Skip Navigation LinksHome > March 2014 - Volume 9 - Issue 2 > Epidemiology of HIV in Latin America and the Caribbean
Current Opinion in HIV & AIDS:
doi: 10.1097/COH.0000000000000031
EPIDEMIOLOGY: CONCENTRATED EPIDEMICS: Edited by Chris Beyrer, Stefan D. Baral, and Patrick S. Sullivan

Epidemiology of HIV in Latin America and the Caribbean

De Boni, Raquel; Veloso, Valdilea G.; Grinsztejn, Beatriz

Free Access
Article Outline
Collapse Box

Author Information

Instituto de Pesquisa Clinica Evandro Chagas – FIOCRUZ, Rio de Janeiro, Brazil

Correspondence to Beatriz Grinsztejn, IPEC – FIOCRUZ, Av. Brasil 4365, Rio de Janeiro 21040-360, Brazil. E-mail:

Collapse Box


Purpose of review: The aim of the present review is to update HIV/AIDS Epidemiology in Latin America and the Caribbean highlighting the concentrated aspect of epidemic in the region.

Recent findings: Among general population, HIV prevalence in Latin America is at stable levels (0.2–0.7%). The Caribbean still has one of the highest HIV prevalence rates in the world (<0.1–3%), but incidences have declined around 49%. This is not the current situation for high-risk key populations; most incident cases occur among MSM. Available data on transgender women suggest that they are the most-at-risk group. Female sex workers still have a 12-fold the chance of being HIV positive compared with other women. IDU prevalence was revised to 0.45%, but non-IDU has been suggested as a mediator between sexual risk and HIV.

Summary: The increase in treatment coverage (mean is at 63%) resulted in modifications of HIV/AIDS epidemiology. New strategies to seek, test and link key populations to care are urgently needed and targeted interventions to prevent HIV expansion among them must be adopted. These strategies should consider the particular situation regarding social inequalities, discrimination and violence that pervade the HIV epidemic among key populations.

Back to Top | Article Outline


The last comprehensive review about the Epidemiology of HIV in Latin America was published in 2008. It underscored the concentrated aspect of the epidemic in most of the countries, especially among MSM [1]. In a recently published review of HIV prevalence data through 2010 of MSM and female sex workers (FSW) from Latin America and the Caribbean (LAC), the estimated median prevalence among MSM (10.6%) was reported to be five times higher than that of FSW [2▪]. The aim of this review is to provide an update on HIV/AIDS Epidemiology in LAC by addressing studies published since 2011 and providing the highlights related to key populations.

Back to Top | Article Outline


The HIV epidemic is not homogenous across the Latin America and Caribbean countries. In 2012, 1.5 million adults and children were estimated to be living with HIV in Latin America, with a stable prevalence ranging from 0.2% in Mexico to 0.7% in Guatemala, Panama and Uruguay (Table 1). In the same year, the Caribbean had 250 000 individuals living with HIV, but still had one of the highest HIV prevalence rates in the world with estimates for the general population ranging from less than 0.1% in Cuba to around 3% in the Bahamas [3▪]. In three of the five highest populated Caribbean countries, women outnumbered men among adults living with HIV [4].

Table 1
Table 1
Image Tools

With respect to mother-to-child transmission (MTCT), many of the countries have incomplete estimates, often with large confidence intervals (Table 1), which indicates that further improvement of national surveillance systems are still needed. Efforts to obtain data on underrepresented populations, as the study conducted among six native populations from the Peruvian Amazon [5], may also be important to identify other populations that may be at risk. Despite these limitations, 2012 data from the Caribbean showed a remarkable increase in the combined antiretroviral treatment (cART) coverage for pregnant women living with HIV, approaching an overall 79% coverage [3▪].

