Development & Aid, Headlines, Health, Latin America & the Caribbean, Population

HEALTH-LATIN AMERICA: AIDS Increasing Among Poor In Latin America

Estrella Gutierrez

CARACAS, Jun 14 1998 (IPS) - The AIDS virus in Latin America is increasingly affecting the poor, people in rural areas, heterosexuals and women, more so than other sectors of society, according to the United Nations.

Because more women have been infected with the acquired immune deficiency syndrome (AIDS) this also has brought with it the problem of transmission of the virus to infants during pregnancy, explains Mario Bronsman, an Argentinian sociologist and public health specialist.

Bronsman, who lives in Mexico, is one of a team of Latin American experts working within a programme on AIDS and HIV that has operated since 1996 with the support of five U.N. agencies.

The rapid spread of the AIDS virus among poor sectors is explained by the lack of AIDS education they have received and the lack of economic re sources to protect themselves. The rise in the number of AIDS sufferers in rural areas predominantly is the result of migration, Bronsman said during a recent trip to Venezuela.

The problem is not that there are more cases of HIV/AIDS in the countryside, but that the amount time it takes for the number of cases to double is much less in rural areas, he said. He gave as an example that, in 1994, 3 percent of those affected by HIV/AIDS were from rural areas. Today that figure is 6 percent.

When immigrants arrive in cities, they increase their efforts to protect themselves, but they also put themselves more at risk. When they return to their home town, either permanently or temporarily, they continue engaging in risky practices – and many abandon the use of “safe sex.”

In most Latin American countries , the focus of the epidemic has shifted from the groups with the highest risk exposure to those that are most socially vulnerable, two distinct scenarios which should not be confused, Bronsman said.

As an example of these vulnerable groups, Bronsman cited the example of the growing number of women who are being infected by their partners in heterosexual relationships.

Brazilian physician Paulo Texeira, another expert associated with the U.N. programme, said that while homosexual and bisexual transmission was declining throughout the world this was not the case with heterosexual transmission.

With the growth of infection among women, there is also an increase in prenatal transmission. Texeira cited Venezuela as an example, where in the last semester 3.1 percent of new cases corresponded to infants who were born with the virus , whereas earlier figures for this group had never exceeded 1.2 percent.

Texeira stated that confronting the problem of pregnant women with HIV should be one of the priorities of public policies and private organizations in the region. Treatment was available to provide immunity for the foetus in 70 percent of such cases, cost 500 dollars.

Bronsman explained that the AIDS outbreak comprised three different epidemics: those infected, those who are sick, and those who have died. Current analyses of the situation are based on the latter one, taking what happened “years ago” as a starting point.

The three epidemics converge on the fact that since the human immunodeficiency virus (HIV) was identified, like all disasters they increasingly have affected the poorest sectors of society. Illnesses can begin among society’s more privileged sectors, but these have resources to protect themselves, he added.

In Brazil, U.N. experts have documented that in 1997, 60 percent of those affected only had a primary school education. Initially, the epidemic affected people with university degrees. In fact, there was a growing North-South disparity on a global scale, with almost all of the 16,000 people infected each day residing in Africa, Asia and Latin America, or in the so-called economies in transition of Eastern Europe.

U.N. statistics indicated that at the end of 1997, there were 30.6 million people with AIDS, with 5.8 million of those having been infected in the past year, during which 2.3 million people died from the disease. Some 11.7 million people have died from the disease worldwide.

One in every 100 adults in the world has AIDS and 90 percent live and die in the developing world. Of the 16,000 new cases of HIV infection each day, more than 40 percent are women and more than 50 percent are between the ages of 15 and 24.

In Latin America, the U.N. said, the problem still had not reached uncontrollable proportions. At the end of 1997, there were 1.3 million people in the region suffering from AIDS – 19 percent of whom were women. This last figure jumped to 33 percent in the Caribbean.

Bronsman does not believe there is any “efficient and accessible treatment” for the disease, but does predict that the AIDS epidemic will soon go from being a deadly virus to a chronic illness in the regions and among the social sectors that can afford treatments. Presently, the use of a combination of three different medications, which has proven effective among some AIDS patients, costs about 14,000 dollars per year for one person – an amount only the rich can afford in any nation.

Another actor in the equation affecting Latin America was that there were various ways of framing the very concept of an AIDS epidemic in relation to the risk factors involved, Bronsman said.

In Mexico, for example, the epidemic is associated primarily with homosexual transmission, while in Brazil and Central America it is linked with heterosexual transmission. Further south, the highest rates of transmission are the result of drug use -close to 50 percent of all cases in Argentina.

These three variations, however, coexist within single countries with on dominating in one region and another in another part of the country. There was a tendency to oversimplify the problem in order to produce average for situations that are not averageable and which should be confronted separately, Bronsman explained.

In terms of measures to confront the AIDS epidemic Bronsman stressed the need to be aggressive with public prevention policies that include publicity campaigns, with up front information. There also was a need for organised treatment of all AIDS patients, through the support of private organizations and of society as a whole.

Bronsman and Texeira agreed that in terms of strategies, Brazil implemented the boldest strategies, ensuring medications for all patients even if this meant pending 700 million dollars this year. Brazil had not fallen into the false dilemma of whether or not to guarantee medications, regardless of cost and its results, therefore, had been promising

In Sao Paulo, where in 1992 AIDS became the leading cause of death of women between the ages of 20 and 34, there was a significant drop in the mortality rate in 1997, comparable to that seen in the industrialized countries in the North.

Bronsman admitted that conservative groups in the region were mustering forces against prevention campaign, but pointed out that such groups had not campaigned against condom use, the most effective means of disease prevention.

He stated that health campaigns must be targeted specifically toward the most vulnerable groups, especially women and youth, since most patients contracted AIDS between the ages of 25 and 35, which meant they contracted the virus between the age of 15 and 25.

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HEALTH-LATIN AMERICA: AIDS Increasing Among Poor In Latin America

Estrella Gutierrez

CARACAS, Jun 14 1998 (IPS) - The AIDS virus in Latin America is increasingly affecting the poor, people in rural areas, heterosexuals and women, more so than other sectors of society, ZCZC DAP007 LLLL AA AB ARJ XJ WX DD QN SERVENG .LONAAMS LA HE PR HEALTH-LATIN AMERICA: AIDS Increasing Among Poor In Latin America

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