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At the beginning of the twenty-first century, Brazil ranked second only to the United States in the number of reported cases of AIDS. Because Brazil's extensive poverty and inequality, its fragile economic situation, and its limited network of health services, the scarce prevention/intervention resources targeted only the most visible at risk populations -- gay men, sailors, prostitutes, and street children. Virtually forgotten were Brazil's hidden drug users, as well as the tens of millions of individuals living in the country's thousands of favelas, or shantytowns, which are a characteristic part of almost every Brazilian city. In Sex, Drugs, and HIV/AIDS in Brazil the authors examine the emergence of AIDS in Brazil, its linkages to drug use and the sexual culture, and its epidemiology in such populations as cocaine users, "street children," and male transvestite prostitutes. Special attention is focused on an HIV/AIDS community outreach program established in Rio de Janeiro, which represented the first such prevention/intervention program in all of Brazil targeting indigent cocaine users. This 6-year initiative was funded by the U.S. National Institute on Drug Abuse, and carried out by the authors of this book. The research combines anthropological, sociological, and biological perspectives; all data were gathered through empirical and ethnographic techniques.
Recent innovative research has identified key factors that put vulnerable South African women at risk of HIV/AIDS and gender-based violence, including high-risk patterns of alcohol abuse and sexual partnering, gender norms that place men in control in sexual relationships, low educational levels and limited access to employment, poor health care, inadequate housing, and sex work. These studies suggest that targeted HIV-prevention interventions can effect improvement for this vulnerable population when programs remain sensitive to gender and cultural differences and expectations and address the social and economic inequalities that make women vulnerable. Solving these problems on a larger economic scale will require institutional participation and political support for women’s equity, HIV-prevention literacy, and a broader HIV-prevention agenda. This can be accomplished with a multilevel, collaborative response from government, community, and international partners using multiple prevention strategies and fostering sustainability.