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Review
. 2005 Jul;95(7):1162-72.
doi: 10.2105/AJPH.2004.054593. Epub 2005 Jun 2.

A critical analysis of the Brazilian response to HIV/AIDS: lessons learned for controlling and mitigating the epidemic in developing countries

Alan Berkman  1 , Jonathan Garcia, Miguel Muñoz-Laboy, Vera Paiva, Richard Parker
Affiliations
Review

A critical analysis of the Brazilian response to HIV/AIDS: lessons learned for controlling and mitigating the epidemic in developing countries

Alan Berkman et al. Am J Public Health. 2005 Jul.

Abstract

The Brazilian National AIDS Program is widely recognized as the leading example of an integrated HIV/AIDS prevention, care, and treatment program in a developing country. We critically analyze the Brazilian experience, distinguishing those elements that are unique to Brazil from the programmatic and policy decisions that can aid the development of similar programs in other low- and middle-income and developing countries.Among the critical issues that are discussed are human rights and solidarity, the interface of politics and public health, sexuality and culture, the integration of prevention and treatment, the transition from an epidemic rooted among men who have sex with men to one that increasingly affects women, and special prevention and treatment programs for injection drug users.

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Figures

FIGURE 1—
FIGURE 1—
Percentage of AIDS cases by type of transmission and year of diagnosis: Brazil, 1980–2003. Source. National AIDS Program, Brazilian Ministry of Health. Note. Notified cases up to December 31, 2003.
FIGURE 2—
FIGURE 2—
Gender ratio (male to female) of notified AIDS cases: Brazil, 1985–2002. Source. National AIDS Program, Brazilian Ministry of Health.
FIGURE 3—
FIGURE 3—
Percentage of AIDS cases among those aged 19 years and older, by level of education: Brazil, 1985–2002. Source. National AIDS Program, Brazilian Ministry of Health.
FIGURE 4—
FIGURE 4—
Number of AIDS cases and incidence rate, by year of diagnosis: Brazil, 1992–2003. Source. National AIDS Program, Brazilian Ministry of Health. Note. Notified cases up to December 31, 2003.
FIGURE 5—
FIGURE 5—
AIDS mortality rate, by gender: Brazil, 1984–2002. Source. National AIDS Program, Brazilian Ministry of Health.
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References

    1. National Coordination for STD and AIDS. The Brazilian Response to HIV/AIDS. Brasília, Brazil: Ministry of Health; 2000.
    1. Parker R, Passarrelli CA, Terto V, Pimenta C, Berkman A, Muñoz-Laboy M. The Brazilian response to HIV/AIDS: assessing its transferability. Divulgação em Saúde para Debate. 2003;27:140–142.
    1. Ministry of Health of Brazil, National Coordination for STD and AIDS. Drugs and AIDS. The Brazilian Response to HIV/AIDS: Best Practices. Brasilia, Brazil: Ministry of Health; 2000:116–130.
    1. World Health Organization. The World Health Report 2004: changing history. Available at: http://www.who.int/whr/2004/en/report04_en.pdf. Accessed October 7, 2004.
    1. Antonio de Ávila Vitória M. The experience of providing universal access to ARV drugs in Brazil. Divulgação em Saúde para Debate. 2003;27:247–264.

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