User:Joarfr/sandbox/2

Out of all the countries in Central America, Honduras had the most initial cases of HIV/AIDS and is still the Central American country most adversely affected by the global HIV/AIDS epidemic. As of 1998, Hondurans made up only 17% of the Central American population, yet Honduras contained 50% of the initial AIDS cases in Central America and 60% of all Central American cases in 2001. In more recent years, new HIV infections have decreased by 29% since 2010 while AIDS-related deaths have increased by 11% since then.

First cases
The incubation period, during which HIV/AIDS was first introduced into the Honduran population without being recognized, is estimated to be during the end of the 1970s and into the 1980s. In 1984, the first case of HIV/AIDS in Honduras was identified in a man who reported having travelled to San Francisco multiple times in the years preceding his diagnosis, which was confirmed in 1985 when he tested positive for Kaposi's sarcoma and antibodies for HIV. Four men, all reporting having traveled outside of the country, constituted the first cases recognized in Honduras. Three of those men were likely to have contracted HIV from homosexual transmission, while one contracted the virus likely from heterosexual transmission. By 1992, the 100 Honduran cases of HIV/AIDS included almost every risk group associated with HIV/AIDS: men who have sex with men (MSM), men who have sex with men and women (MSM/W), commercial sex workers, children of HIV-positive mothers, intravenous drug users, and blood transfusion recipients. Since spreading to other populations, HIV/AIDS is considered to be transmitted mainly heterosexually in Honduras and thought to have been introduced to the heterosexual population through bisexual transmission. Additionally, groups such as marines and soldiers, who had increased interaction with the exterior and were also more likely to have multiple sexual partners, contributed to the spread of HIV/AIDS throughout Honduras.

Geographical predominance
The areas most heavily affected by HIV/AIDS cases tend to be within what is called the Central Corridor of Development (Corridor Central de Desarrollo), affecting urban areas such as Tegucigalpa, San Pedro Sula, La Ceiba, El Progreso, Comayagua, Puerto Cortés, Tela, La Lima, and Choluteca. The disease's originated in the northern part of the country, with especially high rates in Tegucigalpa and San Pedro Sula, which was the original epicenter of the disease. In San Pedro Sula, rates of HIV prevalence were estimated to be as high as 14 to 21% of the population at the height of the epidemic in Honduras. HIV/AIDS has since spread to the south, east, and west of Honduras, including the Honduran Bay Islands in the Caribbean, though these regions were affected later than the north. Municipalities with the highest reported incidences of HIV infection are found on the border with neighboring countries El Salvador, Guatemala, and Nicaragua.

Demographical predominance
HIV/AIDS has most affected young people in Honduras, ranging from 20 to 39 years of age. The main risk groups associated with HIV/AIDS in Honduras are female sex workers (FSWs), men who have sex with men, the Garífuna community, prisoners, and transgender women.

[ Honduras is home to 17% of Central America’s population. Honduras is also where 60% of the region’s HIV infections are reported. HIV is spreading slowly but steadily in many populations, and infections occur in equal proportions among men and women. The highest rates of HIV infection occur in Tegucigalpa and San Pedro Sula. Prevalence in some vulnerable populations is high. Some of these vulnerable populations include men who have sex with men (MSM), ethnic minority groups, male and female sex workers, and prisoners.

Studies of HIV prevalence in Honduras cited by the United Nations Joint Programme on AIDS (UNAIDS) include the following:


 * A 2001 study showed a prevalence of greater than 8% in both men and women in the ethnic Garifuna population.
 * Prevalence of 8 to 9% in female sex workers in Tegucigalpa and San Pedro Sula was found in a 2001 study; and findings from a 2002 study showed a prevalence of 13% in female sex workers in San Pedro Sula.
 * Studies in 2001 and 2002 showed prevalence of 16% in urban areas among men who have sex with men.
 * A 1997 study found prevalence of 6.8% among military recruits.

AIDS is the leading cause of death among Honduran women of childbearing age and is the second-leading cause of hospitalization among both men and women. Sexually transmitted infections are common, and condom use in risky sexual encounters is sporadic and variable.]

Among the Garífuna
According to the Centers for Disease Control in the U.S., 4.5 percent of the Garifuna population has HIV. The disease is often compounded by low incomes, lack of media attention, lack of sex education, and gender dominance.

The article “Rapid Ethnographies Assessment of HIV/AIDS among Garifuna Communities in Honduras: Informing HIV Surveillance among Garifuna Women" shows that among individuals between the ages of 16-20, 5 percent of the population possesses HIV/AIDS. From the assessments made by (UNAIDS, 2004) over 60,000 people in the country live with HIV/AIDS with 44% of the Garifuna people suffering.

However, the Garifuna stand out for fighting the disease in unique ways. Whereas other places fight primarily with medicine, the Garifuna fight HIV/AIDS with music and dancing. Music is helping to heal the sorrow and tighten the community (Oliver N. Greene). The songs exhibit beliefs of the Garifuna people: cohesiveness, revival, and love. They also allow people from different cultures to experience their culture, asking for help through dancing and theater. Finding ways to help prevent infections is the main goal, but with small steps at a time.

National response
National efforts to reduce the number of new HIV infections have been in place since the late 1980s. President Maduro has publicly committed himself to support the national response to HIV/AIDS, and HIV/AIDS is one of five health issues that receive priority government attention. A second national strategic plan for the 2002–2006 period is in place, but its focus and application have been stymied by a lack of national funds for its implementation. The national response to HIV/AIDS has been led by the Ministry of Health, with collaboration from other ministries and several nongovernmental organizations (NGOs). The ministry now provides antiretroviral treatment to more than 3,000 individuals with AIDS. In 2017, the Ministry of Health resolved to cover all treatment for those living with HIV, regardless of CD4 count, and internal funding covers 95% and 70% of treatment costs and preventative efforts respectively.

By the beginning of the 90s, blood began to be screened for HIV on a national scale in Honduras, five years after the US began screening blood donations. HIV/AIDS cases due to blood transfusions began to decrease by 1991.

Still, in 2013, around half of Hondurans infected were unaware they were living with HIV.

[Honduras’s long-term plan is to prevent new infections and to provide services to those who are most at risk for HIV infection, including young people, sex workers, men who have sex with men, institutionalized persons, and the Garifuna ethnic group. ]

International response and aid
The Global Fund to Fight AIDS, Tuberculosis and Malaria has disbursed US$90,720,054 of the US$96,502,161 originally signed to Honduras for HIV/AIDS programs alone.

Honduras has been promised more than $40 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria, and thus far has received $13.7 million to implement its long-term health goals, $7.98 million of which is specifically for HIV/AIDS. This grant, combined with bilateral assistance other countries, will allow Honduras to tackle the HIV/AIDS epidemic in the coming years.

Access to ARV treatment
As of 2016, 51% of Honduras affected by HIV/AIDS were able to receive antiretroviral treatment (ART), and 54% of HIV-positive pregnant women were receiving treatment or had utilized prophylaxis as a means of prevention of mother to child transmission (PMTCT). In 2013, 42% of people were still accessing health care and receiving treatment after 12 months, and one in three patients had reached an undetectable viral load.