Central American Countries With High HIV Prevalence Must Intensify Prevention Efforts, World Bank Report Says
Four of the six Latin American countries with the highest HIV prevalence rates in the region are in Central America, and those countries must intensify their prevention efforts before the epidemic "run[s] out of control," according to a World Bank report issued on Tuesday at the third Central American Congress on Sexually Transmitted Diseases/HIV/AIDS, also called Concasida 2003, according to a World Bank release. Belize, Honduras, Panama and Guatemala have the highest adult HIV prevalence in Central America, ranging from 2% of adults in Belize to 1% in Guatemala, according to the report, titled "HIV/AIDS in Central America: An Overview of the Epidemic and Priorities for Prevention." Although HIV is transmitted primarily through heterosexual contact in these countries, HIV is "generally concentrated" in high-risk populations, such as men who have sex with men, commercial sex workers, prisoners and the Afro-Caribbean population, according to the report. More men are HIV-positive than women in Central America, but the "gender gap is closing," according to the release. "The HIV/AIDS epidemic in Central America is serious and is worsening, and although the epidemic continues to be concentrated in high-risk populations, it has become generalized in some countries," Jane Armitage, the World Bank's director for Central America, said. The report indicates that adult HIV prevalence in El Salvador, Guatemala and Panama could reach 2% by 2010 if the epidemic's current pattern continues.
Some Central American countries have implemented policies such as free condom distribution to prevent HIV transmission, but those programs must be "improved and expanded" and governments need to "focus more" on prevention, Helena Ribe, World Bank sector leader for human development in Central America, said, according to the release. According to the World Bank's Allocation by Cost-Effectiveness Model, Central American officials can make a "substantial impact" with limited resources if they channel funds to the most cost-effective HIV prevention programs. The report says that cost-effective programs could include free condom distribution to high-risk groups; condom social marketing; information, education and communication for high-risk groups; and access to rapid HIV testing, according to the release. Helen Saxenian, World Bank lead economist for health in Latin America and the Caribbean, said that Central American governments can establish highly effective prevention campaigns with limited resources, but she added that current funding levels are inadequate. "In order to prevent between 10% and 20% of new infections, countries must invest at least $1 million each year in highly cost-effective [HIV] prevention activities," Saxenian said. Armitage said, "Fortunately, there is still time to limit the current and future impact of HIV/AIDS. Prevention is the key" (World Bank release, 10/14).