Over the period of 2005–2012, increased cART coverage resulted in a substantial reduction in mortality from AIDS-related causes, specifically, a greater than 25% decrease in the Bahamas and Haiti, and a greater than 50% reduction in the Dominican Republic [6,7]. As people live longer, HIV prevalence and AIDS cases reporting are less effective at monitoring rapid epidemic changes [8,9], but estimating incidence rates remains challenging [10]. Mostly, LAC incidence data come from the Joint United Nations Program on HIV/AIDS estimates, which indicate that, for the 2001–2012 period, new cases remained stable in Latin America and had a pronounced decline (49%) in the Caribbean [3▪].

Box 1
Box 1
Image Tools

Although there is progress on the use of novel HIV infection surveillance approaches, these initiatives remain fragmented and limit the usefulness of the information for program planning and evaluation. Incidence studies using BED-capture enzyme immunoassays and studies addressing phylogenetic mapping have increased [11–13]. Some approaches, aimed to identify transmission networks, have combined techniques to reach hidden populations with molecular epidemiology such as the one conducted in El Salvador with MSM and FSW using respondent-driven sampling (RDS) [14]. Advances in monitoring transmitted drug resistance (TDR) were also made, and are increasingly important to guide the selection and rational use of cART in the region, as low-to-moderate TDR [15] has been identified in several countries [16].

The methods to estimate prevalence of HIV infection among hard-to-reach populations, as well as the size of the key populations, are in constant advance and its discussion is beyond the scope of this manuscript. Efforts to implement some probabilistic approach have been made in LAC, and researchers have increased the use of RDS, as described by Montealegre et al. review [17]. However, many of the reviewed studies were not published as scientific articles and others may have a 5-year gap between data collection and publication, possibly because of a low number of data analyses resources. Additionally, information from MSM, FSW and IDU tends to be restricted to major cities or areas where HIV/AIDS prevalence is elevated; therefore, caution must be made when making generalizations.

Back to Top | Article Outline


MSM are vulnerable population for HIV and prevalence rates were still increasing worldwide in 2012 [18▪]. Most of the new HIV cases in LAC occur among MSM [19]; in Jamaica, HIV point prevalence among this population was estimated to be as high as 37.6% (Fig. 1) [3▪].

Figure 1
Figure 1
Image Tools

The largest study of MSM (n = 3859) using RDS in LAC was conducted across 10 Brazilian cities and estimated that HIV prevalence ranged from 9.1 to 16.6% [20]. In El Salvador, HIV prevalence among MSM was 10.8% (95%; CI 7.4–14.7%), 21% of these individuals were diagnosed as being recently infected. The young MSM (15–24 years) in this population were three times more likely to be a recent infection than the older MSM [21].

A study conducted in Argentina (RDS, n = 500) estimated an incidence rate of 5.6 per 100 person-year among MSM who only had sexual contact with other men, and an incidence of 4.28 per 100 person-year among MSM who also have sexual intercourse with women (P = 0.032). The first group also had a higher prevalence of HBV, Treponema pallidum and human papillomavirus indicating that interventions for preventing HIV and sexually transmitted diseases transmission should consider differences in sexual partnership [22].

Few studies have evaluated the main transmission networks among MSM from LAC. A mathematical model of the USA and Peru estimated that between 4 and 30% of HIV transmission events (depending on the parameter model) result from contacts with an acutely infected partner, and around 30% of infections occur with main partners [23]. In two cities from El Salvador, San Salvador and San Miguel, 34.9 and 58.8% of interviewed MSM reported bisexual behavior in the 12 months before the interview [24]. Overall, inconsistent condom use was reported by 51.7% of MSM who also had sex with women and by 60.2% of MSM who only had sex with men (P = 0.13). Besides the understanding of HIV transmission among MSM networks, this information is critical to better understand the ‘bridging’ of HIV transmission among MSM and females, and for proposing specific/targeted prevention strategies for those in stable relationships.

