The Caribbean, Central and South America network (CCASAnet) brings together researchers with expertise in HIV care, science, and collaborative research, as well as in data structure design, analysis, and management. The project has the following aims:

• To create and support a network of participating sites in the Caribbean and Central and South America for sharing of existing research and clinical data related to the epidemiology of HIV and related disorders;
• To create a shared data repository and associated technologies for data merging that forms the union of the data sets submitted by sites;
• To conduct and facilitate research using the shared data repository that enables answers to questions that cannot be answered by any single source;
• To develop and evaluate new biostatistical methods relevant to HIV epidemiology;
• To develop a program of education and training that will assist sites to improve the quality and consistency of their clinical research activities;
• To participate with other regional IEDEA networks in the development of international standards for sharing and meta-analysis of HIV-related data.

Resource-constrained settings in Africa, Asia, Central and South America (Latin America), and the Caribbean together accounted for greater than 95% of all prevalent and incident HIV cases in 2004. Sub-Saharan Africa has the worst regional epidemic, followed by the Caribbean. The lower prevalence in Latin American countries disguises serious, localized, and diverse epidemics, largely fueled by sexual transmission. AIDS quickly has become one of the most menacing threats to achieving meaningful improvements in developing nations, as the disease already has reversed progress and advancements, severely impacted the labor force, and caused decreases in life expectancy in many affected regions. Current high prevalence levels mean that even those countries that do eventually reverse the epidemic's course will have to contend with serious AIDS-related consequences for subsequent years, shaping the lives of at least several generations.

Longer lifespan of HIV-positive persons fortunate to receive highly active antiretroviral therapy (HAART) has ushered in a new era, one in which many questions remain unanswered or have yet to be defined. New or differing manifestations of therapeutic side-effects, co-infections, and diseases of general populations may be observed with time. Treatment-related toxicities, though well-recognized, are poorly understood and may vary according to host polymorphisms, the presence of co-morbidities, source of drug manufacture, or multiple other factors. Additionally, viral diversity and the development of resistance to antiretroviral therapy (ART) respectively remain major obstacles to vaccine development and long-term efficacy of therapy. Each of these issues likely will emerge with importance and differing manifestations as ART is introduced into broader, more genetically and culturally diverse populations and less-developed regions of the world.

CCASAnet focuses on six nations representing a comprehensive picture of HIV/AIDS in the Caribbean and Central and South America. Argentina, Brazil, Chile, Haiti, Honduras, and Peru make up approximately 8% of the world's population. An estimated 2.1 million people in these countries were living with HIV and AIDS at the end of 2003 - 5.7% of all infected persons worldwide. During 2004, an estimated 293,000 persons were newly infected and 131,000 deaths occurred due to HIV/AIDS in the Caribbean and Latin America region, representing 6.1% of total new infections and 4.2% of total deaths due to AIDS worldwide. These data reflect the slow expansion of HIV prevention and care to the Caribbean and Latin America compared with the northern region of the Western hemisphere and Europe.

The CCASAnet proposal was submitted in response to the International Epidemiologic Databases to Evaluate AIDS (IeDEA) RFA. CCASAnet is one of seven projects that were funded by the U.S. National Institute of Allergy and Infectious Diseases and the U.S. National Institutes of Health. Other funded IeDEA regions include North America, East Africa, West Africa, Central Africa, South Africa, and Asia-Pacific.