Human immunodeficiency virus, AIDS, and drug consumption in South America and the Caribbean: epidemiological evidence and initiatives to curb the epidemic

Abstract

Objective. The paper reviews data on drug use in relation to the spread of human immunodeficiency virus and AIDS in South America Conclusion. Greater participation of Latin American and Caribbean countries in research protocols and continued debate on both successful and failed experiences should be encouraged in order to minimize existing barriers to the full adoption of effective measures to curb the human immunodeficiency virus and AIDS epidemic in this Region.South America; Caribbean; drug use; cocaine, human immunodeficiency virus; AIDS. ABSTRACTEpidemiological studies addressing the intertwined epidemics of injection drug use, human immunodeficiency virus (HIV) and AIDS in South America and the Caribbean are still fragmentary. Health professionals and policy makers face great difficulties in assessing the initiatives aimed at curbing the spread of HIV in different countries of the Region (1) and providing management and care to HIVinfected drug users (2).Given these obstacles, a remarkable achievement has been the inclusion of South American cities in large, multicenter studies such as those sponsored Key wordsHacker MA, Malta M, Enriquez M, Bastos FI. Human immunodeficiency virus, AIDS and drug consumption in South America and the Caribbean: epidemiological evidence and initiatives to curb the epidemic. Rev Panam Salud Publica. 2005;18(4/5):303-13.

Prevention of HIV/AIDS among injecting drug users in Russia: Opportunities and barriers to scaling-up of harm reduction programmes

“…The denial of HIV/AIDS and behavioural risks contributing to the epidemic are not uncommon in many countries [82,83]. In the Soviet Union and postcommunist Russia this denial has been reinforced by the political discourse of the Soviet ideology aimed at bringing up "ideal" men and women.…”

Heroin Use and Injection Risk Behaviors in Colombia: Implications for HIV/AIDS Prevention

“…Some studies point to both the availability of heroin in Colombia’s internal market and the widespread prevalence of local heroin use since the mid-1990s (Hacker, Malta, Enriquez, & Bastos, 2005; Mejía Motta, 2003). Epidemiological studies confirm an increase in local heroin use in recent decades (Gobierno Nacional de la República de Colombia, 2004, 2009; Pérez Gómez, 1989, 1999; Pérez Gómez, Scoppetta, & Peña, 2002; Rumbos, 2001).…”

Epidemiological aspects mortality of acquired immunodeficiency syndrome in the city of Florianópolis, Brazil (1986–2006)

“…Untill the 1990s, issues with drug trafficking and consumption, especially cocaine, showed the exposure of IDUs to AIDS in the South region, with epidemics spotted in coastal municipalities of Santa Catarina and Rio Grande do Sul (15,17,21) . These facts represent the process of heterosexualization, feminization, interiorization and impoverishment of the disease in the 20 th century.…”

“…Late diagnosis, resistance of patients to antiretroviral drugs, gaps in assistance, difficulties in adhesion and improper treatment of coinfections such as hepatitis and tuberculosis still contribute to lethality among adults living with AIDS. The access to prevention resources, to health services and to early treatment, on the other hand, favor survival among these patients (17,21) . Stabilization and reduction in obits are related to the treatment with antiretroviral drugs, especially in the South and Southeast regions, where the epidemics is established for longer, with the control of drugs entrance and consumption, the change in the pattern of injecting drugs use to oral or inhalation routes (ecstasy, crack rocks, crystal, among others), and the reduction of cases among homosexual/bisexuals, and IDUs (5) .…”

“…When the subject is prevention, Brazil has invested in public policies to promote access to health, education and social features for the population in general (10,11,13,21) . Epidemiological surveillance of Florianópolis, paying attention to AIDS and to the perspective of treatment with antiretroviral drugs, invested in a decentralization of assistance to AIDS patients and created, starting in 2006: two Specialized Centers (SAEs) located in the center and in the mainland, two Assistance and Advising Centers (CTAs) in the central area (inland) and in the mainland, and the Program for Damage Reduction (PRD), aiming at avoiding HIV transmission among IDUs.…”