Unprotected anal intercourse (UAI) is the main transmission route in this population, and factors such as the use of illicit drugs, having a stable male partner and psychological abuse have been associated with increased UAI frequency in the aforementioned studies [25,26]. Of note, 40–70% of MSM enrolled in studies conducted in the region had never been tested for HIV [21,20,25,24], indicating that targeted strategies for locating and testing this population are urgently needed. Furthermore, investigation into the low testing rates was performed in Peru using an Internet-based survey. The survey results showed that the primary reasons for MSM to not be tested were the fear of a positive result and not knowing where to be tested [27].

Previous research have suggested that populations included in RDS and time-location sampling (TLS) studies may have different characteristics, with the former most frequently enrolling individuals with lower educational and income levels [28]. In accordance with that, a study using TLS conducted in Mexico City (n = 3000) approached MSM at gathering places (clubs, bars, streets) and produced estimates for a population of 6000–14 000 MSM. They had a higher education and socio-economical level than the average population, and yet more than 30% of the respondents had never been tested for HIV [29].

Back to Top | Article Outline


Transgender women (TGW) are individuals assigned as ‘male’ at birth but who identify themselves as female and/or transgender. Although they represent a smaller population than MSM, TGW have extremely elevated HIV infection rates. A meta-analysis across 15 countries (10 were low-and middle-income countries and five of those in LAC) estimated an HIV prevalence of 17.7% (95%; CI 15.6–19.8) in this population, with an odds ratio (OR) of 50.0 (95%; CI 26.5–94.3) for HIV infection among TGW versus all adults in reproductive age in LMIC [30▪].

TGW represent the most heavily impacted population in Peru, with an overall HIV point prevalence of 30% [31]. Risks associated with HIV infection among TGW are mainly linked to high rates of sex work, limited formal education, irregular use of condoms and drug abuse, coupled with extreme marginalization and lack of other options for survival [32,33,35]. Social exclusion and violence are factors that contribute to increased vulnerability and limitations on access to care and prevention. In fact, a study conducted in Argentina showed that TGW sex workers had the highest incidence rate (11.3 per 100 person-year) ever described in the country [34].

Studies to understand HIV transmission, associated behavior and health needs of TGW are as rare in LAC as in other parts of the world, and the use of qualitative–quantitative approaches and triangulation methods could be very promising in achieving this intent.

Back to Top | Article Outline


In a meta-analysis, the prevalence of HIV among FSW from 11 LAC countries was estimated at 6.1% (95%; CI 5.7–6.6); the odds of being HIV positive were 12 times higher than that of women from the general population. However, there was great variability within the LAC region. For example, in Chile, FSW had 0.29 (0.02–4.64) times the odds of the female population; in Guyana, the OR was 25.26 (20.47–31.17) [35].

Variability of within country prevalence estimates was also observed. For example, in Brazil, prevalence was 1.8% for FSW from Goiás [36], 4.8% in a study conducted in 10 Brazilian cities [37] and 5.1% in a systematic review [38]. Intracountry differences may be because of the actual different prevalence rates among the cities, socio-cultural aspects and methods used to sample the target population as well as to estimate the rates. Most studies use convenience samples [39], but there is also an increase in the use of RDS [40] and TLS [41]. A study conducted in Peru has used a probability sample combined with a venue-based sample and estimate 0.5% HIV prevalence among this population [42].

Many uncertainties persist related to the use of condoms with stable partners and drug use, but data from behavioral surveys suggest that the knowledge about HIV transmission and the efficacy of preventive measures seem to be increasing among FSW. Longer periods of prostitution, discounted rates for performing sex acts and association with other STD [37] are three key factors associated with increased risk of HIV infection in the FSW population. Among FSW in an Argentinean study, being socially rejected because of sex work and being arrested were both associated with an increased chance of being HIV positive [43].

