Epidemiology of AIDS in the Americas

As of June 30 1994 a total of 985119 cases of AIDS had been reported to the World Health Organization (WHO) but because of underreporting the real number is estimated to be about 3 million. The number of adults infected with HIV was around 15 million of whom 6 million were women. Moderate projections indicate that by the year 2000 worldwide there will be at least 10 million adult cases of AIDS and 30-40 million people infected with HIV of whom 10 million will be children. 90% of the cases are in the developing countries. The WHO estimated in 1985 that 50% of HIV transmission occurred via the heterosexual route which would increase to 75-80% by 2000. As of December 10 1993 in 45 countries of the Americas a total of 425978 cases of AIDS had been reported to the Panamerican Health Organization (PAHO); 248446 of these died. In northern America 57% of the reported cases were among homosexual and bisexual men and more than one-fourth among intravenous drug addicts. In Latin America the proportion of AIDS cases among homosexuals and bisexuals varied from 14% to 69.5% as of December 1993. PAHO estimated that 2.5 million persons were infected with HIV in the Western Hemisphere with about 1 million infected in northern America. Of this figure about 300000-500000 were women and fewer than 150000 were in Latin America and the Caribbean. In Central America the female clinical cases of AIDS multiplied 40 times in the past 5 years (up to 1994). A study indicated that in Haiti approximately 1 out of 10 pregnant women were infected with HIV. Genital infections such as chancre syphilis and gonorrhea attract large amounts of macrophages to the genital region augmenting the quantity of CD4 receptors necessary for the HIV infection. The preventive strategy for the control of HIV should include the improvement of the quality and quantity of health services for the detection treatment and prevention (condoms counseling) of other sexually transmitted diseases.