Since 1980, 74.9 million people have been infected by the Human Immunodeficiency Virus (HIV), and 32 million have died by Acquired Immunodeficiency Syndrome (AIDS) [1]. After decades of HIV/AIDS experience, ending HIV transmission remains a challenge to world health authorities. While global AIDS-related deaths have decreased by more than 50% after Antiretroviral Therapy (ART) was implemented, the HIV/AIDS incidence rate achieved only a slight decrease [1,2,3].
The scarcity of public policies for combatting HIV and economic regional disparities are directly correlated with the increase in the incidence of HIV in Latin America (LA), where 1.9 million people live with HIV and AIDS (PLWHA). Between 2010 and 2018, a 7% increase in new HIV infections was recorded throughout LA [1, 2, 4].
Bạn đang xem: The HIV epidemic in Colombia: spatial and temporal trends analysis
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Among all LA countries, Colombia has the fourth highest HIV/AIDS prevalence rate. Its national HIV/AIDS prevalence is approximately 0.7%, but much higher among key populations – men who have sex with men, sex workers, injection drug users and prisoners. Colombia is part of the Caribbean region, which has the second-highest prevalence of HIV/AIDS in the world after sub-Saharan Africa. In this region, by the end of 2019, there were 330,000 PLWHA, 6900 AIDS-related deaths and 13,000 new HIV infections recorded in the same year. Considering the progress towards 90-90-90 targets proposed by UNAIDS to end HIV by 2030, Colombia reached only 62% of that goal. For example, approximately 50% of Colombian people living with HIV still have not been diagnosed for the virus, and only 55% of PLWHA are on ART. Of those receiving treatment, only 68% are virally suppressed. All Colombians and legal immigrants have access to HIV tests and ART [5].
Several factors contribute to the expansion of HIV in Colombia; such factors include social inequalities with the majority of its population living in poverty and with low access to the healthcare system, social discrimination and stigmatization of PLWHA, the forced displacement of the population by internal armed conflicts, the high level of violence against women and sexual tourism [6,7,8].
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The recent immigration flux of Venezuelans also contributes to the expansion of the HIV epidemic in Colombia by placing a substantial burden on the health care resources of Colombian border municipalities. Given the collapse of the healthcare system in Venezuela, Venezuelans living with HIV migrate to Colombia in search of treatment. Until 2018, approximately 2000 Venezuelans in Colombia were living with HIV. Although immigrants with Colombian Permits of Permanence have full access to the healthcare system, including free ART, the massive influx of Venezuelans into Colombia has led to an overload in administrative processing; many Venezuelan immigrants remain illegal [9, 10]. This phenomenon has impacted Colombia’s healthcare economy. Colombia spends approximately 0.5% of it’s healthcare resources and 1% of it’s social health insurance budget, in HIV treatment alone [11].
The HIV epidemic can be addressed by describing its different dynamics in each Colombian territory given that the epidemic is influenced by sociopolitical and economic factors [2, 12]. Spatial analysis studies are ideal in identifying areas that are highly affected by the epidemic and in highlighting contributing territorial factors. Likewise, temporal trend studies optimize and reveal the impact of public policies against the epidemic [13].
Therefore, this study aimed to analyse the HIV/AIDS epidemic in Colombia by employing spatial and temporal trend analysis techniques. Here, we considered the incidence of HIV/AIDS and AIDS mortality rates.
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