No end in sight

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Science  17 Jul 2015:
Vol. 349, Issue 6245, pp. 230-231
DOI: 10.1126/science.349.6245.230

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Tijuana, Mexico, has vastly improved its HIV/AIDS treatment and prevention efforts over the past decade, now providing free antiretrovirals to all infected people. But like many locales around the world, its HIV/AIDS response also illustrates that a vast distance separates the dream of "ending AIDS"—which is gaining increasing attention worldwide—and reality. Its one publicly funded HIV/AIDS clinic is located far from downtown, is difficult for people to reach, and has only three doctors treating a patient load of around 1000 people. HIV-infected people in Tijuana who know they are living with the virus rarely receive treatment, a tiny percentage fully suppress their viral levels, and some still die in AIDS hospices without ever having taken antiretroviral drugs. Needle sharing among people who inject drugs is commonplace. HIV testing in not routinely done in gay bars or the red light district. And the prevalence in drug users, sex workers, gay men, and transgender people ranges from 5% to 20%—and is showing no signs of declining.

  • * in Tijuana, Mexico

    Reporting for this story was supported in part by a grant from the Pulitzer Center on Crisis Reporting.