The HIV epidemic in Latin America: accomplishments and challenges on treatment and prevention

Curr Opin HIV AIDS. 2019 Sep;14(5):366-373. doi: 10.1097/COH.0000000000000564.

Abstract

Purpose of review: To describe how countries in Latin America and the Caribbean are (or are not) meeting 2016 WHO guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, that is, their progress on the adoption of 'Treat All' and of preexposure prophylaxis (PrEP) as an additional prevention tool for people at substantial risk of HIV infection.

Recent findings: The HIV epidemic in the region continues largely concentrated in vulnerable populations with MSM and transgender women (TGW) suffering the highest burden. On treatment, the challenges of late initiation as well as suboptimal adherence persist. On prevention, recent studies on PrEP willingness in key populations show promising results, meanwhile PrEP implementation projects as well as actual PrEP adoption by national health systems is expanding. A glimpse of real-world PrEP uptake is shown through Brazil's first-year experience of offering PrEP in multiple cities in all regions of the country.

Summary: In conclusion, accomplishments have been made though challenges for fully addressing the HIV epidemic persist. The impact of both treatment and PrEP will be limited by the availability and prompt use of all services, including HIV testing.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-HIV Agents / therapeutic use*
  • Epidemics
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control
  • Humans
  • Latin America
  • Pre-Exposure Prophylaxis
  • South America / epidemiology

Substances

  • Anti-HIV Agents