher rates of infection than the general population. [2] Colombia's health care system and conception of a "right to health", created by the T-760 decision of 2008, have revolutionized access to HIV treatment. Despite this, the quality of health insurance and treatment for HIV has often been disputed. [3]

Contents

Prevalence

Approximately 120,000 people in Colombia are living with HIV, according to UNAIDS. [1] Colombia's rate of HIV prevalence, which is 0.4%, is on par with HIV prevalence in other Latin American and Caribbean nations. [4] New HIV infections in Colombia peaked between the years of 1993–1997, and have since dropped off. In recent years, the estimated number of new HIV infections in Colombia has dropped gradually, with an estimated 5,600 new infections in 2016. [1]

HIV is more common among men than women in Colombia. Men have an HIV prevalence rate of about 0.6%, whereas women have a prevalence rate of about 0.2%. [1]

Testing and treatment

A 2012 study that surveyed the records of almost 30,000 Colombians between the ages of 18 and 69 found that 19.7% had been tested for HIV. People living in rural areas, people with less education, men, and people over the age of 65 were less likely to have been tested than the general population. Women, urbanites, people with more education, and young people were more likely to have been tested than the general population. Consistent with factors throughout the region and the world, common reasons given for not seeking HIV testing included a low-risk perception of becoming infected, feeling healthy, stigma associated with HIV, and feeling unprepared, both financially and emotionally, for the possibility of an HIV diagnosis. [5] In Colombia, 36% of people living with AIDS have virally suppressed loads. [1]

Government policies

Two landmark decisions, one in 1993 and one in 2008, significantly altered access to HIV treatment in Colombia. At the beginning of the HIV epidemic, about 20% of Colombia's population was on private healthcare, with the rest relying on public health care. [3]

In 1993, the passage of Law 100 created a system of privatized but regulated universal health care—under the new system, private insurance companies competed for clients with government oversight. Insurance companies were mandated only to cover treatment listed under Colombia's obligatory health plan. There were two types of insurance schemes under the new system—one to which employees and employers contributed, and one which was subsidized by the government. [3]

Although the contributory scheme offered more comprehensive health care overall, the antiretroviral medication used to treat HIV (AZT) was not covered under either version of the government's obligatory health plan. Individuals seeking AZT were forced to file tutelas, or pleas, in order to access it. [3] One activist action, called Operation Wasp, involved filing seven tutelas in seven different courts in Bogotá so as to occupy the court dockets for ten days. All of the judges targeted by Operation Wasp ruled in favor of the tutelas. [3]

In 2008, with annual tutelas totaling around 100,000 the Constitutional Court of Colombia reached the T-760 decision, which made the obligatory government health plan more generous and provided for measures to be taken to decrease the incidence of arbitrary denial of health coverage. [3] The T-760 decision fundamentally reframed how health care was viewed in Colombia, and is commonly viewed as having created a "right to health" conception of health care in which health care is viewed as a human right. [3]

Today, almost 100% of Colombians are insured. The quality of that insurance has often been disputed, with reports of individuals being denied healthcare due to administrative or bureaucratic reasons. [3]

Needle and syringe program

In 2014, the Colombian Ministry of Health launched needle and syringe programs (NSPs) in five Colombian cities: Medellín, Bogotá, Cali, Cucuta, and Armenia. At its launch, the government allotted 100,000 syringes for distribution to people who inject drugs, in most cases heroin. [6]

Opioid substitution therapy

Colombia is one of only five countries in Latin America and the Caribbean to offer opioid substitution therapy, a drug therapy that involves replacing a drug such as heroin with another, less harmful opioid. In theory, OST would reduce rates of infection among intravenous drug users by decreasing the use of injection drugs. OST services are available in seven Colombian cities, but it is unknown how widely used these services are. [7]

AIDS activism in Colombia

Influenced by the emergence of similar groups in the U.S, early AIDS activism in Colombia initially consisted of support groups for people with AIDS. These groups, such as Seguro Social, El Club de la Alegría, and El Cartel de la Vida, focused initially on issues such as self-care and support for people with AIDS. Later, the groups shifted their focus towards access to treatment for HIV and AIDS. [3] Consistent with AIDS activism in other countries, early AIDS activism in Colombia was closely linked to LGBTQ organizations and the LGBTQ community as a whole. [3]

Affected populations

Men who have sex with men)

Men who have sex with men in Colombia experience significantly higher rates of HIV infection than does the general population. The prevalence of HIV among MSM in Colombia ranges from 6% to 24%, [8] and is highest in Cali, Bogotá, and Barranquilla. [9] Bogotá's rate of HIV among MSM is 15%, and the rate of HIV among MSM in Colombia as a whole is 17%. [1]

In a survey of seven Colombian cities, between 14% and 31% of men who have sex with men reported ever being tested for HIV.

