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Alan Berkman, MD, Jonathan Garcia, BA, Miguel Muñoz-Laboy, DrPH, Vera Paiva, PhD and Richard Parker, PhD

The authors are with the Department of Sociomedical Sciences and the Center for Gender, Sexuality and Health, Mailman School of Public Health, Columbia University, and the International Core of the HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY. Alan Berkman is also with the Department of Epidemiology, Mailman School of Public Health, Columbia University. Vera Paiva is also with NEPAIDS, the Nucleus for AIDS Prevention Studies, Institute of Psychology, University of São Paulo, São Paulo, Brazil. Vera Paiva and Richard Parker are also with the Brazilian Interdisciplinary AIDS Association, Rio de Janeiro, Brazil.

Correspondence: Requests for reprints should be sent to Richard Parker, PhD, Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 600 West 168th St, New York, NY 10032 (e-mail: rgp11{at}columbia.edu).

The Brazilian National AIDS Program is widely recognized as the leading example of an integrated HIV/AIDS prevention, care, and treatment program in a developing country. We critically analyze the Brazilian experience, distinguishing those elements that are unique to Brazil from the programmatic and policy decisions that can aid the development of similar programs in other low- and middle-income and developing countries.

Among the critical issues that are discussed are human rights and solidarity, the interface of politics and public health, sexuality and culture, the integration of prevention and treatment, the transition from an epidemic rooted among men who have sex with men to one that increasingly affects women, and special prevention and treatment programs for injection drug users.

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