Public Health Aspects of HIV/AIDS in Low and Middle Income Countries: Epidemiology, Prevention and Care

In 1981, the recognition of unusual clusters of Pneumocystis carinii pneumonia and Kaposi sarcoma among men who have sex with men in Los Angeles and New York heralded the beginning of the AIDS epidemic.^1- 2 Within a year, additional cases were identified among Haitians living in the United States and subsequently among previously healthy young adults in Haiti.^3- 4 The spread of human immunodeficiency virus (HIV) in Haiti, one of the poorest countries in the world, foreshadowed a global epidemic that has become the defining public health issue of current times. The most recent report from the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that there were 2.7 million new HIV infections and 2 million AIDS deaths in 2007.⁵ An estimated 33 million individuals are living with HIV, reflecting a pandemic that is stabilizing but at unacceptably high levels. Low- and middle-income countries are disproportionately affected. Sub-Saharan Africa alone accounts for two-thirds of the global burden of HIV.