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This chapter begins with a description of the epidemiology of AIDS and HIV in Brazil. It then discusses treatment, results of free access to antiretroviral drugs, co-infection, and prevention. The HIV/AIDS epidemic in Brazil was detected early in the 1980s. Its progress seems to have been at least partially curbed by early and integrated response, including the establishment of an inclusive epidemiological surveillance system. The epidemic is characterized as concentrated since the prevalence among certain vulnerable groups is higher than 5%, but it is below 1% in the general population.

In chronic heart failure (CHF) 85% of patients have been reported some episode of erectile dysfunction and 34% reported overactive bladder. We evaluate the muscle reactivity of isolated corpus cavernosum (CC) and detrusor muscle (DM) of CHF rats (CHFR). Concentration responses curves to phenilephrine (PE) in CC (4wks); and carbachol (CCh), KCl in DSM were obtained from CHFR (4‐12wks). Nitrergic and neurogenic responses induced by electrical field stimulation were obtained in CC and DM (respect). Intracavernosal pressure (ICP) and cystometry (in vivo, respect.) also were evaluated. PE contracted CC with a potency (pEC50) of 5.44 ± 0.04. The pEC50 of PE did not change in CHFR (5.36 ± 0.06), but, the maximal response (Emax) was increased (2.5 ± 0.1mN/mg; P<0.05) compared with sham rats (SR; 1.9 ± 0.1 mN/mg). Nitrergic relaxation in CC was significantly decreased at higher frequencies in CHFR. ICP was reduced in CHFR vs SR (P<0.05). CCh and KCl contracted DM with a pEC50 of 5.42 ± 0.07 and 0.90 ± 0.12, respectively. The pEC50 of CCh and KCl did not change in CHFR (5.68 ± 0.07; 1.34 ± 0.11, respect.), but, the Emax were increased (1.09 ± 0.07; 0.88 ± 0.05mN/mg, respect; P<0.05) vs SR (1.45 ± 0.10; 1.29 ± 0.11 mN/mg, respect.). In CHFR neurogenic contractions in DM were significantly increased in all frequencies vs SR. Cystometry were increase in CHFR vs SR (P<0.05). In conclusion, CHFR exhibit an impaired nitrergic response (CC) and erectile function, and an increase of contractile‐mechanism in DSM and cystometry featuring the genitourinary dysfunctions in CHFR. Grant Funding Source: FAPESP/CNPq