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March 1997 |
AIDS SURVEILLANCE IN THE AMERICAS*
Introduction
The Regional Program on AIDS/STD. The mandate for PAHO's Regional Program on AIDS/STD is to promote, design and facilitate technical activities and policies to improve the capacity of Member Countries to reduce the number of future infections and to provide timely and adequate care for people living with HIV/AIDS/STD.
The Regional Program is part of a broader set of culturally-sensitive, gender-specific, multinational and multisectoral responses to HIV/AIDS and STD in the Americas. The following types of technical assistance provide a framework for the Program's myriad activities: dissemination of information; training; direct technical cooperation; resource mobilization;
The Regional Program on AIDS/STD is designed to: advocate for HIV/STD prevention and control at the country level in Latin America and the Caribbean; strengthen management capacity to develop and implement policies for HIV and STD prevention and control; involve nongovernmental organizations (NGOs) in prevention and control efforts and build networks among NGOs at the country level; coordinate regional cooperation with PAHO and the World Health Organization headquarters; and analyze financial and administrative data to ensure effective execution and monitoring of national programs; provide direct technical cooperation to Member Countries including (but not limited to): epidemiological analysis; development of educational materials and country HIV/STD surveillance reports; laboratory support for STD diagnosis, and improvement of blood safety measures, etc.; promote research about HIV/AIDS epidemiological trends, their relation to other STD, prevention messages, and surveillance, socioeconomic impact, etc.; disseminate information (technical and scientific) to and from Member Countries; establish sentinel surveillance, and advise and train professionals to monitor HIV/STD infection and trends at the country level.
AIDS Surveillance in the Americas
PAHO began its AIDS Surveillance System in 1986, although cases had been reported informally to PAHO since 1983. The information is currently submitted to PAHO from 47 countries and territories of the Region of the Americas. These data are received within 30 to 45 days after the end of each quarter. PAHO then produces a report, which is distributed to all the countries in the Region. Twice a year PAHO sends the information to the World Health Organization headquarters in Geneva, Switzerland, where data are gathered from all regions, and produced as the Global AIDS Report.
As of December 1996, a cumulative total of 742,273 cases were reported in the Americas. From these, 13,119 are pediatric cases ( < 15 years old). A total of 437,407 cumulative deaths have been reported since 1986.
Certain factors such as underdiagnosis, underreporting and delayed reporting affect the completeness of the data. This could be considered when analyzing 1995 data. Additionally, many times the countries provide the number of cases by year but can not report the corresponding age, sex and risk factor for those cases.
PAHO and its Member Countries are working continuously to improve the quality and completeness of the information, to be able to analyze and provide
a better profile of the epidemic in each consecutive report.
In 1994, the rate of reported AIDS cases per million population in Latin America was 58.2, in the Caribbean 202.8, and in
North America 236.3 (Table 1). The primary modes of HIV transmission in the subregions are homo/bisexual (Andean Area, Southern Cone, Brazil and Mexico) and heterosexual (Central American Isthmus and the Caribbean). Transmission attributed to intravenous drug use is common in the Southern Cone and Brazil with 29.7% and 26.5%, respectively.
In the Southern Cone and Central America the age of the highest infection is the group between 20-29 years old for both sexes and for females in Brazil. In the Andean Area, Mexico and the Caribbean is age of infection is between 30-39 years old for males and females, as well as for males in Brazil.
Source:Division of Disease Prevention and Control, AIDS/STD Program (HCP/HCA), PAHO
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