Intravenous drug Users

In Colombia, people who inject drugs had an HIV prevalence rate of 2.8% in 2017. [1] Although additional studies are needed, recent epidemiological studies have shown an increase in both heroin usage and heroin injection in Colombia. Of particular note is the fact that though exported heroin in Colombia is of high quality, the heroin that is not exported and remains in Colombia to be sold to Colombian drug users tends to be of low quality and therefore tends to be water-soluble, which makes it more likely to be injected. A primary concern about the rise in the rate of drug injection in Colombia is the spread of HIV, both among drug-injecting and non drug-injecting populations. [10] A 2014 study found that heroin production in Colombia had formed "injection networks" which have the potential to spread HIV, particularly among young men. [11]

Sex workers

The 2017 prevalence of HIV among sex workers in Colombia was 1.2%. Over 90% of sex workers are aware of their HIV status, and over 94% report condom usage. [1] At the same time, many sex workers say that the see HIV testing as pointless, because they lack access to adequate treatment should they test positive. [3]

Related Research Articles

<span class="mw-page-title-main">Epidemiology of HIV/AIDS</span> Pandemic of HIV/AIDS

The global pandemic of HIV/AIDS began in 1981, and is an ongoing worldwide public health issue. According to the World Health Organization (WHO), by 2023, HIV/AIDS had killed approximately 40.4 million people, and approximately 39 million people were infected with HIV globally. Of these, 29.8 million people (75%) are receiving antiretroviral treatment. There were about 630,000 deaths from HIV/AIDS in 2022. The 2015 Global Burden of Disease Study estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year. Incidence of HIV has continued to fall, decreasing by 23% from 2010 to 2020, with progress dominated by decreases in Eastern Africa and Southern Africa. As of 2020, there are approximately 1.5 million new infections of HIV per year globally.

<span class="mw-page-title-main">HIV/AIDS in Europe</span>

In Western Europe, the routes of transmission of HIV are diverse, including paid sex, sex between men, intravenous drugs, mother to child transmission, and heterosexual sex. However, many new infections in this region occur through contact with HIV-infected individuals from other regions. In some areas of Europe, such as the Baltic countries, the most common route of HIV transmission is through injecting drug use and heterosexual sex, including paid sex.

Human immunodeficiency virus and acquired immune deficiency syndrome in Burma is recognised as a disease of concern by the Ministry of Health and is a major social and health issue in the country. In 2005, the estimated adult HIV prevalence rate in Burma was 1.3%, according to UNAIDS, and early indicators show that the epidemic may be waning in the country, although the epidemic continues to expand in parts of the country. Four different strains of HIV are believed to have originated from Burma, along heroin trafficking routes in northern, eastern and western Burma.

Since the first HIV/AIDS case in the Lao People's Democratic Republic (PDR) was identified in 1990, the number of infections has continued to grow. In 2005, UNAIDS estimated that 3,700 people in Lao PDR were living with HIV.

Kenya has a severe, generalized HIV epidemic, but in recent years, the country has experienced a notable decline in HIV prevalence, attributed in part to significant behavioral change and increased access to ARV. Adult HIV prevalence is estimated to have fallen from 10 percent in the late 1990s to about 4.8 percent in 2017. Women face considerably higher risk of HIV infection than men but have longer life expectancies than men when on ART. The 7th edition of AIDS in Kenya reports an HIV prevalence rate of eight percent in adult women and four percent in adult men. Populations in Kenya that are especially at risk include injecting drug users and people in prostitution, whose prevalence rates are estimated at 53 percent and 27 percent, respectively. Men who have sex with men (MSM) are also at risk at a prevalence of 18.2%. Other groups also include discordant couples however successful ARV-treatment will prevent transmission. Other groups at risk are prison communities, uniformed forces, and truck drivers.

Although Senegal is a relatively underdeveloped country, HIV prevalence in the general population is low at around 0.08 per 1000 people, under 1% of the population. This relatively low prevalence rate is aided by the fact that few people are infected every year – in 2016, 1100 new cases were reported vs 48,000 new cases in Brazil. Senegal's death due to HIV rate, particularly when compared it to its HIV prevalence rate, is relatively high with 1600 deaths in 2016. Almost two times as many women were infected with HIV as men in 2016, and while almost three times as many women were receiving antiretroviral therapy (ARV) as men, only 52% of HIV positive people in Senegal received ARV treatment in 2016.

HIV/AIDS in Eswatini was first reported in 1986 but has since reached epidemic proportions. As of 2016, Eswatini had the highest prevalence of HIV among adults aged 15 to 49 in the world (27.2%).

