RELEVANT DATA FROM COUNTRIES IN LATIN AMERICA AND THE CARIBBEAN ON HIV/AIDS EPIDEMICS FOR THE ELIMINATION OF MOTHER TO CHILD TRANSMISSION ON HIV (EMTCT) AND THE ACHIEVEMENT OF MDG –6 UPDATED DATA BY MARCH 2011 This document presents information on EMTCT and Millennium Development Goal 6. It presents data from countries in the Latin America and Caribbean Region, disaggregated by indicators on eliminating mother-to-child transmission of HIV in low- and middle-income countries and combating HIV/AIDS, malaria and other diseases. The tables and charts in this document were created using data taken from “Children and AIDS. Fifth Stocktaking Report, 2010”. Additional comments are provided in blue boxes. For EMTCT we have taken the following indicators: 1. Estimated adult HIV prevalence rate (%) (15-49 years old), end 2009. The estimated adult HIV prevalence rate is the percentage of adults (15-49 years old) living with HIV as of 2009. 2. Antenatal Care Coverage (%) 2005-2009. Data refer to the most recent year available during the period specified in the column heading. The antenatal care coverage is the percentage of women (15–49 years old) attended at least once during pregnancy by skilled health personnel (doctors, nurses or midwives). 3. Annual number of births, 2009 (thousands). The annual number of births is the estimated number of live births in 2009. 4. Estimated number of HIV+positive pregnant women, 2009. The needs estimates are based on the methods described in the Annex. The estimates for individual countries may differ according to the estimation methods used. The estimated number of HIV+positive pregnant women is the estimated number of pregnant women living with HIV as of 2009. In the case of the Venezuela estimate, the estimates of the number of pregnant women living with HIV who need antiretrovirals for preventing mother-to-child transmission are currently being reviewed and will be adjusted, as appropriate, based on ongoing data collection and analysis> As a result, some countries have requested that only a range, or no needs estimates at all, be published. 5. Reported number of HIV+positive pregnant women who received ARVs for PMTCT, 2009. The reported number of HIV+positive pregnant women who received ARVs for PMTCT is the number of women testing HIV+positive during visits to antenatal clinics who were provided with antiretrovirals (ARVs) to prevent mother-to-child transmission. In the case of Argentina, Costa Rica, El Salvador, Suriname and Uruguay the reporting period is from January–December 2008. For MDG Goal 6, we have taken the following indicators: 1. HIV prevalence among young people (15-24 years old), 2009. United Nations General Assembly Special Session on HIV/AIDS (2001) indicator. 2. Percentage of young people (15-24 years old) with multiple partners who used a condom at last sex (2005-2009). United Nations General Assembly Special Session on HIV/AIDS (2001) indicator. Data refer to the most recent year available during the period specified in the column heading. Data on Peru and Guatemala is based on small denominators (typically 25-49 unweighted cases). 3. Percentage of young people (15-24 years old) who have comprehensive knowledge of HIV (2005-2009). United Nations General Assembly Special Session on HIV/AIDS (2001) indicator. Data refer to the most recent year available during the period specified in the column heading. 4. Orphan school attendance ratio (2005-2009). United Nations General Assembly Special Session on HIV/AIDS (2001) indicator. Data refer to the most recent year available during the period specified in the column heading. Orphan school attendance ratio: Percentage of children (10-14 years old) who have lost both biological parents and who are currently attending school as a percentage of non-orphaned children of the same age who live with at least one parent and who are attending school.

5. Estimated antiretroviral therapy coverage among children (percentage), December 2009. The coverage estimates are based on the estimated unrounded numbers of children receiving antiretroviral therapy and the estimated unrounded need for antiretroviral therapy (based on UNAIDS/WHO methodology). The ranges in coverage estimates are based on plausibility bounds in the denominator, that is, low and high estimates of need.

