Late Presentation HIV/AIDS Is Still a Challenge in Brazil and Worldwide

Abstract

Despite all the efforts to contain the HIV/AIDS epidemics, there still are individuals of unknown diagnosis. These present high risk of mortality and after diagnosis respond very poorly to treatment. Late testing also represents a reduced opportunity in controlling the transmission of HIV and causes an indirect increase in the transmission rates of other diseases, such as tuberculosis. In European countries, as well as in the United States, a great number of people, represented especially by illegal immigrants, black individuals, and women, markedly present at a later state of infection. In 1996, Brazil was the very first developing country to offer free and universal access to antiretroviral therapy, as well as easy access to HIV testing and care. Nonetheless, there is still a significant number of young and adult subjects who look for HIV/AIDS services and hospitals at later stage of infection by HIV (late presenters). Here we discuss important aspects related to the late diagnosis of HIV in Brazil and worldwide.

Epidemiology of HIV, syphilis, and hepatitis B and C among manual cane cutters in low-income regions of Brazil

“…In Brazil, the epidemic of HIV/AIDS is moving from urban centers and reaching small cities and villages [ 10 ], and this investigation supports this dynamic. Most rural workers were poor seasonal migrants with low education, from small cities of the poorest regions of Brazil (North and Northeast).…”

“…In Brazil, the epidemic of HIV infection started in the industrialized regions of the southeast and south, and vulnerable urban groups have the highest burden of this infection [ 7 – 9 ]. However, in the last decade the HIV epidemic has reached inner cities and rural regions, far from the epicenter of the epidemic, where access to health services is limited and often low quality [ 10 ]. Further, HIV infection is often accompanied by other asymptomatic sexually transmitted infections such as syphilis and viral hepatitis, which, like HIV, have great potential for dissemination in impoverished vulnerable populations [ 1 ].…”

“…Further, HIV infection is often accompanied by other asymptomatic sexually transmitted infections such as syphilis and viral hepatitis, which, like HIV, have great potential for dissemination in impoverished vulnerable populations [ 1 ]. There are few studies in Brazil on the epidemiology of these infections in less populated regions of the country [ 8 , 10 ].…”

Late diagnosis of Human Immunodeficiency Virus infection and associated factors

“…Like Brazil, most of the countries in Latin America face a concentrated epidemic, with a large number of people still undiagnosed and a high prevalence of late diagnosis and, consequently, late onset of ART ( 27 ) . Late diagnosis is a continuous, worrying, and serious challenge for the control of the AIDS pandemic, as it is directly related to higher rates of morbidity and mortality ( 28 - 29 ) and to the need for greater investment by the health systems ( 10 , 30 ) .…”

Economic and epidemiological evaluation of text message-based interventions in patients with the Human Immunodeficiency Virus

“…3) Smile, breathe, and go ahead. The model was based on HIV infection prevalence rates in Brazil considering the year 2017 (1,20) . The 20- The effectiveness data were based on data from the RCT (reduction of viral load) and on data from the literature (general infection rate) (21)(22)(23)(24) .…”