Antiretroviral Drugs in Latin America

Two countries in Latin America, Brazil and Argentina, provide antiretroviral treatment for all people in those countries infected with HIV.

Brazilian officials estimate that they spent approximately US$300 million in 1999 providing drugs for 75,000 people. Health officials there say that savings in episodes of hospitalization and medical care for HIV-infected persons justify the costs of purchasing and providing drugs that improve survival. Considerable savings also accrue from avoiding the indirect costs of illness.

The Brazilians maintain that without antiretroviral therapy, many more people with HIV would develop OIs associated with the immune impairment that accompanies disease progression. Brazilian health officials estimated that over a one-year period between 1997 and 1998, they averted approximately US$136 million in hospital admission and treatment costs alone for people with HIV. Argentina also provides antiretroviral therapy for those who are HIV positive. The result has been a decrease of over 40% in the rate of new AIDS cases reported each year, from a peak of 71.6 per million people in 1996 to 41.3 per million people just two years later.

HIV surveillance in Brazil includes data from antenatal (prenatal care) clinics, sex workers, and injection drug users (IDU). In 1988-1989, approximately 4% of women in antenatal clinics in the port city of Santos tested HIV positive. (Santos has been an epicenter of the HIV epidemic in Brazil, with infection rates spreading continuously, and geographically, outward.) In 1990, 1% of women in antenatal clinics tested positive in São Paulo. In other cities, including Pôrto Alegre and Rio de Janeiro, 3% of such women tested HIV positive in 1996.

HIV prevalence among sex workers is estimated to be highest in Santos, where 14% tested positive when they were last measured in 1991. In the mid-1990s, HIV prevalence among sex workers was 6% in the state of Minas Gerais and 11% in Rio de Janeiro.

The highest HIV prevalence in Brazil has been found in IDU. Fifty percent of IDU tested in two sites in Santos were HIV positive in 1989. Since 1990, one-third of all IDU in major urban areas tested positive. A recent study found HIV in 12% of jail inmates.

Data on HIV infection among MSM are limited; however, some estimate that up to 10% of MSM in major urban areas are infected. In 1995, 18% of males tested HIV positive at sexually transmitted disease (STD) clinics in Rio de Janeiro.

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