HIV/AIDS Epidemic In Brazil Research Papers Example

Abstract

The HIV/AIDS prevention and control program Brazil has drawn the attention of the whole world. Wealthy nations such as the USA are contemplating of borrowing a leaf from Brazil following the success that has been registered there. Brazil has managed to reduce the prevalence of HIV/AIDS through a number of approaches. They include free access to anti-retroviral drugs, free condom distribution, media campaigns, counseling, and reduction of stigma. This success has been realized because of a solid political will, as well as the government’s collaboration with non-governmental organizations. This paper evaluates what Brazil has done right, and what the USA can learn from it.

Key Words

Brazil, HIV/AIDS, USA.

Introduction

Brazil is undergoing tremendous developments in different sectors including that of health. Its AIDS treatment program has been lauded by pundits as one of the most successful. This paper attempts to provide a picture of Brazil’s HIV/AIDS status. In addition, this discussion will compare and contrast Brazil’s treatment protocols with those of the USA. This paper is written through the lenses of a US representative at the World Health Organization.

Overview of Brazil

Initially, Brazil was known as the Federative Republic of Brazil, and it is the largest country in Latin and South America (Fausto, 1999). Brazil is ranked at number five in terms of the biggest nations in the world when population and geographical area are taken into account. Brazil boasts as single largest Portuguese-speaking nation in the world; in fact, the only Portuguese-speaking nation in the Americas (Fausto, 1999).
On the East, Brazil is bordered by the Atlantic Ocean, and it has a coastline of 7,491 km (Fausto, 1999). All other South American nations except Chile and Equator border Brazil. Brazil’s landmass constitutes 47.3 percent of the entire South American continent (Fausto, 1999). Brazil lies in the tropical climatic zone with the Amazon Forest and River, the key defining natural habitats. The country’s tropical forest hosts numerous ecological systems and different wildlife. Brazil boasts of extensive natural resources and hundreds of protected areas. For that matter, these exceptional environmental heritage has earned Brazil a place in the 17 most mega-diverse areas in the world (Fausto, 1999).
Prior to the landing of the Portuguese settlers, Brazil was inhabited by diverse tribal nations (Fausto, 1999). After being conquered by Portugal, It became a Portuguese colony until 1808. In 1815, Brazil was designated as a Kingdom, and Rio de Janeiro was made the empire’s capital city. Later, in 1822, Brazil gained independence from Portugal that led to the formation of the Empire of Brazil (Fausto, 1999). The Empire was governed by a parliamentary system and a constitutional monarchy. In 1889, Brazil became a presidential republic following a military coup de ’tat. Currently, the country’s constitution that was engineered in 1988 defines it as a federal state. Collectively, this federal state is made up of 26 states, a federal district, and 5, 570 municipalities (Fausto, 1999).
Brazils’ economy is ranked at number seven in the world when purchasing power party, and nominal Gross Domestic Product (GDP) are taken into consideration (Guilherme, 2012). In 2010, the country’s economy was regarded as the fastest growing economy. The economic growth has given Brazil a significant international recognition; it has become amongst the most influential nations. Brazil is a member of the G20 and United Nations, as well as a host of other regional and international economic and political organizations (Guilherme, 2012). It has been recognized as a regional power in Latin America, but on the international stage, its economy falls in the middle power category with the prospects of advancing to a global economic powerhouse (Guilherme, 2012).
According to the 2008 census, Brazil is estimated to have 190 million people (Avert, 2012). The ration of men to women stands at 0.95: 1 meaning that the number of men is almost equal to the number of females. Eighty-three percent of the population lives in the urban areas (Avert, 2012). The Southeastern and Northeastern states are the most populated states in the country. By 2008, illiteracy levels in Brazil stood at 1.48 percent; in youths under the age of 19 years (15-19), the illiteracy level was at 1.74 percent (Avert, 2012). The Northeast state, which is predominantly rural had the highest illiteracy levels at 20.3 percent. Generally, illiteracy levels are higher in the rural areas (24%) than in the urban areas (9%) (Avert, 2012).
Brazil is said to have close to 67 uncontacted tribes. The National Research by Household Sample in 2008 released race percentages in Brazil (Fausto, 1999). They were as follows: 48.3% or 92 million (White), 43.8% or 82 million (Brown), 13 million (6.8%) (Black) and 0.28 percent as Asian (Fausto, 1999). Brazil is characterized by social and class lines with some degree of racism. However, social class has higher influence over race. Catholic is largest religion in this country with its followers comprising of 73 percent of the entire population. Protestants follow at 15 percent (Fausto, 1999). Other minor religions account for the remaining percentages. Portuguese is the national language of Brazil. There is a huge Portuguese influence on the Brazil’s culture following its colonization by Portugal (Fausto, 1999).
