HIV and injection drug use in Latin America.

OBJECTIVE: This paper presents HIV/AIDS-related data on injection drug use (IDU) and drug use trends in Latin America, and policy issues and strategies developed to face the HIV epidemic.
METHODS: Serosurveillance data on HIV/AIDS and IDU in Latin America were compiled. Key experts were consulted in Argentina, Brazil, Colombia and Mexico. Published and grey literature was reviewed. An overview and information on selected countries is discussed in order to analyse different responses.
RESULTS: IDU AIDS cases are driving the epidemiological trend in the Southern Cone at 34.3%, followed by Brazil at 20.2%, Latin Caribbean 2.8%, Central America 0.9%, Mexico 0.6%, and the Andean area 0.2%. Available prevalence data are absent or scarce with the exception of Argentina and Brazil. Even with evidence of HIV transmission occurring in IDU, there is a notorious lack of studies in most other countries. In 1984-2000 only four out of 21 Latin American countries had reported prevalence studies.
CONCLUSION: For countries that have already initiated harm-reduction programmes (HRP) the great challenge is to ensure that these activities are sustained. In other countries, IDU as a high-risk factor is currently of less importance. However, an increase in the frequency of IDU has been detected, and HIV prevalence is expected to increase. It is therefore necessary to implement HRP to encourage and help drug users to adopt safer methods, such as access to equipment and sterile materials, cleaning materials and information about safe sex, as well as counselling, support groups and medical assistance.