Chicago Tribune (CT) - FRIDAY, November 7, 1997 Edition: NORTH SPORTS FINAL Section: NEWS Page: 18 Word Count: 651
Laurie Goering, Tribune Staff Writer.

"The situation is not exploding as in India, parts of Asia and sub-Saharan Africa," said Luiz Loures, Latin American head of the United Nations AIDS program. "(But) if we don't observe explosions in the region, it doesn't mean we won't observe them in the future," he warned.

By 2000, AIDS will be the leading cause of death for men ages 15 to 44 in Latin America, scientists predict. Growing use of heroin, particularly in southern Brazil and Argentina, raises the specter of a new class of Latin AIDS victims. In addition, the disease's spread through prostitutes--a runaway problem in countries like Thailand--remains poorly understood in Latin America.

Perhaps most baffling to scientists, however, is that AIDS seems mainly confined to homosexuals, bisexuals and intravenous drug users in South America's southern cone but appears to be primarily a heterosexual disease in Central America and the Caribbean.

"What characterizes Latin America is the huge diversity of the epidemic," said Dr. Daniel Tarantola, director of the International AIDS Program at Harvard University's School of Public Health and one of more than 40 members of the Monitoring the AIDS Pandemic Network who are meeting this week in Rio.

Cultural taboos and misunderstandings may have led many heterosexual AIDS carriers to misreport how they got the disease, scientists suggested, and underreporting remains a problem. Yet early data leave little doubt "there is a potential for heterosexual spread of HIV through the general population," Loures warned.

Brazil, Latin America's giant, has the largest number of AIDS cases in the region--110,000, or more than half the Latin American total over the last 15 years. At least half a million Brazilians carry the AIDS virus, Brazilian health officials estimate.

Altogether, 1.3 million Latin Americans are HIV carriers, or about 0.6 percent of the overall population, World Health Organization figures show. Latins make up 7 percent of AIDS carriers worldwide.

The greatest concentrations of AIDS cases in Latin America are in the Caribbean, in island nations such as the Bahamas, Barbados, Trinidad and Tobago, and Jamaica.

Belize, in Central America, has a concentration of AIDS cases 70 percent higher than Brazil, though its overall numbers are lower.

As in much of the rest of the world, one of every three people infected with HIV in Latin America is a woman, up from 1 in 40 in the early 1980s.

Women appear to be contracting the disease primarily through sex with male drug users or with bisexual men, the researchers said, but female promiscuity also is playing a role.

In Brazil, where bisexuality among married men is widespread and wives often feel uneasy about asking their husbands to wear condoms, the spread of the disease to women has been particularly difficult to stop, AIDS experts said.

The best hope for controlling the disease in Latin America remains education, said Peter Lamphtey, director of the AIDS Control and Prevention Project funded by the U.S. Agency for International Development.

In Africa, which has the world's most severe AIDS problem, condom use has risen 200-fold in the last 10 years, despite initial warnings that the prophylactics would never gain acceptance, he said.

Brazil, which saw its AIDS death rate fall this year for the first time after starting free public distribution of AIDS treatment drugs, has persuaded 40 percent of its young adults to use condoms regularly, said Pedro Chequer, the head of Brazil's Ministry of Health program on sexually transmitted diseases and AIDS.

Roman Catholic Church officials and conservative organizations have long objected to condom use in largely Catholic Latin America, and Pope John Paul II in a visit to Rio last month reiterated that position.

Copyright 1997/The Chicago Tribune. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Chicago Tribune, 435 North Michigan Avenue, Chicago, IL 60611.
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