HIV/AIDS in Latin America

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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]

Contents

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 LGBT+ 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 and 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 LGBT+ friendly clinics. [5] Other main prevention methods include condom availability, education and outreach, HIV awareness, and mother-to-child transmission prevention. [1]

Prevalence

The 2001 prevalence rate of HIV/AIDS in Latin America was highest in Belize (2%), Honduras (1.9%), Panama (1.54%) and  Guatemala (1.4%). [6] 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%). [6]

History

The first documented reporting of what would come to be known as HIV/AIDS happened in June 1981. [7] In September 1982, AIDS is given its name and a case definition for the very first time. [8] 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. [9] Blood screening in Mexico was scare in the early 1990s, which contributed to 63% of female AIDS cases stemming from blood transfusions. [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

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] In 2009, the Elimination Initiative was launched in partnership with UNICEF, the Pan American Health Organization, the Latin American Center for Perinatology (CLAP) and other organizations. It aimed to integrate the services of prevention and diagnosis of both HIV and syphilis within the framework of primary care services, prenatal, sexual, reproductive and family health. [13]

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. [14] 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. [15] [1]

See also

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

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Angola has a large HIV/AIDS infected population, however, it has one of the lowest prevalence rates in the Southern Africa zone. The status of the HIV/AIDS epidemic in Angola is expected to change within the near future due to several forms of behavioral, cultural, and economic characteristics within the country such as lack of knowledge and education, low levels of condom use, the frequency of sex and number of sex partners, economic disparities and migration. There is a significant amount of work being done in Angola to combat the epidemic, but most aid is coming from outside of the country.

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

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<span class="mw-page-title-main">HIV/AIDS in Malawi</span> Impact of the immunodeficiency virus in the African nation

As of 2012, approximately 1,100,000 people in Malawi are HIV-positive, which represents 10.8% of the country's population. Because the Malawian government was initially slow to respond to the epidemic under the leadership of Hastings Banda (1966–1994), the prevalence of HIV/AIDS increased drastically between 1985, when the disease was first identified in Malawi, and 1993, when HIV prevalence rates were estimated to be as high as 30% among pregnant women. The Malawian food crisis in 2002 resulted, at least in part, from a loss of agricultural productivity due to the prevalence of HIV/AIDS. Various degrees of government involvement under the leadership of Bakili Muluzi (1994–2004) and Bingu wa Mutharika (2004–2012) resulted in a gradual decline in HIV prevalence, and, in 2003, many people living in Malawi gained access to antiretroviral therapy. Condoms have become more widely available to the public through non-governmental organizations, and more Malawians are taking advantage of HIV testing services.

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

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

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<span class="mw-page-title-main">HIV/AIDS in Zimbabwe</span> Major public health issue

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<span class="mw-page-title-main">HIV-affected community</span> Medical condition

The affected community is composed of people who are living with HIV and AIDS, plus individuals whose lives are directly influenced by HIV infection. This originally was defined as young to middle aged adults who associate with being gay or bisexual men, and or injection drug users. HIV-affected community is a community that is affected directly or indirectly affected by HIV. These communities are usually influenced by HIV and undertake risky behaviours that lead to a higher chance of HIV infection. To date HIV infection is still one of the leading cause of deaths around the world with an estimate of 36.8 million people diagnosed with HIV by the end of 2017, but there can particular communities that are more vulnerable to HIV infection, these communities include certain races, gender, minorities, and disadvantaged communities. One of the most common communities at risk is the gay community as it is commonly transmitted through unsafe sex. The main factor that contributes to HIV infection within the gay/bisexual community is that gay men do not use protection when performing anal sex or other sexual activities which can lead to a higher risk of HIV infections. Another community will be people diagnosed with mental health issues, such as depression is one of the most common related mental illnesses associated with HIV infection. HIV testing is an essential role in reducing HIV infection within communities as it can lead to prevention and treatment of HIV infections but also helps with early diagnosis of HIV. Educating young people in a community with the knowledge of HIV prevention will be able to help decrease the prevalence within the community. As education is an important source for development in many areas. Research has shown that people more at risk for HIV are part of disenfranchised and inner city populations as drug use and sexually transmitted diseases(STDs) are more prevalent. People with mental illnesses that inhibit making decisions or overlook sexual tendencies are especially at risk for contracting HIV.

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.

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. 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. 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.

<span class="mw-page-title-main">Transgender sex workers</span>

Transgender sex workers are transgender people who work in the sex industry or perform sexual services in exchange for money or other forms of payment. In general, sex workers appear to be at great risk for serious health problems related to their profession, such as physical and sexual assault, robbery, murder, physical and mental health problems, and drug and alcohol addiction. Though all sex workers are at risk for the problems listed, some studies suggest that sex workers who engage in street-based work have a higher risk for experiencing these issues. Transgender sex workers experience high degrees of discrimination both in and outside of the sex industry and face higher rates of contracting HIV and experiencing violence as a result of their work. In addition, a clear distinction needs to be made between consensual sex work and sex trafficking where there is a lack of control and personal autonomy.

<span class="mw-page-title-main">LGBT health in South Korea</span>

The health access and health vulnerabilities experienced by the lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual (LGBTQIA) community in South Korea are influenced by the state's continuous failure to pass anti-discrimination laws that prohibit discrimination based on sexual orientation and gender identity. The construction and reinforcement of the South Korean national subject, "kungmin," and the basis of Confucianism and Christian churches perpetuates heteronormativity, homophobia, discrimination, and harassment towards the LGBTQI community. The minority stress model can be used to explain the consequences of daily social stressors, like prejudice and discrimination, that sexual minorities face that result in a hostile social environment. Exposure to a hostile environment can lead to health disparities within the LGBTQI community, like higher rates of depression, suicide, suicide ideation, and health risk behavior. Korean public opinion and acceptance of the LGBTQI community have improved over the past two decades, but change has been slow, considering the increased opposition from Christian activist groups. In South Korea, obstacles to LGBTQI healthcare are characterized by discrimination, a lack of medical professionals and medical facilities trained to care for LGBTQI individuals, a lack of legal protection and regulation from governmental entities, and the lack of medical care coverage to provide for the health care needs of LGBTQI individuals. The presence of Korean LGBTQI organizations is a response to the lack of access to healthcare and human rights protection in South Korea. It is also important to note that research that focuses on Korean LGBTQI health access and vulnerabilities is limited in quantity and quality as pushback from the public and government continues.

References

  1. 1 2 3 4 5 6 7 8 9 "HIV and AIDS in Latin America the Caribbean regional overview". Avert. 2015-07-21. Retrieved 2019-11-17.
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  3. ↑ "Homophobia and HIV". Avert. 2015-07-20. Retrieved 2019-11-17.
  4. 1 2 "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. 1 2 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. PMID   11714621.
  7. ↑ "A Timeline of HIV and AIDS". HIV.gov. 2016-05-11. Retrieved 2019-11-18.
  8. ↑ "Current Trends Update on Acquired Immune Deficiency Syndrome (AIDS) --United States". www.cdc.gov. Retrieved 2019-11-18.
  9. ↑ 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. S2CID   21327411.
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  11. 1 2 3 4 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. 1 2 3 4 5 "Prevention | HIV Basics | HIV/AIDS | CDC". www.cdc.gov. 2019-12-02. Retrieved 2019-12-05.
  13. ↑ Organización Panamericana de la Salud. Iniciativa regional para la eliminación de la transmisión maternoinfantil de VIH y de la sífilis congénita en América Latina y el Caribe: documento conceptual. Montevideo: CLAP/SMR; set. 2009
  14. ↑ 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.
  15. ↑ 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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