The Department of Sexually Transmitted Infections, AIDS, and Vital Hepatitis (DSAV) provides statistics on HIV/AIDS. .As of 2009, the prevalence of HIV/AIDS in Brazil stood 0.5 percent, and as of now nearly 660,000 people are living with this disease (DSAV, 2015). Generally, prevalence of HIV/AIDS is high in the urban areas than in the rural areas. In the 80s and 90s, the HIV/AIDS epidemic was threatening to bring the Brazil to its knees, but thanks to the country’s robust anti-AIDS program, the epidemic has stabilized (DSAV, 2015). Key preventative and treatment strategies have been implemented and have contributed immensely to the current drop in HIV/AIDS status in the country (DSAV, 2015). Even though, most of the people with HIV/AIDS in Brazil are not economically empowered, they have full access to HIV/AIDS treatment. DSAV reports that the majority of the infected persons have no stable or high-paying jobs but they are able to access ARVs thanks to the government’s initiative. Besides, Brazil does not rely on outside aid such from the UN or US: It uses local solutions.
Between 1980 and the first half of 2012, there were 656, 701 proved cases of AIDS in Brazil (DSAV, 2015). As of 2011, the incidence rate was 17.9 cases/100,000 people. When the epidemic is looked at with respect to different geographical regions of the country, it has been reported that between 2000 and 2011, in the South-East region, the incidence dropped from 22.9 to 21.0 cases/100,000 people (DSAV, 2015). In the same, period, the incidence rate went up in the South rising from 27.1 to 30.9 (DSAV, 2015). The incidence rose from 9.1 to 20.8, 14.3 to 17.5 and 7.5 to 13.9 in the North, Midwest and Northeast respectively. The Southeast region, which is the most urbanized, has the highest number of cases (56%) (DSAV, 2015).
At the moment, the number of cases are still high in men when compared to their female counterparts although this difference continues to decrease as time goes by (DSAV, 2015). The differences in AIDS cases is computed by dividing the number of men with AIDS by the number of females with the condition. In 1986, the ratio of AIDS cases in the ratio of males to women was 6:1, but by 2010, it had dropped to 1.7:1 (DSAV, 2015). In addition, AIDS is still highly prevalent in the age group p of 25-49 in both males and females. However, in the age group of 13 to 19, the statistics are a bit different; the prevalence is higher among females than males (DSAV, 2015). This scenario has been present from 1998 to date. Data among the young people indicates that even though they have been made aware of the issues surrounding sexually transmitted diseases including HIV/AIDS, the cases of HIV/AIDS are still high (DSAV, 2015).
Sexual intercourse is the chief mode of transmission in all groups. In some females, approximately 1 percent, transmission is due to heterosexual intercourse with HIV victims (DSAV, 2015). In males, 43 percent of all cases result from heterosexual intercourse, 24.5 percent and 7.7 percent from homosexual and bisexual intercourses respectively (DSAV, 2015). The heterosexual men are hardest hit group because the prevalence is still high in this group. Males who have poor educational background have been found to be at a high risk of contracting HIV. There has been a dramatic reduction in the prevalence of HIV/AIDS in the age group of 15 to 24 years in the past 12 years (DSAV, 2015). However, in the same age group, the prevalence among gay men has increased by 10.1 percent. Another important statistic is the reduction of cases among children under the age of five. As of 2011, there only 745 cases. In fact, there has been a 55 percent reduction in HIV/AIDS cases among children under five years in from 2000 to 12 (DSAV, 2015). This statistic is indicative of a high successive rate in the policy that seeks to reduce mother-to-child transmissions.
Brazil has been applauded for its efforts to reduce the prevalence of HIV/AIDS. In order to stop mother-to-child transmission, the Brazilian Ministry of Health has engineered a program that ensures that expectant HIV-positive females take Anti-Retrovirals (ARVs) during the course of their pregnancy and at childbirth (Nunn, Fonseca, Bastos, & Gruskin, 2009). Those whose viral load in not known or is exceptionally high are advised to give birth via cesarean section. On the other hand, children born to HIV-positive mothers are put on special ARVs and are not breast-fed. In other groups, for instance, below 24 years group, the government has rolled out a program that ensures free access to condoms (Nunn, Fonseca, Bastos, & Gruskin, 2009). The use condoms has not only focused this group, but also other groups. In addition, infected people have been advised to use condoms. The government distributes both male and female condoms for free (Nunn, Fonseca, Bastos, & Gruskin, 2009).
In addition, the government has heightened media campaigns that educate people on the means of HIV transmission, and treatment methods (DSAV, 2015). Television, newspapers, and billboards are the major media that are used. The government educates people on condom use, stigma of HIV/AIDS patients, the rights of the infected people, and means to avoid transmission (DSAV, 2015). Furthermore, the government also targets high-risk groups such as sex workers, injecting drug users, and men who have sex with men. The government is working with groups that support gay relationships to reduce stigma and encourage tolerance. In addition, people in this group are given advice on how to practice safe sex (DSAV, 2015).