1. DATA FOR EMTCT: Eliminating mother-to-child transmission of HIV in low- and middleincome countries

Table 1 Estimated adult HIV prevalence rate (%) (15-49 years old), end 2009 Country Belize Haiti Jamaica Trinidad and Tobago Barbados Guyana Suriname Dominican Republic Panama El Salvador Guatemala Honduras Argentina Colombia Uruguay Chile Ecuador Peru Costa Rica Mexico Paraguay Bolivia Nicaragua Cuba Antigua and Barbuda Brazil Dominica Grenada Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Venezuela

Rate 2.3 1.9 1.7 1.5 1.4 1.2 1.0 0.9 0.9 0.8 0.8 0.8 0.5 0.5 0.5 0.4 0.4 0.4 0.3 0.3 0.3 0.2 0.2 0.1 -

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Chart 1: Estimated adult HIV prevalence rate (%) (15-49 years old), end 2009 Cuba Nicaragua Bolivia Paraguay Mexico Costa Rica Peru Ecuador Chile Uruguay Colombia Argentina

Rate

Honduras Guatemala El Salvador Panama Dominican Republic Suriname Guyana Barbados Trinidad and Tobago Jamaica Haiti Belize

0

0.5

1

1.5

2

2.5

There is no data available for Antigua and Barbuda, Brazil, Dominica, Grenada, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines and Venezuela.

Only the Honduran HIV epidemic has reversed it course – meaning that the annual number of new infections is lower than the annual AIDS death rate.

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Table 2 Antenatal Care Coverage (%) 2005-2009

Country Antigua and Barbuda Barbados Cuba Dominica Grenada Saint Kitts and Nevis Saint Vincent and the Grenadines Argentina Dominican Republic Saint Lucia Brazil Paraguay Trinidad and Tobago Uruguay Belize Colombia El Salvador Mexico Peru Guatemala Guyana Honduras Jamaica Costa Rica Nicaragua Suriname Bolivia Haiti Chile Ecuador Panama Venezuela

Rate 100 100 100 100 100 100 100 99 99 99 97 96 96 96 94 94 94 94 94 93 92 92 91 90 90 90 86 85 -

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Chart 2: Antenatal Care Coverage (%) 2005-2009 Haiti Bolivia Suriname Nicaragua Costa Rica Jamaica Honduras Guyana Guatemala Peru Mexico El Salvador Colombia Belize

Rate

Uruguay Trinidad and T obago Paraguay Brazil Saint Lucia Dominican Republic Argentina Saint Vincent and the Grenadines Saint Kitts and Nevis Grenada Dominica Cuba Barbados Antigua and Barbuda

75

80

85

90

95

100

There is no data available for Chile, Ecuador, Panama and Venezuela.

There is an effort to improve ANC coverage with integration of EMTCT. 5

Table 3 Annual number of births, 2009 (thousands) Country Brazil Mexico Colombia Argentina Peru Venezuela Guatemala Ecuador Haiti Bolivia Chile Dominican Republic Honduras Paraguay Nicaragua El Salvador Cuba Costa Rica Panama Jamaica Uruguay Trinidad and Tobago Guyana Suriname Belize Barbados Saint Lucia Grenada Saint Vincent and the Grenadines Antigua and Barbuda Dominica Saint Kitts and Nevis

Number 3026 2021 917 691 605 600 456 279 274 262 252 224 202 154 140 125 116 76 70 52 50 20 13 10 7 3 3 2 2 1 1 0

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Chart 3: Annual number of births, 2009 (thousands)

St. Kitts and Nevis Dominica Antigua and Barbuda St. Vincent and the Grenadines Grenada Saint Lucia Barbados Belize Suriname Guyana Trinidad and Tobago Uruguay Jamaica Panama Costa Rica Cuba

Number

El Salvador Nicaragua Paraguay Honduras Dominican Republic Chile Bolivia Haiti Ecuador Guatemala Venezuela Peru Argentina Colombia Mexico Brazil 0

500

1000

1500

2000

2500

3000

3500

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Table 4 Estimated number of HIV-positive pregnant women, 2009 Country Brazil Haiti Mexico Colombia Dominican Republic Guatemala Argentina Peru Honduras Chile Ecuador El Salvador Jamaica Panama Belize Bolivia Paraguay Guyana Nicaragua Uruguay Costa Rica Cuba Suriname Antigua and Barbuda Barbados Dominica Grenada Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Trinidad and Tobago Venezuela

Estimate 5000 -

Low estimate 3700 2600 1500