Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Sep;14(5):366-373.
doi: 10.1097/COH.0000000000000564.

The HIV epidemic in Latin America: accomplishments and challenges on treatment and prevention

Paula M Luz  1 , Valdilea G Veloso, Beatriz Grinsztejn
Affiliations
Review

The HIV epidemic in Latin America: accomplishments and challenges on treatment and prevention

Paula M Luz et al. Curr Opin HIV AIDS. 2019 Sep.

Abstract

Purpose of review: To describe how countries in Latin America and the Caribbean are (or are not) meeting 2016 WHO guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, that is, their progress on the adoption of 'Treat All' and of preexposure prophylaxis (PrEP) as an additional prevention tool for people at substantial risk of HIV infection.

Recent findings: The HIV epidemic in the region continues largely concentrated in vulnerable populations with MSM and transgender women (TGW) suffering the highest burden. On treatment, the challenges of late initiation as well as suboptimal adherence persist. On prevention, recent studies on PrEP willingness in key populations show promising results, meanwhile PrEP implementation projects as well as actual PrEP adoption by national health systems is expanding. A glimpse of real-world PrEP uptake is shown through Brazil's first-year experience of offering PrEP in multiple cities in all regions of the country.

Summary: In conclusion, accomplishments have been made though challenges for fully addressing the HIV epidemic persist. The impact of both treatment and PrEP will be limited by the availability and prompt use of all services, including HIV testing.

PubMed Disclaimer

Figures

Box 1
Box 1
no caption available
FIGURE 1
FIGURE 1
Preexposure prophylaxis MSM demand (bars with ranges) and uptake (dark gray) in 2018 for 14 Brazilian cities, 12 of which were chosen by Department of Surveillance, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis of the Ministry of Health for the second nation-wide respondent-driven sampling study that estimated HIV prevalence and behavioral practices related to HIV risk, and two other cities that were able to provide PrEP to more than 100 MSM (Florianopolis and Campinas). The percentage uptake is given by the numbers within the bars. Footnote: y-axis upper limit was set to 20 000 to increase clarity. Numbers not shown include demand for Rio de Janeiro 13590 (8562-20702) and São Paulo 22386 (14218-34475). PrEP, preexposure prophylaxis.
See this image and copyright information in PMC

References

    1. UNAIDS. Miles to go. 2018.
    1. WHO. HIV treatment and care fact sheet. WHO HIV policy adoption and implementation status in countries. Available at: https://apps.who.int/iris/bitstream/handle/10665/259532/WHO-HIV-2017.58-... 2018.
    1. Ravasi G, Grinsztejn B, Baruch R, et al. Towards a fair consideration of PrEP as part of combination HIV prevention in Latin America. J Int AIDS Soc 2016; 19 7 Suppl 6:21113. - PMC - PubMed
    1. Carriquiry G, Fink V, Koethe JR, et al. Mortality and loss to follow-up among HIV-infected persons on long-term antiretroviral therapy in Latin America and the Caribbean. J Int AIDS Soc 2015; 18:20016. - PMC - PubMed
    1. Grinsztejn B, Luz PM, Pacheco AG, et al. Changing mortality profile among HIV-infected patients in Rio de Janeiro, Brazil: shifting from AIDS to non-AIDS related conditions in the HAART era. PLoS One 2013; 8:e59768. - PMC - PubMed

Publication types

Substances