Geographic Distribution

AIDS is a serious public health problem worldwide. It has been reported in more than 136 countries. In 1983 the Centers for Disease Control in the U.S. had been informed about 3,000 cases. By the end of 1989, 200,000 cases had been reported to the WHO, but they estimated that the pandemic was from 5-10 million. In 1993, 75% (371,086) of the cases that were reported worldwide were from the Americas, and of these 289,320 were in the United States and 36,481 were in Brazil. In Mexico in 1996 there were 26,651 cases (57% dead); 38,083 cases have been reported overall, and this disease occupies the 19th place in causes of mortality. Conservatively, taking into account that the epidemic has lessened, the number of people infected by HIV for each AIDS case is estimated to be 4:1. It predominates in men. In America and Europe this disease is seen in homosexuals who are 20-35 years old and in bisexuals. In the United States 10% of the adult men population is homosexual. In Africa the homosexual:heterosexual ratio is 1:1, in this Continent and in Asia heterosexual transmission predominates. It affects all social classes.

There are several epidemiologic patterns of transmission. Pattern I includes homosexual and bisexual men, intravenous drug users, hemophiliacs, transfusion recipients and heterosexual couples and children of people in these groups. Pattern II comprises the active young heterosexual population, transfusion recipients and children of affected women. Pattern I is observed in the United States, Western Europe, Asia and Australia. Pattern II is seen in the non-industrialized countries of Africa and the Caribbean where the distribution in men and women is almost the same. In Latin America the pattern is changing from I to II, and now it is considered as I/II. Pattern III

appears in places where AIDS is only recently introduced such as Eastern Europe, North Africa, the Middle East, and in general, Asia and the Pacific. In Mexico AIDS is transmitted by sexual contact in 70-88% (35% homosexuals, 27.5% bisexual, 21.1% heterosexual), by blood and blood derivatives in 10.6-14.9% (transfusion 5.9%, renumerated donors 2.5%, hemophiliacs 1.3%), intravenous drug users in 0.4-0.9%, perinatal transmission in 1.1%, and occupational in less than 1%. In women transmission occurs via blood products in 53.6% and by heterosexual transmission in 43%. In children the transmission is perinatal in 54.9%, by transfusion in 25.5% (17.5% in hemophiliacs) and by sexual abuse in 2.1%.

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