Sex workers are encouraged to use condoms although condom use in this group is still poor (DSAV, 2015). The government has also made significant steps in reducing injecting drug use that was another common form through which the virus was transmitted. Through media campaigns and counseling services, injecting drug use has fallen dramatically. Perhaps, the most significant approach that the government has made is the enhanced access to ARVs. The government provides free ARVs to people with HIV/AIDS, and this has led to a significant reduction in the mortality rates (DSAV, 2015). On top of that, it has increased the life expectancy of HIV positive patients.
When compared with the USA, Brazil seems to have a more elaborate plan. In the United States, the cost of HIV/AIDS treatment ranges from $2000 to $5000 per month (Nunn, Fonseca, Bastos, & Gruskin, 2009). Over the course of a patient’s lifetime, the expected cost is likely to reach half a million dollars. The USA has made significant steps in reducing the prevalence of HIV, but the burden is on treating those that have been infected. According to the Centers for Disease Control, more than half of the people that are diagnosed with HIV fail to receive regular health care (Nunn, Fonseca, Bastos, & Gruskin, 2009).
For those who receive regular care, 42 percent are covered by Medicaid while 12 percent are uninsured (Nunn, Fonseca & Gruskin, 2009). There are a number of initiatives that have been taken by the USA government in helping the HIV uninsured patients to access healthcare. The Ryan White Care Act, for instance, gives assistance to those that have no healthcare insurance. It helps in the payment for medication (Nunn, Fonseca & Gruskin, 2009). HIV/AIDS patients receive free drugs through Medicaid and AIDS Drug Assistance Program (ADAP). The Affordable Care Act has also enhanced access to care for HIV/AIDS patients. However, access to Medicaid is determined by a person’s income or job. Those who receive the insurance must prove that they are ineligible to access or pay for medical care. In addition, private insurers are reluctant to cover AIDS patients thus making it harder for such patients to receive alternative health insurance (Nunn, Fonseca & Gruskin, 2009).
In essence, the cost of treatment of HIV/AIDS AIN Brazil is almost zero when compared to their compatriots in the USA. In Brazil, the government is taking care of almost everything from free testing to free provision of ARVs (Nunn, Fonseca & Gruskin, 2009). Close association between the government and civil rights groups has played a vital role in the management of HIV/AIDS in Brazil. The government is working hand in hand with these groups and has led to a reduction in stigmatization, as well as a splendid adoption of the free ARVs program. Brazil’s fight against HIV/AIDS is better understood in the form of social and political changes that have taken place in this country (Nunn, Fonseca & Gruskin, 2008). There are a number of elements that have helped Brazil realize success sin the fight of HIV/AIDS.
Firstly, the strong association between Non-Governmental Organizations (NGOs), civil groups, and the government is a huge plus (Avert, 2012). This solid association has ensured that government policies are adopted in the grassroots. Secondly, there is solid political leadership and will to fight this disease. Thirdly, there is non-judgmental, tolerant approach to the prevention of HIV. Fourthly, there is a strong focus on condom use. Fifthly, the provision of free treatment to all HIV/AIDS patients, as well as concerted efforts to reduce the costs of ARVs. There are also promotions to enhance tolerance and reduce stigma. These elements have made Brazil a global leader in the fight against AIDS, and many nations have started adopting the Brazil model for HIV/AIDS prevention (Avert, 2012).
In summary, this paper has evaluated the prevalence of HIV/AIDS in Brazil, as well as compared and contrasted the treatment protocols available in both Brazil and the USA. Brazil was hard hit by this disease since its inception in the 1980s, but this country has made tremendous steps in the reduction of HIV/AIDS cases. The approach taken by Brazil has become a global model. In essence, Brazil provides free treatment to all HIV/AIDS patients; this includes free access to ARVs. Besides, there is strong political will and leadership to fight this epidemic. The government has opened up its arms and is working with numerous civil rights groups and NGOs in the fight of HIV/AIDS. On the other hand, even though the USA has made big strides in the reduction of HIV/IADS prevalence, the cost of treatment is still high. Access to ARVs and other health care services for HIV/AIDS patients is still wanting. The USA government should borrow a leaf from Brazil and make the treatment of HIV/AIDS-free for all if it hopes to enhance its success in the fight of HIV/AIDS.

References

Avert (2012). HIV/AIDS in Brazil. Retrieved from http://www.avert.org/hiv-aids-brazil.htm
Fausto, B. (1999). A Concise History of Brazil. Cambridge: CUP.
Gui, L., and Dianne, D. (2012). Tourism in Brazil: Environment, Management and Segments. London: Routledge.
Nunn, A., Fonseca, E., Bastos, F., and Gruskin, F. (2009). AIDS Treatment In Brazil: Impacts And Challenges. Health Aff (Millwood), 28(4), 1103–1113. doi:  10.1377/hlthaff.28.4.1103
Nunn, A., Fonseca, E., Gruskin, S. (2009). Changing Global Essential Medicines Norms to Improve AIDS Treatment: Lessons from Brazil. Global Public Health, 4 (2), 130–149