A number of countries in Latin America and the Caribbean – including Argentina, Brazil, Chile, Cuba, the Dominican Republic, Guyana, Mexico, Nicaragua and Uruguay – have made major progress in expanding the availability of antiretroviral treatment (ART) for people with HIV, saving the lives of thousands and preventing many new infections, the Pan American Health Organization/World Health Organization (PAHO/WHO) reports in a series of country-specific data analyses published this week.
Several countries, however, face major “treatment gaps” that leave many people who need HIV medication without access to it. Overcoming these gaps will require improvements in early diagnosis, referrals, and monitoring of HIV patients, as well as greater efficiency in the procurement and use of ART, PAHO/WHO analysts say.
The series of fact sheets released this week provide data on the HIV epidemic in 32 countries and territories of the Americas. Details are provided on HIV prevalence, the percentage of HIV patients on ART, public spending on ART, HIV mortality, HIV-tuberculosis co-infections, and other key aspects of the epidemic.
Country-level data are available for Antigua and Barbuda, Argentina, The Bahamas, Barbados, Belize, Bolivia, Brazil, Colombia, Costa Rica, Cuba, Dominica, the Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, St. Lucia, St. Kits and Nevis, St. Vincent, Suriname, Trinidad and Tobago, Uruguay, and Venezuela.
The country-specific analyses show, among other findings, that:
- In Latin America, Chile and Nicaragua have the highest rates of coverage of antiretroviral treatment for those who need it (among countries for which good data are available).
- In the Caribbean, Cuba and Guyana have the highest ART coverage rate (among countries for which good data are available).
- Eleven countries report high dependency on external financing for antiretrovirals.
- Fourteen out of 26 countries (54 percent) reported at least one stock-out episode, endangering patients whose health is dependent on HIV treatment.
- Regionwide, 63 percent of adults in ART are on first-line regimens recommended by WHO, and 33 percent are on WHO-recommended second-line treatments. Anguilla, Grenada, Guyana and Honduras have the highest rates of compliance with these WHO recommendations.
- Some countries – particularly Uruguay, Suriname, the Dominican Republic, Bolivia and Guatemala – use multiple regimens for first-line ART, placing a higher burden on their health systems.
The country-level analyses follow the release in May of the PAHO/WHO report Antiretroviral Treatment in the Spotlight: A Public Health Analysis in Latin America and the Caribbean. It recommends that health system weaknesses be addressed, balancing an individual approach with a public health perspective, to ensure that the Region of the Americas remains a global leader in ART.