World AIDS conference comes to Latin America

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The first International AIDS Conference to focus on Latin America will open tomorrow in Mexico City, the largest city in the Spanish-speaking world. The conference, held every two years, is the biggest gathering of AIDS experts, advocates, people with HIV and physicians, and this year it has attracted more than 22,000 delegates.

This year’s meeting will draw particular attention to issues that make the epidemic in Latin America and the Caribbean distinctive. It will have the strongest focus on men who have sex with men of any International AIDS Conference to date, with a major pre-conference meeting devoted to the subject and several major sessions and symposia highlighting the need for more effective prevention work with gay and bisexual men, especially in resource-limited settings.

The meeting will also highlight the need to bring marginalised groups into the centre of national responses to HIV, and to tackle stigma and discrimination.


mother-to-child transmission (MTCT)

Transmission of HIV from a mother to her unborn child in the womb or during birth, or to infants via breast milk. Also known as vertical transmission.


Social attitudes that suggest that having a particular illness or being in a particular situation is something to be ashamed of. Stigma can be questioned and challenged.


In everyday language, a general movement upwards or downwards (e.g. every year there are more HIV infections). When discussing statistics, a trend often describes an apparent difference between results that is not statistically significant. 


A product (such as a gel or cream) that is being tested in HIV prevention research. It could be applied topically to genital surfaces to prevent or reduce the transmission of HIV during sexual intercourse. Microbicides might also take other forms, including films, suppositories, and slow-releasing sponges or vaginal rings.

task shifting

The delegation of healthcare tasks usually performed by more highly trained health personnel to those with less training, such as nurses and community health workers. Task shifting has allowed HIV services to be scaled up, especially in resource-limited settings.

In Latin America HIV predominantly affects men who have sex with men, sex workers and injecting drug users, all highly stigmatised groups in the region. More than 2 million people are living with HIV in the region – more than western Europe and the United States combined – but HIV prevalence is low in comparison to sub-Saharan Africa, at around 0.5%. This makes it doubly difficult for affected communities to win attention and priority in the region, despite notable successes in Brazil.

On the global level AIDS 2008 will highlight the need for new breakthroughs in HIV prevention after a string of disappointing results in trials of biomedical prevention tools like microbicides and vaccines. Using antiretroviral drugs in vaginal gels that can protect against HIV infection will be one focus of discussion, with encouraging data due to be presented on an animal study showing that the approach looks promising.

But the hottest prevention topic at the conference will focus on the question: when does someone with undetectable HIV levels in the blood stop being infectious to others? Recent advice by the Swiss Federal AIDS Commission that heterosexuals in monogamous relationships where the HIV-positive partner has undetectable viral load, and where neither person has a sexually transmitted infection, can stop using condoms due to a theoretically low risk of infection has triggered fierce debate worldwide, and that debate will emerge in several major conference sessions this week.

Another topic that has provoked debate and protest is the growing international trend to use criminal sanctions against people with HIV who transmit the virus. Numerous sessions and presentations during the week will examine the consequences of the trend and illustrate the scope of this punitive development in the international response to HIV.

As in Bangkok in 2004 and Toronto in 2006, the treatment-related focus of the conference will be on expanding access to antiretroviral therapy in developing countries. This year, with more than 3 million people now on treatment, sessions will pay particular attention to how treatment access can be expanded further by giving more responsibility for prescribing and monitoring treatment to non-physicians such as nurses and clinical officers – so-called `task shifting`.

There will also be a major focus on making treatment more available to children, and increasing the number of women who have access to antiretroviral drugs to prevent mother to child transmission of HIV. Coverage levels still hover between 20% and 30% in many African countries, the region with the highest rate of mother to child transmission, despite the proven effectiveness of short courses of single drug or two-drug treatment for mothers around the time of delivery.

During the week will be publishing extensive coverage of the XII International AIDS Conference, along with a daily summary bulletin of the key news stories. If you do not already receive aidsmap news bulletins, you can sign up here.

You can also view webcasts of selected conference sessions at the Kaiser Network HIV/AIDS website, and listen to expert commentary podcasts at the Clinical Care Options for HIV website.