HIV, syphilis, and viral hepatitis among Latin American indigenous peoples and Afro-descendants: a systematic review/ Infeccion por el VIH, sifilis y hepatitis virales en las poblaciones indigenas y afrodescendientes en América Latina: una revision sistematica/HIV, sifilis e hepatite viral em povos indigenas e afrodescendentes da America Latina: uma revisao sistematica

Objective. To identify and summarize existing literature on the burden of HIV, sexually transmitted infections (STIs), and viral hepatitis (VH) in indigenous peoples and Afro-descendants in Latin America to provide a broad panorama of the quantitative data available and highlight problematic data gaps. Methods. Published and grey literature were systematically reviewed to identify documents published in English, Spanish, or Portuguese with data collected between January 2000 and April 2016 on HIV, STI, and VH disease burden among indigenous peoples and Afro- descendants in 17 Latin American countries. Results. Sixty-two documents from 12 countries were found. HIV prevalence was generally low (< 1%) but pockets of high prevalence (> 5%) were noted in some indigenous communities in Venezuela (Warao) (9.6%), Peru (Chayahuita) (7.5%), and Colombia (Wayuu females) (7.0%). High active syphilis prevalence (> 5%) was seen in some indigenous communities in Paraguay (11.6% and 9.7%) and Peru (Chayahuita) (6.3%). High endemicity (> 8%) of hepatitis B was found in some indigenous peoples in Mexico (Huichol) (9.4%) and Venezuela (Yanomami: 14.3%; Japreira: 29.5%) and among Afro-descendant quilombola populations in Brazil (Frechal: 12.5%; Furnas do Dionisio: 8.4% in 2008, 9.2% in 2003). Conclusions. The gaps in existing data on the burden of HIV, STIs, and VH in indigenous peoples and Afro-descendants in Latin America highlight the need to 1) improve national surveillance, by systematically collecting and analyzing ethnicity variables, and implementing integrated biobehavioral studies using robust methodologies and culturally sensitive strategies; 2) develop a region-wide response policy that considers the needs of indigenous peoples and Afro-descendants; and 3) implement an intercultural approach to health and service delivery to eliminate health access barriers and improve health outcomes for these populations. Keywords HIV; sexually transmitted diseases; syphilis; hepatitis, viral, human; health of indigenous peoples; Latin America. Objetivo. Identificar y resumir la bibliografia existente sobre la carga de la infeccion por el VIH, las infecciones de transmision sexual (ITS) y las hepatitis virales en las poblaciones indigenas y afrodescendientes en America Latina para proporcionar un panorama amplio de los datos cuantitativos disponibles y poner de relieve las brechas problematicas que pudiera haber en los datos. Metodos. Se hizo un examen sistematico de la bibliogr