Abstract

Simple is not always true or useful in medicine and in particular in public health, where most phenomena have multiple determinants; the lack of data could complicate the attempt to understand some epidemiological situations and leaves an open territory for debate. Studies performed since the first years of the AIDS epidemic described one or more factors related to disparities in clinical outcomes of HIV-infected people; social status, gender, drug usage, sexual minorities, race/ethnicity are the determinants more frequently involved as explanations for these differences. The outcome of HIV-infected people was greatly improved after the introduction of the highly active antiretroviral therapy (HAART) in 1996. But, at the beginning, HAART was available only in some countries; the late and incomplete access to HAART in sub-Saharan Africa, the region with the largest number of people living with HIV infection, aggravated the racial disparities and the injustice feelings at the global level. Another factor contributed to this perception: even in developed countries, the access to medication was more difficult for people belonging to some minority groups. The situation could be considered as a denial of the right to health as it is defined in international treaties because of: unavailability of HIV-related structures, services or goods; existence of cultural/social/religious barriers to access prevention, diagnosis and/or treatment; disparities in accessibility and lack of quality of HIV management ¹