An estimated 2.2 million people were living with HIV in Latin America and the Caribbean in 2018 (1.9 million in Latin America and 340,000 in the Caribbean). This equates to an HIV prevalence of 0.4% in Latin America and 1.2% in the Caribbean. In the same year, there were 100,000 new infections in Latin America and 16,000 in the Caribbean, and 41,700 people died from AIDS-related illnesses (35,000 in Latin America and 6,700 in the Caribbean).1
Antiretroviral treatment (ART) coverage has been relatively high and AIDS-related deaths relatively low in Latin America for many years. However, little progress has been made on slowing the rate of new infections in the last decade, which overall have fallen by just 1% between 2007 and 2017, and new infections among young people within key populations are on the rise. However, AIDS-related deaths over the same period have fallen by 12%.2
In 2018, 80% of people living with HIV in Latin America were aware of their HIV status. Of those who were aware, 62% were accessing antiretroviral treatment (ART). Of those on treatment, 55% were virally suppressed. 3
There has been moderate progress made on both prevention and treatment in the Caribbean. The annual number of new HIV infections among adults in the Caribbean declined by 18% between 2010 and 2017, and deaths from AIDS-related illness fell by 23%. In this part of the region, there was a large gap in awareness of HIV status at the start of the HIV testing and treatment cascade.4
In 2018, 72% of people living with HIV in the Caribbean were aware of their HIV status. Of those who were aware, 77% were accessing antiretroviral treatment (ART). Of those on treatment, 74% were virally suppressed.5
Nearly 90% of new infections in the Caribbean in 2017 occurred in four countries – Cuba, Dominican Republic, Haiti and Jamaica – while 87% of deaths from AIDS-related illness occurred in the Dominican Republic, Haiti and Jamaica. Haiti alone accounts for nearly half of annual new HIV infections and AIDS-related deaths.6
Despite its small population size, the Caribbean has a high HIV prevalence globally at 1.2% (West and Central Africa stands at 1.5% and the highest prevalence global is in East and Southern Africa at 7%).7
Latin America and the Caribbean has a concentrated epidemic, which means HIV prevalence is low among the general population but among certain groups such as men who have sex with men and transgender women, prevalence is particularly high. Young people are also disproportionately affected by HIV in the region.
In 2017, gay men and other men who have sex with men accounted for 41% of HIV infections in Latin America, and key populations and their sexual partners represented more than three quarters of new infections overall.8 In the Caribbean, gay men and other men who have sex with men accounted for nearly a quarter of new infections in 2017. In total, key populations and their sexual partners represented two thirds of new infections.9
Brazil has played a key leadership role in the reinvigoration of HIV prevention in Latin America. However, the election of Jair Bolsonaro of the Social Liberal Party (PSL) as president in October 2018 could significantly reverse the progress made on HIV in Brazil and possibly the wider region, as well as deny human rights for many vulnerable populations.
Bolsonaro has described himself as a ‘proud homophobe’ and is opposed to state-funded treatment for people living with HIV. Many in Brazil’s LGBTI community say they experienced an increase in violence and threats during the election campaign and there were record numbers of murders of LGBTI Brazilians between 2016 and 2018.10