Back to Top | Article Outline


Unlike MSM, TGW and FSW, the number of studies including IDU from LAC has decreased in recent years. This reduction may be associated with the revised estimates of IDU prevalence (0.45% (95%; CI 0.31–0.61)) and HIV prevalence among IDU (6.9%) in LAC [44]. However, in Mexico especially along the United States border, an increasing IDU prevalence was reported, sometimes in association with sex work [45,46]. These trends were observed via epidemiological studies not through general surveillance data. Therefore, it is important that we continue to investigate and report on IDU, as most of the manuscripts included in this review do not capture this information.

Noninjecting drug use (NIDU) is indirectly associated with HIV by increasing sexual risk behavior, and studies have associated NIDU with increasing chance of HIV among MSM, TGW and FSW [47,48]. In Peru, problem drinking was associated with an increase in risky sexual behavior in the MSM population [49], but few studies have approached alcohol influence on HIV transmission and the impact of alcohol use may be underestimated in LAC.

Limited data on HIV prevalence for NIDU are available beyond 2011. A study conducted in Tijuana (Mexico) with a convenience sample of 164 NIDU (who were neither MSM nor FSW), found an overall HIV prevalence of 3.7% (similar to IDU which was 4%) and only 36% of NIDU reported having previously been tested for HIV [50]. Given the increase in cocaine/crack-cocaine availability observed in some LAC countries [44], and anecdotal results pointing to an association between crack cocaine and HIV (mediated by sexual behavior/exchanges between sex drugs), this population should be kept under surveillance.

Back to Top | Article Outline


Considering the aforementioned, many advances were made in order to achieve the Millennium Goals and an ‘AIDS-free’ generation. The results from the HPTN 052 study [51] successfully demonstrated that treatment is an effective prevention measure with a profound impact in public health. As a result, the increased cART coverage in LAC countries in recent years has likely contributed to the control of the epidemic. A Pan American Health Organization (PAHO) report estimated that mean cART coverage in the region is at 63%; four countries (Chile, Cuba, Guyana and Nicaragua) are considered as having universal access to treatment (more than 80% coverage). Countries with high coverage also have higher retention rates for follow-up care, which is essential for the achievement of undetectable viral loads. The continued provision of treatment and even higher increases in coverage are new challenges for the LAC's health systems and governments, as regional per-patient cost of ART is US$508 annually (US$232–3323) and almost a third of the countries are highly dependent on international sources for funding [52▪].

Arán-Matero et al.[53] have estimated that 79% of public spending on HIV/AIDS in LAC is devoted to treatment initiatives whereas prevention efforts received 15% of total funds. Interventions and programs to prevent the HIV expansion among key populations represented only 4% of prevention expenditures. Incredible progress has been made in the HIV prevention field during the last few years, and most at risk populations may benefit from the addition of strategies such as postexposure prophylaxis and pre-exposure prophylaxis (PrEP) to the already existing prevention strategies [54]. In fact, a mathematical model of the MSM population from Lima have showed that the use of PrEP would be cost effective for preventing HIV infection at a population level in the city if it could be implemented as an integrated approach, prioritizing high-risk MSM and TGW [55].

With estimates of up to 50% of HIV-positive individuals in LAC being unaware of their serostatus, strides must be made to increase testing and prompt linkage to care. Culturally sensitive strategies to access hard to reach individuals, refer them to testing, link them to care and treatment, and retain them in the health services are highly needed in LAC. Moreover, novel and creative strategies are needed to inspire health practitioners and their clients.

Last but not the least, social inequalities, discrimination and violence pervade the HIV epidemic among key populations from LAC and undermine the efforts for identifying, testing and linking individuals to care. Even though there is a huge difference in socio-cultural characteristics across countries, there are still inequalities and traditional values that may act as barriers for HIV prevention and reinforce stigma among high-risk populations. Interventions that address these issues may have a higher chance of success [56], especially if focused on high-risk groups.

Back to Top | Article Outline


The authors would like to thank Carolyn Yanavich for the valuable comments.

Back to Top | Article Outline
Conflicts of interest

B.G. would like to thank FAPERJ and CNPq for long-term funding.

