Care and support for people living with HIV/AIDS
Care and support for people living with HIV/AIDS
Care and support for people living with HIV/AIDS
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Report on the global <strong>HIV</strong>/<strong>AIDS</strong> epidemic – June 2000the rate in one health centre, in Port Loyola, hitting 4.8%. In the Honduran city of SanPedro Sula, the rate of <strong>HIV</strong> infection among pregnant women has fluctuatedbetween 2% <strong>and</strong> 5% <strong>for</strong> several years. Much of the problem is concentrated inteenagers, suggesting that the worst is still to come. Between one-fifth <strong>and</strong> onetenthof sex workers are infected in various cities in Honduras. In some ethnic subgroups,principally on the Caribbean coast, the prevalence in 15–49-year-old men<strong>and</strong> women exceeds 8%, <strong>and</strong> the rates in men <strong>and</strong> women in their 20s are twice ashigh. In Guatemala, <strong>HIV</strong> infection follows a similar pattern, <strong>with</strong> higher infection ratesamong pregnant women <strong>and</strong> sex workers in coastal cities <strong>and</strong> the capital than inhighl<strong>and</strong> cities.Heterosexual transmission of <strong>HIV</strong> is rarer in other countries of Central America. InCosta Rica, <strong>for</strong> example, <strong>HIV</strong> is transmitted mainly during unprotected sex betweenmen. In this country, as in many other parts of Latin America, there is little systematicsurveillance <strong>for</strong> <strong>HIV</strong> among groups <strong>with</strong> high-risk behaviour, but studies amongmen who have sex <strong>with</strong> men in Costa Rica showed infection rates of 10–16% aslong ago as 1993.In Mexico, too, <strong>HIV</strong> has affected mainly men who have sex <strong>with</strong> men, more than 14% ofwhom are currently infected. <strong>HIV</strong> rates among pregnant women, however, are extremelylow. Data from a programme to reduce the transmission of <strong>HIV</strong> from mothers to infantssuggest that fewer than 1 in every 1000 women of childbearing age is infected. Evenamong female sex workers in Mexico, the prevalence rate is well under 1%.Box 3. A measure of success: young Brazilians increasingly rejectunprotected sexIn Brazil, where over half a million adults are <strong>living</strong> <strong>with</strong> <strong>HIV</strong>, the Government hastaken an active lead in <strong>HIV</strong> prevention, care <strong>and</strong> protection of the rights of <strong>people</strong>affected by the epidemic. Perhaps the most visible commitment is the Government’sundertaking to provide free antiretroviral therapy to all those who need it (see page101). Alongside this, the Government has committed considerable resources tofighting <strong>HIV</strong> through in<strong>for</strong>mation campaigns <strong>and</strong> prevention services. To help ensurethat these services reach not just the general population but also marginalizedgroups, whose members make up an increasing proportion of those infected <strong>with</strong><strong>HIV</strong>, the Government has <strong>for</strong>ged active partnerships <strong>with</strong> nongovernmental organizations<strong>and</strong> others.A survey of the sexual behaviour of 3500 adults shows that young Brazilians are moreable <strong>and</strong> willing to negotiate condom use <strong>with</strong> their partners than ever be<strong>for</strong>e. Whilein 1986 less than 5% of young men reported using a condom the first time they hadsex, the figure in 1999 was close to 50% – a tenfold increase. Among men <strong>with</strong>higher educational levels, over 70% surveyed in 1999 said they used a condom <strong>for</strong>their first act of intercourse.–––>16