HIV/AIDS in Haiti and Latin America

Finally, there is some good news in the fight against HIV in the Americas.

Surprisingly, the news comes from Haiti, one of the countries hardest hit by the epidemic.

According to recent statistics from the Joint United Nations Program on HIV/AIDS (UNAIDS), infection rates have been falling in Haiti in the last few years.

About 190,000 Haitians, or 2.2% of the population, are suffering from HIV/AIDS, according to UNAIDS. Infection rates have been falling more slowly in rural areas than in urban areas, but progress in fighting the disease has been significant for a country with high poverty levels. The percentage of pregnant women who have tested HIV positive has declined by half over the last ten years.

The scenario is optimistic, but many challenges remain. For example, the majority of the Haitian population still lacks sufficient sex education.

Only 15% of women and 28% of men between the ages of 15 and 24 know how to prevent HIV infection, and boys and girls are becoming sexually active at an early age — some as early as ten.

Jean Pape, a Haitian doctor who has been fighting the epidemic for years in Haiti, told the PBS TV program Frontline that the high percentage of people infected with HIV "killed tourism in Haiti," which was the backbone of the Haitian economy. "In addition, goods manufactured in Haiti could no longer be sold in the United States," he said.

Progress in battling the epidemic in Haiti is due, in large part, to the work of people like Doctor Pape and Doctor Paul Farmer, an American doctor who has dedicated his life to the struggle against AIDS on this Caribbean island.

Farmer created the organization Partners in Health and its HIV Equity Initiative. It is dedicated to preventing and treating AIDS in the context of primary care, improving care for tuberculosis, optimizing treatment for sexually transmitted infections and emphasizing women's health.

So far, more than 400 workers have been trained to administer free antiretroviral drugs to AIDS patients in the community, and more than 1,500 patients are currently receiving treatment for AIDS.

Haiti is a special case, with health and economic welfare indices among the lowest on the continent. Only four of every ten Haitians have access to potable water, and there is one doctor for every 10,000 inhabitants.

According to data from UNAIDS, 6.1% of the adult population was HIV positive in 2001, and AIDS has become the top cause of death among sexually active youth and adults. Thanks to prevention and control actions, however, the percentage of infected persons declined to 3.8% by late 2005.

Because of the success of their prevention programs, the Global Fund to Fight AIDS, Tuberculosis, and Malaria has awarded grants to the organizations run by Dr. Pape and Dr. Farmer. The money will be used to help expand existing prevention programs and implement new ones. Both Pape and Farmer have received numerous international awards and recognition for their work.

Beyond Haiti, the AIDS pandemic requires urgent attention in the rest of the hemisphere as well. HIV infections are occurring all over Latin America and the Caribbean, with prevalence rates at 0.5% and 1.0% of the total population, respectively.

In the countries where the prevalence rates are lower, the epidemic is concentrated among socially marginalized populations, such as gay males.

Even though the infection rates among Latin American and Caribbean adults are lower than the rates in Africa — where it is over 20% in some countries like Botswana, Lesotho and Swaziland — the number of people who are HIV positive in the hemisphere is still quite high.

It is estimated that almost two million people are living with HIV in Latin America and the Caribbean. This is more than the number of cases in the United States, Canada, Western Europe, Australia and Japan combined. In 2007, there were 20,000 new infections in the Caribbean and 140,000 in Latin America, according to United Nations figures.

Currently, Argentina, Brazil, Colombia and Mexico have the largest epidemics in the region — due in part to the fact that they simply have larger populations. More than 40% of all people who are living with HIV/AIDS in Latin America live in Brazil.

Fortunately, access to treatment with anti-retroviral drugs in Latin America has increased markedly thanks to the implementation of national AIDS treatment programs. Latin America is currently able to cover about 64% of those who need the drugs, as compared to 30% coverage in sub-Saharan Africa and 25% in some regions of Asia.

Brazil has taken the lead in providing anti-retroviral medications in a national campaign that has received international recognition for its effectiveness. In 1996, the Brazilian government established HIV treatment as a priority, and the government is now providing free medicines through the public health system.

This has allowed many HIV positive persons to live normal lives. It has also decreased the number of AIDS-related deaths and the number of people hospitalized for HIV infections.

Since Latin American and Caribbean nations are all true mosaics of different cultures, religions, customs and socio-economic levels, attention to the HIV epidemic has not been homogeneous — and the disease itself does not have the same characteristics in all places. Stigmas and discrimination prevail in some countries more than others and lead to infected people trying to hide their condition instead of seeking help.

In the case of HIV/AIDS, taboos and discrimination are still some of the biggest obstacles to prevention and treatment. If better information helps overcome these factors, we will demonstrate the determination, generosity and tolerance that we are capable of showing as members of society.