UNAIDS has said that HIV/AIDS in Indonesia is one of Asia's fastest growing epidemics. In 2010, it is expected that 5 million Indonesians will have HIV/AIDS. In 2007, Indonesia was ranked 99th in the world by prevalence rate, but because of low understanding of the symptoms of the disease and high social stigma attached to it, only 5-10% of HIV/AIDS sufferers actually get diagnosed and treated. According to the a census conducted in 2019, it is counted that 640,443 people in the country are living with HIV. The adult prevalence for HIV/ AIDS in the country is 0.4%. Indonesia is the country in Southeast Asia to have the most number of recorded people living with HIV while Thailand has the highest adult prevalence.

<span class="mw-page-title-main">HIV/AIDS in Nepal</span>

The first HIV/AIDS cases in Nepal were reported in 1988. The HIV epidemic is largely attributed to sexual transmissions and account for more than 85% of the total new HIV infections. Coinciding with the outbreak of civil unrest, there was a drastic increase in the new cases in 1996. The infection rate of HIV/AIDS in Nepal among the adult population is estimated to be below the 1 percent threshold which is considered "generalized and severe". However, the prevalence rate masks a concentrated epidemic among at-risk populations such as female sex workers (FSWs), male sex workers (MSWs), injecting drug users (IDUs), men who have sex with men (MSM), Transgender Groups (TG), migrants and male labor migrants (MLMs) as well as their spouses. Socio-Cultural taboos and stigmas that pose an issue for open discussion concerning sex education and sex habits to practice has manifest crucial role in spread of HIV/AIDS in Nepal. With this, factors such as poverty, illiteracy, political instability combined with gender inequality make the tasks challenging.

The Philippines has one of the lowest rates of infection of HIV/AIDS, yet has one of the fastest growing number of cases worldwide. The Philippines is one of seven countries with growth in number of cases of over 25%, from 2001 to 2009.

The southeast-Asian nation of East Timor has dealt with HIV/AIDS since its first documented case in 2001. It has one of the lowest HIV/AIDS-prevalence rates in the world.

Since HIV/AIDS was first reported in Thailand in 1984, 1,115,415 adults had been infected as of 2008, with 585,830 having died since 1984. 532,522 Thais were living with HIV/AIDS in 2008. In 2009 the adult prevalence of HIV was 1.3%. As of 2016, Thailand had the highest prevalence of HIV in Southeast Asia at 1.1 percent, the 40th highest prevalence of 109 nations.

Honduras is the Central American country most adversely affected by the HIV/AIDS epidemic. It is estimated that the prevalence of HIV among Honduran adults is 1.5%.

In 2016, the prevalence rate of HIV/AIDS in adults aged 15–49 was 0.3%, relatively low for a developing country. This low prevalence has been maintained, as in 2006, the HIV prevalence in Mexico was estimated at around 0.3% as well. The infected population is remains mainly concentrated among high risk populations, men who have sex with other men, intravenous drug users, and commercial sex workers. This low national prevalence is not reflected in the high-risk populations. The prison population in Mexico, faces a fairly similar low rate of around 0.7%. Among the population of prisoners, around 2% are known to be infected with HIV. Sex workers, male and female, face an HIV prevalence of around 7%. Identifying gay men and men who have sex with other men have a prevalence of 17.4%. The highest risk-factor group is identifying transgender people; about 17.4% of this population is known to be infected with HIV. Around 90% of new infections occur by sex-related methods of transmission. Of these known infected populations, around 60% of living infected people are known to be on anti-retroviral therapy (ART).

Nicaragua has 0.2 percent of the adult population estimated to be HIV-positive. Nicaragua has one of the lowest HIV prevalence rates in Central America.

With less than 1 percent of the population estimated to be HIV-positive, Egypt is a low-HIV-prevalence country. However, between the years 2006 and 2011, HIV prevalence rates in Egypt increased tenfold. Until 2011, the average number of new cases of HIV in Egypt was 400 per year, but in 2012 and 2013, it increased to about 600 new cases, and in 2014, it reached 880 new cases per year. According to 2016 statistics from UNAIDS, there are about 11,000 people currently living with HIV in Egypt. The Ministry of Health and Population reported in 2020 over 13,000 Egyptians are living with HIV/AIDS. However, unsafe behaviors among most-at-risk populations and limited condom usage among the general population place Egypt at risk of a broader epidemic.

The first HIV/AIDS case in Malaysia made its debut in 1986. Since then, HIV/AIDS has become one of the country's most serious health and development challenges. As of 2020, the Ministry of Health estimated that 87 per cent of an estimated 92,063 people living with HIV (PLHIV) in Malaysia were aware of their status, 58 per cent of reported PLHIV received antiretroviral therapy, and 85 per cent of those on antiretroviral treatment became virally suppressed. Despite making positive progress, Malaysia still fell short of meeting the global 2020 HIV goals of 90-90-90, with a scorecard of 87-58-85.

