Epidemic of AIDS in the countries of the region

HIV pandemic continues to be one of the most important challenges for public health worldwide in terms of communicable diseases. According to the latest “Report on the World Epidemic of AIDS” for 2007, 33 million people live with HIV, where Sub-Saharan Africa is the most severely affected region due to a yet inappropriate access to services for preventing and treating HIV (UNAIDS, 2008/1 ).

According to the United Nations Joint Program on HIV/AIDS, the epidemic of HIV in Latin America is in general terms stable, and new 100,000 HIV infections are projected for 2007, raising the total number of people living with HIV to 1.6 million for the same year (UNAIDS, 2008/1 ).

A more worry-some situation is observed in the Caribbean countries where HIV prevalence in adult population is particularly high (Bahamas, Guyana, Haiti, Belize), altogether amounting to a rate of 1.1%.

Most countries of the region HIV prevalence has been stable in population aged 15-49 with the exception of Honduras, Bahamas, and Dominican Republic where a decrease is observed in 22.2%, 15.4%, and 3.2%, respectively for the period between 2001 and 2007.

In regard to HIV prevalence data in young population by 2007, HIV prevalence in most countries tends to be higher among men than women of the same age with the exception of Guyana, Belize, Trinidad and Tobago, and Dominican Republic, where HIV prevalence in women almost doubles when compared to men. In countries showing greater prevalence, the effect of HIV/AIDS in mortality is higher and results in a decrease in life expectation average thus entailing a regress in progress already achieved (United Nations, 2005/2 ).

Unprotected sex is the main factor of risk in most countries of the region, and according to different reports it has become the primary channel of transmission of the disease particularly in the homosexual population (especially in Central American countries) as well as in the heterosexual population.

Other factors of risk are early age when having sex, multiple sexual partners, adolescent pregnancy, addiction to drugs, and other sexually transmitted diseases which significantly increase the likelihood of infection during intercourse.

There is consensus that systematic use of condoms when practicing sex with non-customary partners reduces the risk of being infected with HIV by sexual transmission. This is one among different mechanisms to reduce the risk of contracting HIV. It is in particular important for young people who frequently have the highest rates of HIV infection as they have a lower previous exposure to the infection and (in general) have a rather higher number of casual sexual partners (United Nations, 2003/3).

While information in the countries of the region in this regard is scarce, data show different realities for the countries. The percentage of use of preservative is higher in men, e.g. in Chile and Honduras the rate does not reach 30%.

Risky behavior in population is mostly due to lack of accurate and complete information about how to prevent exposure to the virus. This indicator reflects the success national information, education, and communication programs have, as well as other initiatives aiming to promote awareness of methods that are valid in the prevention of HIV and in reducing misconceptions about the disease.

While young people aged 15-24 represents 45% of all new HIV infections in adults, many of these young people still lack proper knowledge. For instance, data show that in Bolivia barely 18% of men and 5% of women aged 15-24 have an accurate and comprehensive knowledge of HIV and about ways to prevent transmission (UNAIDS, 2008/1 ).

Prevention of new HIV infections seems to be essential in reversing the course of the epidemic. While access to treatment has gradually growth in recent years, efforts to ensure sound activities in HIV prevention are still lagging behind. Nevertheless, 87% of the countries that have the Goal of universal access have set objectives for HIV treatment, and only barely over half have existing objectives set for fundamental strategies for HIV prevention (UNAIDS, 2008/1 ).

Data from countries of the region show that in only 6 out of the 27 countries for which information is available more than 70% of the population severely infected has access to treatment using antiretroviral drugs. In Bolivia, Paraguay, and Nicaragua the population who have access to treatment do not reach 30%.

Incidence of Malaria in the countries of Latin America and the Caribbean

Malaria and tuberculosis are also treatable and preventable diseases which affect the health and economic wellbeing of the poorest communities in the world.

Incidence of malaria in Latin America and the Caribbean is much lower than in most affected regions in the world. Communication of malaria is present in 9 countries of the region. These countries share the Amazon forest. In addition to this, 8 countries in Central America and the Caribbean have the disease, totaling 21 countries where the disease is endemic (United Nations, 2008/4 ). The Report of Malaria in the world states that much progress has been made with the introducction of prevention and treatment programs for most affected people by this devastating disease in the last four or five years (UNICEF – WHO, 2005/5 ).

According to 2003 data, most countries of the region have reduced the rate of incidence associated to malaria since 1990, and Nicaragua, Honduras, and Belize achieved a remarkable decrease in the rate of incidence. On the other hand, the situation of Guyana and Surinam is of high concerns with an incidence rate exceeding 30%. This is a situation that has grown steadily in recent years.

Incidence, prevalence, and mortality by Tuberculosis in Latin America and the Caribbean

The incidence of tuberculosis, like malaria, has been reduced since 1980 and this trend is expected to continue until 2015. In 2006, the Latin American and the Caribbean countries reported 209,000 new cases of people in productive age affected, in particular men. The situation entailed a severe economic impact on the families and the society as a whole (United Nations, 2008/4 ).