The Overlap of HIV, Key Populations and Psycho-Stimulant drugs CRISTINA PIMENTA, PhD Brazilian Ministry of Health National AIDS Programme Consultant

HIV/AIDS EPIDEMIC IN BRAZIL Concentrated epidemic: populations with higher prevalence are MSM, Female sex workers, drug users, and prison inmates. Unequal distribution of epidemics within marked regional differences ( HIV associated with IDU still persistent in the south region of boarders the country); Sexual transmission of HIV is the most frequent, nevertheless there is persistent vulnerability of HIV transmission related to different drug use dynamics; HIV/Aids prevalence increase (2011) in young people, aged between 17 and 29, specially gay and bisexual men;

MARPS HIV/AIDS EPIDEMIOLOGICAL DATA IN BRAZIL Ministry of Health, 2011,,

4 Alcohol and Drug Use Brazil % reported crack use - (n=3406); 68.87% reported crack use - (n=3406); 7.74% amphetamines 7.74% amphetamines

MARPS: DATA SET IN BRAZIL PROFILE EPIDEMIC IN BRAZIL

HIV TEST COVERAGE- MARPS Brazil, 2010

STIGMA AND VIOLENCE MARPS BRAZIL 54.5% of study participants reported they were discriminated by a person or service/institution related to their social- economic status; and, 66.4% because of drug use Stigma and discrimination among DU(18+) in 10 municipalities (n=3.600). Brazil, 2010

8 Study Summary Crack user population in Brazil is more impoverished when compared to the overall alcohol and drug user populations, with high prevalence of HIV and syphilis. The drug user is still marginalized, has less access and suffers many barriers to HIV counseling and testing, and STI treatment services. Health services present initial reluctance in providing access to treatment for this population. It is evident that there is need to sensitize and build the capacity of public health services for proper reception and treatment of this much vulnerable and marginalized populations.