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HIV/AIDS in Brazil at a glance 11th Advanced HIV Course 1 – 3 September 2013, Aix-en-Provence, France Ana Flor Hexel Cornely Clinical Hospital, Porto Alegre Barbara Silva de Souza Saint Louis Hospital, Paris Diego Lins Guedes Oswaldo Cruz University Hospital, Recife HIV/AIDS in Brazil at a glance Today’s Outline: 1.Epidemics 2.Diagnostic 3.Clinical Care and Treatment 4.Prevention 5.Future changes and global response • World’s fifth largest territory • World's fifth largest population • 190 million inhabitants HIV/AIDS in Brazil: epidemics AIDS incidence/year/region Brazil 2000-2009 • Incidence: inhabitants • 500,000 (2012) • 20.2 cases/100,000 HIV-infected patients ~ 130,000 undiagnosed Incidence/100000 hab/ region Brazil • Features of the HIV epidemic in Brazil: • Prevalence rates lower in the general population (0.6%) than in more vulnerable groups (5.9% IVDUs, 10.5% MSM, 4.9% sex workers) 17.5 Available at http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/53077/em_portugu_s_93155.pdf HIV/AIDS in Brazil: diagnosis • 37% of overall HIV testing coverage HIV testings performeds by SUS, 2003-2011 • Higher coverage amongst the most vulnerable: • 54% MSM • 65.1% Sex workers • 44.3% Drug users • 2.9 million rapid HIV tests in 2012 Available at http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/53077/em_portugu_s_93155.pdf HIV/AIDS in Brazil: clinical care and treatment • 313,000 people have access to ARV therapy (free of charge) • Treatment program covers 200,000 people (>90% of all in need of such support) • 20 available ARV, 11 locally produced • CD4 cell count HIV, viral load and resistance tests (RENAGENO) available Available at http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/53077/em_portugu_s_93155.pdf HIV/AIDS in Brazil: prevention • Free distribution of condoms, constantly rising up (146 m to 500 m/year, 2002 – 2010) • Since 2010: prophylaxis post to Number of condoms distributed by year. Brazil, 2002-2011 exposure unprotected sexual intercourse • Robust and sustainable PMTCT Available at http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/53077/em_portugu_s_93155.pdf HIV/AIDS in Brazil: future challenges and global response • Universal testing of pregnant women by 2015 (84% of them tested in 2010/2011) • Improve surveillance strategies (early detection), ARV to vulnerable populations (MSM, sex workers, discordant partners and prisoners) • South-to-South cooperation Available at http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/53077/em_portugu_s_93155.pdf Thank you! Sunset in the Tapajós River, Amazon