HIV in Latin America and the Caribbean
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.