The authors have no conflicts of interest to declare.

Back to Top | Article Outline


Papers of particular interest, published within the annual period of review, have been highlighted as:

▪ of special interest

▪▪ of outstanding interest

Back to Top | Article Outline


1. Bastos FI, Cáceres C, Galvão J, et al. AIDS in Latin America: assessing the current status of the epidemic and the ongoing response. Int J Epidemiol 2008; 37:729–737.

2▪. Miller WM, Buckingham L, Sánchez-Domínguez MS, et al. Systematic review of HIV prevalence studies among key populations in Latin America and the Caribbean. Salud Pública Méx 2013; 55 (Suppl 1):S65–78.

Provides a review on HIV prevalence among MSM and FSW from LAC and discuss methods used to estimate it.

3▪. UNAIDS. Global report: UNAIDS report on the global AIDS epidemic. 2013. [Accessed 25 September 2013]

Gives insight on epidemiological changes in HIV/AIDS epidemic since 2001 while discuss achievements and challenges to reach the Millennium Development Goals.

4. WHO. Global HIV/AIDS response: epidemic update and health sector progress towards universal access: progress report; 2011.

5. Ormaeche M, Whittembury A, Pun M, et al. Hepatitis B virus, syphilis, and HIV seroprevalence in pregnant women and their male partners from six indigenous populations of the Peruvian Amazon Basin, 2007-2008. Int J Infect Dis 2012; 16:e724–e730.

6. UNAIDS. UNAIDS Report on the global AIDS epidemic; 2012. [Accessed 12 August 2013]

7. Koenig SP, Rodriguez LA, Bartholomew C, et al. Long-term antiretroviral treatment outcomes in seven countries in the Caribbean. J Acquir Immune Defic Syndr 2012; 59:e60–e71.

8. Beyrer C, Abdool Karim Q. The changing epidemiology of HIV in 2013. Curr Opin HIV AIDS 2013; 8:306–310.

9. Diaz T, Garcia-Calleja JM, Ghys PD, et al. Advances and future directions in HIV surveillance in low- and middle-income countries. Curr Opin HIV AIDS 2009; 4:253–259.

10. Hallett TB. Estimating the HIV incidence rate: recent and future developments. Curr Opin HIV AIDS 2011; 6:102–107.

11. De Lima KO, Salustiano DM, Coêlho MRCD, et al. Incidence of recent human immunodeficiency virus infection at two voluntary counseling testing centers in Pernambuco, Brazil, from 2006 to 2009. J Clin Microbiol 2012; 50:2145–2146.

12. Murillo W, Veras N, Prosperi M, et al. A single early introduction of HIV-1 subtype B into Central America accounts for most current cases. J Virol 2013; 87:7463–7470.

13. Junqueira DM, de Medeiros RM, Matte MCC, et al. Reviewing the history of HIV-1: spread of subtype B in the Americas. PLoS One 2011; 6:e27489.

14. Dennis AM, Murillo W, de Maria Hernandez F, et al. Social network-based recruitment successfully reveals HIV-1 transmission networks among high-risk individuals in El Salvador. J Acquir Immune Defic Syndr 2013; 63:135–141.

15. Bennett DE, Myatt M, Bertagnolio S, et al. Recommendations for surveillance of transmitted HIV drug resistance in countries scaling up antiretroviral treatment. Antiviral Ther 2008; 13 (Suppl 2):25–36.

16. Pineda-Penã A-C, Bello D-C, Sussmann O, et al. HIV-1 transmitted drug resistance in latin america and the caribbean : what do we know ? AIDS Rev 2012; 14:256–267.

17. Montealegre JR, Johnston LG, Murrill C, et al. Respondent driven sampling for HIV biological and behavioral surveillance in Latin America and the Caribbean. AIDS Behav 2013; 17:2313–2340.

18▪. Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet 2012; 380:367–377.

