How to select the better sites to focus the prevention strategies in a concentrated epidemic country? The Mexico´s proposal for the the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF)
E. Bravo-Garcia, M. De Luca, C. Magis-Rodriguez, J.A. Izazola-Licea
Centro Nacional para la Prevención y el Control del VIH/SIDA - CENSIDA, Mexico, Mexico
Background: The HIV/AIDS epidemic in Mexico is urban and concentrated among MSM ( HIV prevalence=10%) and male and female IDU (HIV prevalence=6%). Mexico must improve the quality and coverage of its HIV/AIDS prevention strategies. The primary focus is to reduce HIV transmission through the development and implementation of prevention strategies for MSM and IDU populations.
Methods: To select the strategics metropolitan areas/cities an special index was constructed, considering the size of the city, the HIV/AIDS prevalence, the percentage of the MSM population and the AIDS male/female ratio. Sexual behavior surveys, national AIDS/HIV databases and populations estimates were used. Finally, the cities were ranked according with the index constructed.
Results: 44 metropolitan areas/cities were selected for MSM interventions and 4 cities for IDU interventions. Together, in these 44 cities lives the 74 percent of the Mexico´s MSM population, and represents the 72 percent of recent AIDS cases among MSM (2003-2008). The 4 selected cities of IDU represents the 45 percent of the national estimate of IDU and 50 percent of recent AIDS cases. 31 of the 32 states in the country were included. This coverage will contribute to ensuring more equitable access of services for the most affected and in-need populations
Conclusions: Mexico´s proposal was approved by the GF round 9 (aprox 70 millions USD, five years). The main goals are: to reduce the HIV prevalence in MSM from 10 to 8 percent in the 44 selected cities; to reduce the HIV prevalence in IDU (men and women) from 6 to 5 percent in the four selected cities; and to increase the percentage of services certified as "stigma- and discrimination-free" to 75 percent in the 44 selected cities.
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