Regional Overview

• The HIV epidemics in Latin America remain generally stable, but HIV transmission continues to occur among populations at higher risk of exposure. They include sex workers and men who have sex with men -- groups who are not yet being adequately reached with HIV prevention, treatment, care and support services.
• HIV surveillance efforts need to be improved in many countries of this region to enable a better understanding of current epidemic trends.

Country Data and Trends

• Although Brazil is home to about one third of all people living with HIV in Latin America, a simultaneous focus on ensuring access to both HIV prevention and treatment services has helped keep its epidemic stable. Meanwhile, widespread access to antiretroviral therapy halved AIDS mortality rates between 1996 and 2002.
• Increasing numbers of women in Brazil are becoming infected with HIV, largely by their male sexual partners who might have been infected through unprotected sex with another man or woman, or through using unsterile injecting equipment.
• Unprotected sex between men is estimated to account for about half of the HIV infections that are sexually transmitted in Brazil.
• High HIV prevalence has been found among prisoners in Brazil. Almost 6% of male inmates tested at a São Paulo penitentiary were found to be HIV-positive, as were 14% of the women at a detention facility in the same city. Levels of HIV knowledge among prison inmates appear to be high, but access to HIV prevention services inside prisons remains inadequate.
• In recent years unprotected sex n Argentina has become the main route of HIV transmission. Around 80% of new HIV diagnoses in 2005 were attributed to unprotected sexual intercourse, mainly between men and women. Mirroring other countries in the region, the highest HIV prevalence has been found among men who have sex with men.
• In Uruguay unprotected sex (mostly heterosexual) accounts for an estimated two thirds of reported HIV cases. Infection levels are also high among certain groups in the capital of Montevideo: HIV prevalence of 22% among men who have sex with men, and 19% among injecting drug users.
• The majority of people living with HIV in Paraguay at the end of 2005 were men. Most acquired the virus through either unprotected paid sex with other men or when injecting drugs.
• In Chile, most HIV infections are also in men, although increasing numbers of women are acquiring HIV from their male partners, who were probably infected during unprotected sex with other men. Studies published in 2007 have found HIV prevalence to be low among female sex workers; therefore, unsafe heterosexual paid sex probably accounts for only a small percentage of current HIV infections.
• Sex between men continues to represent the main route of HIV transmission in Bolivia, Columbia, Ecuador and Peru.
• In Central America, hidden epidemics of HIV among men who have sex with men are under way in Belize, Costa Rica, El Salvador, Guatemala, Nicaragua and Panama. Compared with HIV prevalence in the adult general population, infection levels in men who have sex with men were seven times higher in Honduras, 10 times higher in Guatemala and Panama, 22 times higher in El Salvador and 38 times higher in Nicaragua, according to research released in 2007.
• The same study found high levels of HIV prevalence among female sex workers in Honduras (10%), Guatemala (4%) and El Salvador (3%), and low prevalence of 0.2% in Nicaragua and Panama.
• A sharp decline in HIV prevalence among female sex workers in three cities in Honduras appears to be linked to significant increases in condom use during commercial sex, suggesting that recent condom promotion and other prevention efforts have been successful.
• Mexico's epidemic remains concentrated largely in men who have sex with men, sex workers and their clients, and people who inject drugs. Unprotected sex between men is estimated to account for more than half (57%) of the HIV infections recorded to date.

Source: 2007 AIDS epidemic update -- regional summary