PAHO Director Dr. Mirta Roses noted that despite more than two decades of efforts to contain the disease, HIV continues to produce some 500 new cases and claims 200 lives each day in the Americas.

“This can be prevented,” said Roses. “Achieving this demands a personal and professional commitment not only from experts in the field but from each and every member of society.”

“Let us make a commitment to fight AIDS. Let us make a firm promise to talk to our young people about it, especially at home. To stop AIDS, let us also invite others, telling them: Stop AIDS, keep the promise.”

Since it began 25 years ago, the HIV epidemic has expanded steadily throughout the Americas and the world despite advances in treatment and knowledge about the disease and how it spreads.

According to the latest data from the Joint United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), some 39.5 million people in the world are today living with HIV. In just the past year, 4.3 million people became newly infected, 65 percent of them in Sub-Saharan Africa. Eastern Europe and Central Asia have also been seriously affected, with rates of HIV infection up by more than 50 percent since 2004.

In Latin America, approximately 1.7 million people are living with HIV, two-thirds of them in the four largest countries: Brazil, Mexico, Colombia and Argentina. However, infection rates are highest in the smaller countries of Central America, Belize, El Salvador, Honduras, Guatemala, and Panama.

Rates are also high in the Caribbean, where 250,000 people are living with HIV. Nearly three-quarters of these are concentrated in two countries: the Dominican Republic and Haiti. Rates of infection are estimated at 1–2 percent in Barbados, the Dominican Republic, and Jamaica; 2–4 percent in the Bahamas, Haiti, and Trinidad and Tobago; and less than 0.1 percent in Cuba.

In the Caribbean, the availability of treatment has helped reduce the number of AIDS deaths from 21,000 in 2004 to 19,000 in 2006. Nevertheless, regionwide, the number of AIDS deaths rose from 64,000 to 84,000 during the same period.

In the Americas region, risky behaviors remain major drivers of the epidemic, including unprotected sex, injecting drug use, and participation in the sex trade.

Dr. Patricio Rojas, chief of PAHO’s HIV Unit, emphasized the importance of the behavior of young people in determining what course the HIV epidemic will take in the future.

“PAHO is quite concerned about the impact of this epidemic on young people,” said Rojas. “The future of the global epidemic will depend largely on contextual factors that affect their decisions. We must empower young people to make the right decisions in their sexual lives, and we must motivate them to get tested for HIV.”

Area of improvement

One area of significant improvement in the PAHO region is the availability of treatment for HIV. As of mid-2006, an estimated 345,000 people in Latin America and the Caribbean were receiving antiretroviral treatment for HIV, or 75 percent of those believed to need treatment. This is the highest rate of treatment coverage for any developing region.

The UNAIDS report singles out the Bahamas, Barbados, Cuba and Jamaica for their significant progress in expanding treatment for people with HIV.

Along with treatment, a number of countries in the region are also expanding voluntary testing services and doing outreach campaigns that encourage people to “Take the Test.” Among countries with active campaigns are Belize, Brazil, El Salvador, Suriname, and Trinidad and Tobago. In 2006, more than 1 million people were tested for HIV in 28 countries that reported to PAHO.

This year’s UNAIDS report on the epidemic highlights a several key factors that contribute to the spread of HIV in Latin America and the Caribbean. These include poverty, migration, poor information, and rampant homophobia.

According to UNAIDS, poor surveillance in some countries of Latin America and the Caribbean has meant that high-risk groups such as men who have sex with men, sex workers, and injecting drug users are not adequately covered by existing prevention and treatment strategies.

“Knowing your epidemic and understanding the drivers of the epidemic such as inequality between men and women and homophobia is absolutely fundamental to the long-term response to AIDS,” said Dr. Peter Piot, executive director of UNAIDS. “Action must not only be increased dramatically, but must also be strategic, focused and sustainable to ensure that the money reaches those who need it most.”

PAHO’s Rojas said that a serious response to the epidemic must include helping countries to develop their technical and analytical capacities so they can generate precise information on the status and dynamics of HIV in the region and on its economic and social impact.

“We know that the region can win this war on the epidemic,” said Rojas. He noted that the Americas region was able to meet and even exceed the goal of getting treatment to 600,000 people by 2005. But he also emphasized the need to raise awareness in all the region’s countries and to carry out campaigns to get people to know their HIV status.

Rojas expressed gratitude to the Global Fund for AIDS, Malaria and Tuberculosis, which has provided funds to a number of lower-income countries in the Americas region to increase levels of treatment for HIV patients. He noted, however, that only one-third of PAHO member countries are eligible for Global Fund assistance. “This is very worrying for us,” he said.

In observance of World AIDS Day, PAHO will host a community forum titled “Speaking about Sexual Health, HIV, and AIDS with Family and Young People.” The organization is also offering free, voluntary and confidential HIV testing for its staff and staff of the Organization of American States (OAS), through a mobile testing clinic. The clinic is part of an ongoing effort to promote education, prevention, and nondiscrimination regarding HIV in the PAHO workplace, in response to a United Nations mandate for all U.N. workers and agencies throughout the world.