Provides estimates of the impact of HIV among MSM worldwide considering prevalence studies and molecular biology studies.

19. Gouws E, Cuchi P. Focusing the HIV response through estimating the major modes of HIV transmission: a multicountry analysis. Sex Transm Infect 2012; 88 (Suppl 2):i76–i85.

20. Kerr LRFS, Mota RS, Kendall C, et al. HIV among MSM in a large middle-income country. AIDS 2013; 27:427–435.

21. Creswell J, Guardado ME, Lee J, et al. HIV and STI control in El Salvador: results from an integrated behavioural survey among men who have sex with men. Sex Transm Infect 2012; 88:633–638.

22. Pando MA, Balán IC, Marone R, et al. HIV and other sexually transmitted infections among men who have sex with men recruited by RDS in Buenos Aires, Argentina: high HIV and HPV infection. PLoS One 2012; 7:e39834.

23. Goodreau SM, Carnegie NB, Vittinghoff E, et al. What drives the US and Peruvian HIV epidemics in men who have sex with men (MSM)? PLoS One 2012; 7:e50522.

24. Kim EJ, Creswell J, Guardado ME, et al. Correlates of bisexual behaviors among men who have sex with men in El Salvador. AIDS Behav 2013; 17:1279–1287.

25. Geibel S, Tun W, Tapsoba P, et al. HIV vulnerability of men who have sex with men in developing countries: Horizons studies, 2001-2008. Public Health Rep 2010; 125:316–324.

26. Rocha GM, Kerr LRFS, de Brito AM, et al. Unprotected receptive anal intercourse among men who have sex with men in Brazil. AIDS Behav 2013; 17:1288–12895.

27. Blas MM, Alva IE, Cabello R, et al. Risk behaviors and reasons for not getting tested for HIV among men who have sex with men: an online survey in Peru. PLoS One 2011; 6:e27334.

28. Kendall C, Kerr LRFS, Gondim RC, et al. An empirical comparison of respondent-driven sampling, time location sampling, and snowball sampling for behavioral surveillance in men who have sex with men, Fortaleza, Brazil. AIDS Behav 2008; 12:S97–S104.

29. Gutiérrez JP. Profile of gay men in Mexico City: results of a survey of meeting sites. Trop Med Int Health 2012; 17:353–360.

30▪. Baral SD, Poteat T, Strömdahl S, et al. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis 2013; 13:214–222.

Provides estimates of HIV burden among TGW.

31. Silva-Santisteban A, Raymond HF, Salazar X, et al. Understanding the HIV/AIDS epidemic in transgender women of Lima, Peru: results from a sero-epidemiologic study using respondent driven sampling. AIDS Behav 2012; 16:872–881.

32. Wilson EC, Garofalo R, Harris DR, et al. Sexual risk taking among transgender male-to-female youths with different partner types. Am J Public Health 2010; 100:1500–1505.

33. Barrington C, Wejnert C, Guardado ME, et al. Social network characteristics and HIV vulnerability among transgender persons in San Salvador: identifying opportunities for HIV prevention strategies. AIDS Behav 2011; 16:214–224.

34. Pando M, Gómez-Carrillo M, Vignoles M, et al. Incidence of HIV type 1 infection, antiretroviral drug resistance, and molecular characterization in newly diagnosed individuals in Argentina: a Global Fund Project. AIDS Res Hum Retroviruses 2011; 27:17–23.

35. Baral S, Beyrer C, Muessig K, et al. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis 2012; 12:538–549.

36. Caetano KAA, França DDDS, Carneiro MADS, et al. Prevalence and virologic profile of HIV infections among female sex workers in Goiânia City, central Brazil. AIDS Patient Care STDS 2013; 27:1–4.

37. Damacena GN, Szwarcwald CL, de Souza Júnior PRB, et al. Risk factors associated with HIV prevalence among female sex workers in 10 Brazilian cities. J Acquir Immune Defic Syndr 2011; 57 (Suppl 3):S144–S152.

