Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

the rate in one health centre, in Port Loyola, hitting 4.8%. In the Honduran city of San
Pedro Sula, the rate of HIV infection among pregnant women has fluctuated
between 2% and 5% for several years. Much of the problem is concentrated in
teenagers, suggesting that the worst is still to come. Between one-fifth and onetenth of sex workers are infected in various cities in Honduras. In some ethnic subgroups, principally on the Caribbean coast, the prevalence in 15-49-year-old men
and women exceeds 8%, and the rates in men and women in their 20s are twice as
high. In Guatemala, HIV infection follows a similar pattern, with higher infection rates
among pregnant women and sex workers in coastal cities and the capital than in
highland cities.
Heterosexual transmission of HIV is rarer in other countries of Central America. In
Costa Rica, for example, HIV is transmitted mainly during unprotected sex between
men. In this country, as in many other parts of Latin America, there is little systematic surveillance for HIV among groups with high-risk behaviour, but studies among
men who have sex with men in Costa Rica showed infection rates of 10-16% as
long ago as 1993.
In Mexico, too, HIV has affected mainly men who have sex with men, more than 14% of
whom are currently infected. HIV rates among pregnant women, however, are extremely
low. Data from a programme to reduce the transmission of HIV from mothers to infants
suggest that fewer than 1 in every 1000 women of childbearing age is infected. Even
among female sex workers in Mexico, the prevalence rate is well under 1%.
Box 3. A measure of success: young Brazilians increasingly reject
unprotected sex
In Brazil, where over half a million adults are living with HIV, the Government has
taken an active lead in HIV prevention, care and protection of the rights of people
affected by the epidemic. Perhaps the most visible commitment is the Government's
undertaking to provide free antiretroviral therapy to all those who need it (see page
101). Alongside this, the Government has committed considerable resources to
fighting HIV through information campaigns and prevention services. To help ensure
that these services reach not just the general population but also marginalized
groups, whose members make up an increasing proportion of those infected with
HIV, the Government has forged active partnerships with nongovernmental organizations and others.
A survey of the sexual behaviour of 3500 adults shows that young Brazilians are more
able and willing to negotiate condom use with their partners than ever before. While
in 1986 less than 5% of young men reported using a condom the first time they had
sex, the figure in 1999 was close to 50% - a tenfold increase. Among men with
higher educational levels, over 70% surveyed in 1999 said they used a condom for
their first act of intercourse.

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