HIV/AIDS has had a substantial impact on health in the LAC region since the early 1980s. The UN has set the goal of eliminating AIDS as a public threat under the SDGs by 2030, with a target defined as reducing the number of new HIV infections and AIDS-related deaths by 90% relative to 2010 (UNAIDS, 2014[1]).
In LAC26, the prevalence in adults aged between 15 and 49 ranged from 0.2% in Guatemala and Honduras to 1.6% in Haiti, Suriname and Guyana in 2024 (Figure 3.26, left panel). Although overall prevalence in the region is relatively low, the number of people living with HIV is over 2.1 million in reporting countries, most of which live in Brazil with 1 100 000 people, followed by Mexico with 400 000 and Colombia with 230 000 (Figure 3.26, left panel).
Expanded access to antiretroviral therapy (ART) has increased the survival rates of people living with HIV, but about half of those eligible for HIV treatment worldwide still do not receive it. In LAC25, the estimated coverage was particularly low (<50%) in Suriname and Saint Lucia, whereas it is 80% or over in Haiti, Peru and Ecuador (Figure 3.27). While some countries with high prevalence (e.g. Haiti) are addressing the issue of treatment coverage, the region remains substantially far from the goal of treating 90% of people living with HIV/AIDS.
The trend of new HIV infections in recent years in the LAC region has overall increased by 10% between 2010 and 2024. However, Caribbean countries show a differential trend as they have made substantial progress in reducing new HIV infections since 2010 (UNAIDS, 2024[2]). In 2024, more than 65% of new infections in the LAC region were in Brazil, Mexico and Venezuela, with Brazil alone accounting for more than one‑third (42.3%) of new infections. Between 2010 and 2024, Haiti, Bahamas, Barbados and Ecuador reduced incidence rates by more than 20% (Figure 3.27). Among the countries reporting an increase in incidence, Venezuela experienced the highest growth at 179%, followed by Peru with 51%, and Guatemala and El Salvador with more than 40%. These increases are also partially explained by the expansion of diagnostic access and self-testing kits.
To meet the UNAIDS HIV targets, aligned with SDG target 3.3 on ending AIDS as a public health threat by 2030, the availability of post – exposure prophylaxis and HIV self – testing should be scaled-up while access to PrEP should be sustained (UNAIDS, 2024[2]). The rapid scale‑up of antiretroviral therapy (ART) in LAC offers an unprecedented opportunity to successfully implement antiretroviral-based interventions for prevention and treatment, as well as to integrate ART with other key services related to sexual and reproductive health and rights, including addressing hepatitis B and C, tuberculosis, provision of clean needles and syringes, medication-assisted therapy, and non-communicable diseases. The benefits of ART and integrated services can only be fully realised if people living with HIV are diagnosed and successfully linked to care. This will require targeted efforts to remove barriers among populations disproportionately impacted by HIV/AIDS, including sex workers, their clients, men who have sex with men, transgender persons, and people who inject drugs, along with collaborations with stakeholders and civil society in at national and subnational levels (Bekker et al., 2018[3]).
