Health care systems in transition: Brazil Part II: The current status of AIDS in Brazil.

Abstract

There were a total 71111 AIDS cases reported to the Ministry of Health through the National Control Program of STDs and AIDS (PNC DST-AIDS) by September 1995. 87% of these cases were in the southeastern and southern regions 55% were from Sao Paulo state and 82% of cases were men. HIV/AIDS risk factors were known for 82% of the 58567 men reported with AIDS; 56% were men who had sex with other men 26% were IV drug users 12% were heterosexuals and 5% were transfusion recipients. Half of the female AIDS cases with known risk factors were heterosexuals 30% were IV drug users and 11% were transfusion recipients. Since the beginning of the HIV/AIDS epidemic in Brazil the male/female ratio has come down from 43:1 in 1985 to 5:1 in 1995. Young children comprise 3.2% of all AIDS cases. The proportion of AIDS cases reported among men due to homosexual and bisexual activity has declined steadily since 1988 with an offsetting increase in the proportion of AIDS cases due to heterosexual relations and to a lesser degree IV drug use. HIV and sexually transmitted disease control policies are controlled at the central level by the Ministry of Health through the PNC DST-AIDS. Such policies are controlled at the state level by the state health secretariat while at the local level disease notifications are monitored medications are provided to individuals and public hospitals and bulletins are regularly published with statistics describing the progress of the epidemic. The authors note that despite the clear need in Brazil for trained health care providers to meet the challenges of HIV/AIDS the curricula of medical schools in Brazil fail to train undergraduates how to manage individuals seeking HIV testing newly HIV-infected persons or people with AIDS.