Treating HIV / AIDS in Latin America

RUSTON, Louisiana – According to UNAIDS data, HIV affected 2.1 million people across Latin America in 2019. That same year, there were reports of 120,000 new infections. In addition, 37,000 people have died from AIDS-related illnesses. While the epidemic is mostly concentrated, meaning that the prevalence in the general population remains low, some groups such as transgender women, sex workers and men who have sex with men (MSM ) run the risk disproportionately get HIV. Progress in HIV prevention and treatment has been moderate to poor, depending on the country. Unfortunately, poverty, homophobia, transphobia and discrimination hamper progress in the fight against HIV / AIDS in Latin America.

What do the numbers say?

Belize, Panama and Uruguay ranked the highest prevalence rate for HIV with 1.9%, 0.9% and 0.6%, respectively. In 2019, 77% of people living with HIV knew their status. Over the past decade, new HIV infections have reached 21% across Latin America. Although the numbers are daunting, AIDS-related deaths declined slightly by 8% between 2010 and 2019.

Evidence from the Pan American Health Organization shows that the COVID-19 pandemic has caused a sharp drop in the number of people receiving HIV tests. “Eight countries in the Caribbean and Latin America reported about 4,000 fewer HIV diagnoses in the first six months of 2020 compared to the same period in 2019.”

Who is most affected by HIV / AIDS?

Transgender women

• In 2020, transgender women were 49 times more likely to contract HIV than the general population.

• Some of the highest HIV prevalence rates for transgender women have been reported in Ecuador at 35%. The lowest was in El Salvador at 7.4%. The prevalence of HIV in Colombia, Panama and Guatemala is over 20%.

• A 2010 study found that 11% of HIV-positive transgender women in Mexico have no relationship with their family. This is often due to stigma and discrimination.

• Transgender women face significantly higher rates of violence than other minority groups. Between 2008 and 2015, the Trans Murder Monitoring Project reported 1,573 trans people murdered in Latin America. The highest number reported was in Brazil at 938.

Men who have sex with men (MSM)

• MSM are most affected by HIV in Latin America and are often classified as heterosexual due to reluctance to disclose their positive status. In 2017, “men who have sex with men accounted for 41%” of total HIV infections in Latin America.

• In Guatemala and El Salvador, HIV prevalence among MSM is the lowest in the region, at around 7%. Bolivia, Mexico and Paraguay reported HIV prevalence of “25%, 21% and 21%, respectively”.

• Homophobia is common across Latin America due to strong religious views and a macho culture. Macho culture asserts male dominance in everyday life. Examples include men having full control of the household, controlling their wives, and not showing any emotions that could be considered too feminine or weak.

• Due to the macho culture, many MSM “also have sex with women, forming bridging populations”. A relay population consists of three or more people who, because of their proximity to an HIV-positive person, are at high risk of contracting HIV.

Pre-exposure prophylaxis (PrEP)

The progress made in increasing the number of people knowing their status and receiving treatment in Latin America has been remarkable. Pre-exposure prophylaxis (PrEP) is part of this progress. PrEP is a once-a-day pill that reduces chances of contracting HIV by 99%. The risk is even lower when using condoms and other preventive measures.

In an interview with The Borgen Project, Johnathan Craig, the Philadelphia Center lab coordinator, said that “without the use of condoms and PrEP, you’re going to have a person at high risk.” Among Latin American countries, Brazil is the only country to offer PrEP through public health insurance. In other countries such as Chile, Guatemala, Mexico and Uruguay, PrEP can be found through the Internet, private health insurance, or through NGOs in the field. “If we could encourage PrEP use among low-income people, whether they are more LGBTQ or heterosexual, we would see lower rates of HIV transmission, and in turn, we would see a significant drop in new infections. to HIV. “

ImPrEP in Brazil, Mexico and Peru

The commitment to provide an effective response to HIV / AIDS in Latin America has been strong. However, research projects like ImPrEP are pushing for a definitive end to HIV / AIDS in Latin America. the ImPrEP study provided same day drug PrEP to more than 5,000 MSM and transgender women in Brazil, Peru and Mexico. Each participant received HIV and STI tests as well as mental health assessments. HIV-negative MSM and transgender women received a 30-day supply of PrEP and were reassessed after 30 days. After a month of PrEP and negative HIV tests, they were given a 90-day supply of PrEP with check-ups every three months.

ImPrEP’s research found that while only “6% of participants did not return,” 71% of participants made two appointments within three months of their first appointment and 97% continued to use PrEP afterward. The continuation of PrEP in Peru was significantly lower than in Brazil and Mexico, with a continuation rate of 53%, 85% and 84%, respectively. Transgender women in all three countries recorded a continuation rate of over 50%. MSM has experienced higher continuation rates.

What’s to come?

Progress is never easy, and it never comes overnight, especially when it affects billions of people. Eradicating HIV / AIDS in Latin America will require a comprehensive approach that involves more than just preventing new HIV infections. It is the first step on the long ladder to progress. It is important to find solutions to prevent the spread of HIV. At the same time, it is essential to help people affected by HIV / AIDS who live in poverty and / or in war-torn countries. With the help of the medical community, NGOs and global governments, a better future is closer than ever.

– Sal Huizar
Photo: Flickr