HIV/AIDS managing a pandemic: as advances in prevention and treatment of HIV/AIDS are being made, some areas of the Americas are making progress in the battle against this devastating disease.

• Author: Chelala, Cesar

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Finally, some good news in the fight against HIV in the Americas, and it's coming from Haiti, one of the countries hardest hit by the epidemic. According to recent statistics from the Joint United Nations Program on HIV/AIDS (UNAIDS), infection rates have been falling in Haiti in the last few years.

About 190,000 Haitians, or 2.2 percent of the population, are suffering from HIV/AIDS, according to statistics of the United Nations Population Fund (UNFPA). Infection rates have been falling more slowly in rural areas than in urban areas, but progress in fighting the disease has been significant for a country with high poverty levels, and the percentage of pregnant women who have tested HIV-positive has declined by half over the last ten years.

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The scenario is optimistic, but many challenges remain. The majority of the Haitian population still lacks sufficient sex education, for example. Only 15 percent of women and 28 percent of men between the ages of 15 and 24 know how to prevent HIV infection, and boys and girls are becoming sexually active at an early age, some as early as ten.

Jean Pape, a Haitian doctor who has been fighting the epidemic for years in Haiti, told the PBS TV program Frontline that the high percentage of people infected with HW "killed tourism in Haiti," which was the backbone of the Haitian economy.... "[In addition] goods manufactured in Haiti could no longer be sold in the United States," he said. Pape is the founder of the organization called GHESKIO, the Haitian Study Group on Kaposi's Sarcoma and Opportunistic Infections.

Progress in battling the epidemic in Haiti is due in large part to the work of people like Dr. Pape and Dr. Paul Farmer, a US-American doctor who has dedicated his life to the struggle against AIDS on this Caribbean island. Farmer created the organization Partners in Health and its HIV Equity Initiative, which is dedicated to preventing and treating AIDS in the context of primary care; improving care for tuberculosis; optimizing treatment for sexually transmitted infections; and emphasizing women's health.

So far more than 400 workers have been trained to administer free anti-retroviral drugs to AIDS patients in the community, and more than 1,500 patients are currently receiving treatment for AIDS. As Farmer explained, also on Frontline, "I think that's Haiti's lesson ... if you can integrate prevention and care and make sure there's better supervision of patients with the help of community health workers, I think other countries with major AIDS epidemics ... are going to see good results."

Pape confirms that observation: "Look at Haiti," he says. "The country...