Fighting HIV — Lessons from Brazil

Grand challenges in chronic non-communicable diseases

“…Meanwhile, HIV infection levels among female sex workers are widely varied. HIV prevalence is very low in some South American countries, such as Chile and Venezuela (Bautista et al, 2006), but prevalence rates of between 2.8% and 6.3% have been found in cities in Argentina (Montano et al, 2005;Bautista et al, 2006;Pando et al, 2006), and 6% prevalence has been reported among sex workers in parts of Brazil (Okie, 2006;Trevisol and da Silva, 2005).…”

“…The country's emphasis on prevention and treatment has helped to keep its HIV epidemic stable for the past several years (Okie, 2006). Amid the concerted promotion of sex education and AIDS prevention in schools, condom use, harm reduction and HIV testing, adult national HIV prevalence has remained steady at roughly 0.5% since 2000.…”

“…One large survey in 2004 found that more than three quarters of injecting drug users did not use non-sterile drug equipment or syringes (Okie, 2006). The decline in HIV infections among injecting drug users appears to be associated with the introduction of harm reduction programmes, changing drug use habits (especially an increase in the inhaling or smoking of 'crack' cocaine), and mortality among drug users (Fonseca et al, 2006).…”

“…It is estimated that one third of adults in Brazil have been tested for HIV (the majority of them women aged 25-39 years) (Paiva, Pupo, Barboza, 2006), and that about one in three HIV-infected Brazilians is aware of his or her HIV status (Okie, 2006). Antiretroviral provision is among the most comprehensive in the world, and is yielding positive results.…”

“…Nationally, mother-to-child transmission of HIV declined substantially, from 16% in 1997 to less than 4% in 2002 (Dourado et al, 2006). AIDS mortality rates decreased by 50% between 1996 and 2002, while AIDS-related hospitalizations fell by 80% during the same period (Okie, 2006 (Vignoles et al, 2006), 7%-15% of men who have sex with men (Montano et al, 2005), and 6% of female sex workers (Montano, et al, 2005;Bautista et al, 2006) have been found to be HIV-infected. As much as one quarter (28%) …”