1. HIV/AIDS in Brazil at a glance 11th Advanced HIV Course 1 – 3 September 2013, Aix-en-Provence, France Ana Flor Hexel Cornely Clinical Hospital, Porto Alegre Barbara Silva de Souza Saint Louis Hospital, Paris Diego Lins Guedes Oswaldo Cruz University Hospital, Recife

2. HIV/AIDS in Brazil at a glance Todays Outline: 1.Epidemics 2.Diagnostic 3.Clinical Care and Treatment 4.Prevention 5.Future changes and global response Worlds fifth largest territory World's fifth largest population 190 million inhabitants

3. HIV/AIDS in Brazil: epidemics Incidence: 20.2 cases/100,000 inhabitants 500,000 HIV-infected patients (2012) ~ 130,000 undiagnosed Features of the HIV epidemic in Brazil: Prevalence rates lower in the general population (0.6%) than in more vulnerable groups (5.9% IVDUs, 10.5% MSM, 4.9% sex workers) Available at http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/53077/em_portugu_s_93155.pdf Incidence/100000 hab/ region Brazil 17.5 AIDS incidence/year/region Brazil 2000-2009

4. HIV/AIDS in Brazil: diagnosis 37% of overall HIV testing coverage Higher coverage amongst the most vulnerable: 54% MSM 65.1% Sex workers 44.3% Drug users 2.9 million rapid HIV tests in 2012 Available at http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/53077/em_portugu_s_93155.pdf HIV testings performeds by SUS, 2003-2011

5. HIV/AIDS in Brazil: clinical care and treatment 313,000 people have access to ARV therapy (free of charge) Treatment program covers 200,000 people (>90% of all in need of such support) 20 available ARV, 11 locally produced CD4 cell count HIV, viral load and resistance tests (RENAGENO) available Available at http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/53077/em_portugu_s_93155.pdf

6. HIV/AIDS in Brazil: prevention Free distribution of condoms, constantly rising up (146 m to 500 m/year, 2002 – 2010) Since 2010: post exposure prophylaxis to unprotected sexual intercourse Robust and sustainable PMTCT Available at http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/53077/em_portugu_s_93155.pdf Number of condoms distributed by year. Brazil, 2002-2011

7. HIV/AIDS in Brazil: future challenges and global response Universal testing of pregnant women by 2015 (84% of them tested in 2010/2011) Improve surveillance strategies (early detection), ARV to vulnerable populations (MSM, sex workers, discordant partners and prisoners) South-to-South cooperation Available at http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/53077/em_portugu_s_93155.pdf

8. Thank you! Sunset in the Tapajós River, Amazon