AIDS in the Americas: A public health priority for the region

The AIDS epidemic continues to grow in the Americas at different velocities in different countries due to the different times of introduction of the virus and because of a host of social/behavioral factors which remain to be elucidated. In some subregions the pattern of transmission is changing rapidly from the homosexual/bisexual to the heterosexual transmission pattern with a consequential increase in perinatal transmission. While the clinical presentation of HIV-1 infection varies throughout the region, the adaptation of a modified case definition for AIDS will aid in the recognition and surveillance of AIDS cases. The recent introduction of HIV-2 into the region has further complicated the increasing prevalence rates of HIV-1 and HTLV-I/II and the associated morbidity and mortality rates observed with these retroviruses. Furthermore, some countries are already beginning to feel the impact of AIDS on their health-care delivery system, and those countries which have yet to feel the impact of AIDS must prepare for the inevitable consequences of a relatively broad epidemic of HIV-1 infection. Consequently, if we are to respond effectively to the AIDS and HIV pandemic, prevention efforts and the mobilization of resources should become a priority at the local, national and global levels.