AIDS in Mexico

By Devon T, Marisa M, Brooklyn K, Sara J

Introduction

AIDS, which stands for acquired immune deficiency syndrome, is a prevalent disease across the world. It is most common in areas in Africa and Russia, in which the citizens are less likely to have access to contraceptives, or are less likely to be knowledgeable on the existence and effects of AIDS. In this presentation we will discuss the prevalence of AIDS in Mexico, which is a country containing fewer cases than Russia and most African countries, but having more cases than most other countries in the world.

Background: AIDS in Mexico

The AIDS epidemic is concentrated primarily among MSM, sex workers and their clients, and people who inject drugs. Results of a 2006 study reported by UNAIDS indicate that sex between men accounts for 57 percent of the HIV infections. Mexico’s National Center for HIV/AIDS Prevention and Control (CENSIDA) estimates that HIV prevalence among MSM was 10 to 13.5 percent in 2006. Results from studies in 2006 by the Biological Behavioral Surveillance Survey conducted in Mexico showed that HIV prevalence rates among male sex workers were 25 percent in Monterrey, and 20 percent in Guadalajara and Mexico City.

The Specifics

Mexico, an estimated 180,000 people were living with HIV, it is estimated that 9,900 people were infected with HIV and that 4,900 people died of AIDS. Unsafe sex amongst men having sex with men is extremely common across Mexico. In 2011, the HIV prevalence range was between 7% in Nicaragua and Honduras and 23% in Panama. Condom use among MSM varies significantly across the region. It is estimated that approximately 1 in 5 men who have sex with men, also have sex with women. Condom use among men who have sex with men is less than half when reporting condom use when having sex with a woman. In recent years, prevention efforts have specifically targeted female sex workers. Whilst data is widely unavailable for male sex workers, five countries did report condom use ranging between 45% in Mexico and 91% in Guatemala. The transmission of HIV through sharing drug injecting equipment is still a huge part of the AIDs epidemic. There are an estimated 2 million drug users who use needles in central and south America and more than a quarter may be infected with HIV. Nevertheless, harm reduction is severely limited. Only 5 Latin American countries provide needle exchanges and among these, the number of clean needles and syringes distributed per IDU, per year is far below the recommended coverage level. HIV prevalence among young people fell by 20% and 33% among young males. To have reduced HIV transmission in this high-risk age group shows that HIV education and prevention strategies are working.

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HAART Implementation

Mexico was one of the first countries to implement free and universal access to HAART in Latin America (2003), as result of protests from NGOs and advocacy within the government. At the end of 2010, a total of 65,000 persons were receiving HAART. However, from 2003 to 2010 almost 40,000 people have died from AIDS. Although so many people died, its still less deaths than were predicted by previous trends. HAART is a program that seems to have great effects on AIDS in Mexico thus far, as seen in the graph below.
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The national response for the prevention and control of HIV/AIDS

In 1986, Mexico established the National Committee against AIDS. Initially the committee was comprised of professionals who provided their services on a part-time basis to coordinate the fight against AIDS. In August 1988, the National Council for Prevention and Control of AIDS (CONASIDA) was established by presidential decree. CONASIDA became the official government agency charged with the responsibility for meeting the diverse challenges of the HIV/AIDS epidemic in Mexico.



The number of CONASIDA staff gradually increased. Initially financial support came from international funds. As of 1991, most of the activities were financed by the Secretariat of Health. At present, more than 90 percent of funds used by the program are provided by the Mexican government.


In 1997 an analysis of healthcare services and needs was made to help prioritize the primary responsibilities of the Secretariat of Health. As a result of this analysis, substantive programs were identified and recommendations were made for new programs at both the federal and state levels. Thus, eleven substantive programs were defined, one of which was the Program for HIV/AIDS and other Sexually Transmitted Diseases, which is the direct responsibility of the CONASIDA.


Integration of HIV and STD services was based on recommendations by various federal and state agencies who had been working together to better coordinate activities and services between both programs. CONASIDA is a part of the federal level of the Secretariat of Health. Its main function is a normative one of coordination and counseling at a national level.

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FONSIDA Project

The FONSIDA, A.C. project was presented on December 12, 1997, at the Health National Council, and was made official three days later when an incorporation deed was signed. The initial fund of $30 million was allocated by the Secretariat of Health; National Autonomous University of Mexico freely provides facilities, equipment, and personnel for project operation; Banamex grants an exemption of fees for the trust; Merck Foundation provided financing for the training of health personnel in charge of specialized services of integral care at the state level; and several specialized laboratories have donated medications. FONSIDA A.C. today provides free treatment to 100 percent of minors under age 18 who have neither Social Security nor other financial resources, as well as to HIV-infected pregnant women for the prevention of perinatal transmission and postpartum for their own treatment. The fundraising campaign has not yet started, but as more funds are obtained coverage is expected to increase.
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The Main Goals of the FONSIDA and CONSIDA Project

Main Focuses:

Prevention of HIV transmission -- perinatally, through blood transfusions, injection drug use, and sexual transmission.

Reduction of the impact of HIV on individuals, families, and society.

Coordination of institutional, interinstitutional, territorial, and intersectorial programs.


CONASIDA's main goals established for the year 2000 are to:

Reduce by 50 percent the number of cases of children infected by HIV during pregnancy, delivery, or lactation.

Reduce HIV transmission through blood transfusion to 0.1 percent.

Reduce AIDS incidence rate to two percent.

Increase the use of condoms by 30 percent.

Provide timely and appropriate care to 80 percent of persons infected by HIV and other STDs.

Eliminate all health sector violations of human rights of persons with HIV.

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Conclusion

In many countries there is little experience in horizontal cooperation orimplementation mechanisms to incorporate the participation of community in the planning and evaluation of health programs. In Mexico, as in other countries, AIDS is a public health challenge which has accelerated the process of learning to listen, incorporate, coordinate, and work jointly with various sectors of society, including civil organizations and representatives of persons affected by this epidemic. AIDS has been improved in Mexico, but still exists.