Discrimination against people with HIV/AIDS or serophobia is the prejudice, fear, rejection, and stigmatization of people with HIV/AIDS. Marginalized, at-risk groups such as members of the LGBTQ+ community, intravenous drug users, and sex workers are most vulnerable to facing HIV/AIDS discrimination. The consequences of societal stigma against PLHIV are quite severe, as HIV/AIDS discrimination actively hinders access to HIV/AIDS screening and care around the world. Moreover, these negative stigmas become used against members of the LGBTQ+ community in the form of stereotypes held by physicians.

Since reports of emergence and spread of the human immunodeficiency virus (HIV) in the United States between the 1970s and 1980s, the HIV/AIDS epidemic has frequently been linked to gay, bisexual, and other men who have sex with men (MSM) by epidemiologists and medical professionals. It was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. The first official report on the virus was published by the Center for Disease Control (CDC) on June 5, 1981, and detailed the cases of five young gay men who were hospitalized with serious infections. A month later, The New York Times reported that 41 homosexuals had been diagnosed with Kaposi's sarcoma, and eight had died less than 24 months after the diagnosis was made.

References

  1. 1 2 3 4 5 6 7 8 "Colombia". UNAIDS. UNAIDS. Retrieved 11 December 2017.
  2. ↑ Ballvé, Teo. "Colombia: AIDS in the Time of War". nacla.org. Retrieved 14 December 2017.
  3. 1 2 3 4 5 6 7 8 9 10 11 Prachniak-rincón, Corey; Villar de Onís, Jimena (Dec 2016). "HIV and the Right to Health in Colombia". Health and Human Rights. 18 (2): 157–169. PMC   5395009 . PMID   28559683.
  4. ↑ García, Patricia J; Bayer, Angela; Cárcamo, César P (1974). "The Changing Face of HIV in Latin America and the Caribbean". Electroencephalogr Clin Neurophysiol. 37 (2): 393–8. doi:10.1007/s11904-014-0204-1. PMC   4136548 . PMID   24824881.
  5. ↑ Arrivillaga M1, Hoyos PA, Tovar LM, Varela MT, Correa D, Zapata H. (2012). "HIV testing and counselling in Colombia: evidence from a national health survey and recommendations for health-care services". International Journal of STD & AIDS. 23 (11): 815–21. doi:10.1258/ijsa.2012.011468. hdl: 11522/3551 . PMID   23155103. S2CID   44374524.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
  6. ↑ McKenzie, Victoria (2014-07-04). "Colombia kicks off 1st clean needle program for drug addicts". Colombia Reports. Retrieved 8 November 2017.
  7. ↑ "HIV AND AIDS IN LATIN AMERICA THE CARIBBEAN REGIONAL OVERVIEW". Avert. 2015-07-21. Retrieved 13 December 2017.
  8. ↑ Carol A. Reisen, Maria Cecilia Zea, Fernanda T. Bianchi, Paul J. Poppen, Ana Maria del Río González, Rodrigo A. Aguayo Romero, and Carolin Pérez (2014). "HIV testing among MSM in Bogotá, Colombia: The role of structural and individual characteristics". AIDS Educ Prev. 26 (4): 328–44. doi:10.1521/aeap.2014.26.4.328. PMC   4121962 . PMID   25068180.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ↑ Martha Lucía Rubio Mendoza, Jerry Owen Jacobson, Sonia Morales-Miranda, Clara Ángela Sierra Alarcón, Ricardo Luque Núñez (2015). "High HIV Burden in Men Who Have Sex with Men across Colombia's Largest Cities: Findings from an Integrated Biological and Behavioral Surveillance Study". PLOS ONE. 10 (8): e0131040. Bibcode:2015PLoSO..1031040R. doi: 10.1371/journal.pone.0131040 . PMC   4529092 . PMID   26252496.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  10. ↑ José Miguez, Maria; Page, Bryan; Baum, Marianna K (1997). "Illegal drug use and HIV-1 infection in Colombia". The Lancet. 350 (9091): 1635. doi: 10.1016/S0140-6736(05)64059-7 . PMID   9393372. S2CID   31656328.
  11. ↑ P. Mateu-Gelabert1, D. Berbesi2, I.E.M. Motta3,4, H. Guarino1, S. Harris (2014). "Heroin production in Colombia: A time-bomb for a drug injection-driven HIV epidemic in Colombia?". National Institute on Drug Abuse. Retrieved 16 November 2017.{{cite web}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.