38. Malta M, Magnanini MMF, Mello MB, et al. HIV prevalence among female sex workers, drug users and men who have sex with men in Brazil: a systematic review and meta-analysis. BMC Public Health 2010; 10:317.

39. Goldenberg S, Rangel G, Vera A, et al. Exploring the impact of underage sex work among female sex workers in two Mexico-US border cities. AIDS Behav 2013; 16:969–981.

40. Kim AA, Morales S, Lorenzana de Rivera I, et al. HIV incidence among vulnerable populations in Honduras: results from an integrated behavioral and biological survey among female sex workers, men who have sex with men, and Garifuna in Honduras, 2006. AIDS Res Hum Retroviruses 2013; 29:516–519.

41. Hakre S, Arteaga G, Núñez AE, et al. Prevalence of HIV and other sexually transmitted infections and factors associated with syphilis among female sex workers in Panama. Sex Transm Infect 2013; 89:156–164.

42. Cárcamo CP, Campos PE, García PJ, et al. Prevalences of sexually transmitted infections in young adults and female sex workers in Peru: a national population-based survey. Lancet Infect Dis 2012; 12:765–773.

43. Pando Ma, Coloccini RS, Reynaga E, et al. Violence as a barrier for HIV prevention among female sex workers in Argentina. PLoS One 2013; 8:e54147.

44. UNODC. World Drug Report. United Nations; 2013.

45. Strathdee SA, Magis-Rodriguez C, Mays V, et al. The emerging HIV epidemic on the Mexico-US border; an international case study characterizing the role of Epidemiology in surveillance and response. Ann Epidemiol 2012; 22:426–438.

46. Ulibarri MD, Strathdee S, Ulloa EC, et al. Injection drug use as a mediator between client-perpetrated abuse and HIV status among female sex workers in two Mexico-US border cities. AIDS Behav 2011; 15:179–185.

47. Duncan J, Gebre Y, Grant Y, et al. HIV prevalence and related behaviors among sex workers in Jamaica. Sex Transm Dis 2010; 37:306–310.

48. Angulo-Arreola IA, Bastos FI, Strathdee S. Substance abuse and HIV/AIDS in the Caribbean: current challenges and the ongoing response. J Int Assoc Phys AIDS Care 2011; Epub ahead of print.

49. Deiss RG, Clark JL, Konda KA, et al. Problem drinking is associated with increased prevalence of sexual risk behaviors among men who have sex with men (MSM) in Lima, Peru. Drug Alcohol Depend 2013; 132:134–139.

50. Deiss R, Lozada R, Burgos J, et al. HIV prevalence and sexual risk behavior among noninjection drug users in Tijuana, Mexico. Glob Public Health 2012; 7:175–183.

51. Cohen M, Chen Y, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. New Engl J Med 2011; 365:493–505.

52▪. PAHO. Antiretroviral Treatment in the Spotlight: a public health analysis in Latin America and the Caribbean. 2012.

Provides country estimates of ART coverage and costs for treatment and prevention in LAC.

53. Arán-Matero D, Amico P, Arán-Fernandez C, et al. Levels of spending and resource allocation to HIV programs and services in Latin America and the Caribbean. PLoS One 2011; 6:e22373.

54. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. New Engl J Med 2010; 363:2587–2599.

55. Gomez GB, Borquez A, Caceres CF, et al. The potential impact of preexposure prophylaxis for HIV prevention among men who have sex with men and transwomen in Lima, Peru: a mathematical modelling study. PLoS Med 2012; 9:e1001323.

56. Huedo-Medina TB, Boynton MH, Warren MR, et al. Efficacy of HIV prevention interventions in Latin American and Caribbean nations, 1995–2008: a meta-analysis. AIDS Behav 2010; 14:1237–1251.


HIV/AIDS; Latin America and the Caribbean; review

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.


Article Tools



Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.