Instituto de Pesquisa Clinica Evandro Chagas - FIOCRUZ, Rio de Janeiro, Brazil.
Curr Opin HIV AIDS. 2014 Mar;9(2):192-8. doi: 10.1097/COH.0000000000000031.
The aim of the present review is to update HIV/AIDS Epidemiology in Latin America and the Caribbean highlighting the concentrated aspect of epidemic in the region.
Among general population, HIV prevalence in Latin America is at stable levels (0.2-0.7%). The Caribbean still has one of the highest HIV prevalence rates in the world (<0.1-3%), but incidences have declined around 49%. This is not the current situation for high-risk key populations; most incident cases occur among MSM. Available data on transgender women suggest that they are the most-at-risk group. Female sex workers still have a 12-fold the chance of being HIV positive compared with other women. IDU prevalence was revised to 0.45%, but non-IDU has been suggested as a mediator between sexual risk and HIV.
The increase in treatment coverage (mean is at 63%) resulted in modifications of HIV/AIDS epidemiology. New strategies to seek, test and link key populations to care are urgently needed and targeted interventions to prevent HIV expansion among them must be adopted. These strategies should consider the particular situation regarding social inequalities, discrimination and violence that pervade the HIV epidemic among key populations.
本综述旨在更新拉丁美洲和加勒比地区的艾滋病毒/艾滋病流行病学,重点关注该地区流行的集中性。
在普通人群中,拉丁美洲的艾滋病毒流行率处于稳定水平(0.2-0.7%)。加勒比地区仍然是世界上艾滋病毒流行率最高的地区之一(<0.1-3%),但发病率下降了约 49%。这并不是高风险关键人群的现状;大多数新发病例发生在男男性行为者中。现有的跨性别女性数据表明,她们是感染风险最高的群体。性工作者感染艾滋病毒的几率仍然是其他女性的 12 倍。静脉注射吸毒者的流行率已修订为 0.45%,但有人认为,非静脉注射吸毒者是性风险和艾滋病毒之间的中介。
治疗覆盖率的增加(平均为 63%)导致了艾滋病毒/艾滋病流行病学的变化。迫切需要寻找、检测和将关键人群联系到护理的新策略,并且必须采取有针对性的干预措施,防止他们之间艾滋病毒的传播。这些策略应考虑到普遍存在于关键人群艾滋病毒流行中的社会不平等、歧视和暴力等特殊情况。