Antiretroviral therapy use in selected countries in Latin America during 2013–2017: results from the Latin American Workshop in HIV Study Group

Abstract

ABSTRACT: Objective: To document antiretroviral use in Latin America during the last decade. Methods: We collected indicators from 79 HIV health care centres in 14 Latin American Spanish-speaking countries for 2013–2017. Indicators were analysed by age, sex and other characteristics and weighted by the estimated people under care (PUC) population in each country. Results: We gathered information on 116 299 PUC. One-third belonged to centres reporting a shortage of at least one antiretroviral therapy (ART) drug for >30 days during 2017. At end 2017, 95.1% of PUC were receiving ART. During 2013–2017, 45 329 people living with HIV were admitted to 39 centres. ART initiated during the first year after admission increased from 76.7% in 2013 to 83.8% in 2017. In 35 centres across the study period, 71.7% of PUC started ART with tenofovir disoproxil fumarate and lamivudine, and zidovudine use decreased. The third most common ART drug, EFV, reached 64.8%. Raltegravir and other alternatives increased annually to almost 10% of total use in 2017. Conclusions: Initial ART in Latin America is not based on the most recent scientific evidence and recommendations; use of drugs with higher efficacy and safety profiles and guarantee of ART availability continues to be a public health challenge.