The HIV/AIDS epidemic in Latin America and the Caribbean is characterized by a stable adult HIV prevalence of 0.4 percent, which has remained unchanged between 2001 and 2010. The epidemic in the Caribbean has slowed significantly since the mid-1990s, with the adult HIV prevalence declining from 1.0 in 2001 to 0.9 in 2010. In 2010, approximately 76,000 people in Latin America and the Caribbean died of AIDS, and 112,000 were newly infected.
The number of people newly infected with HIV is declining, but the absolute number of people living with HIV/AIDS (PLWHA) is increasing as more people are tested and have access to antiretroviral therapy (ART). The estimated number of PLWHA in the region is 1.7 million, with two-thirds residing in five countries: Argentina, Brazil, Colombia, Haiti, and Mexico. The Caribbean and Central American subregions have higher adult prevalence rates than South America, with countries such as Haiti, the Bahamas, and Belize having rates in 2009 as high as 1.9, 3.1, and 2.3 percent, respectively.
The epidemics in Latin America and the Caribbean are being fueled by unprotected sex between men, with HIV prevalence of at least 10 percent among men who have sex with men (MSM) in 9 of 14 countries in the region. Social stigma keeps these epidemics hidden, and many MSM also have sex with women. HIV prevalence among sex workers is relatively high in Central and South America, especially in Guyana, Honduras, Guatemala, El Salvador, and Suriname. Injecting drug use is another significant source of transmission in the southern cone of South America and in parts of Mexico.
The main route of HIV transmission in the Caribbean is reported to be unprotected sex between men and women and between men, including paid sex. Sex work, including sex tourism, is a primary source of transmission. The prevalence of HIV among sex workers varies considerably, from 2 percent in the Dominican Republic to 5 percent in Jamaica to 17 percent in regions of Guyana and 24 percent in parts of Suriname. Most-at-risk populations, including MSM, sex workers, and injecting drug users, are disproportionately affected by the epidemic.
Prevention of mother-to-child transmission of HIV (PMTCT) services have increased in Latin America and the Caribbean, resulting in a decline in the number of children younger than 15 years living with HIV. The number of children acquiring the disease in the region decreased by 45 percent between 2001 and 2010. Antiretroviral therapy (ART) coverage reached 63 percent in 2010, the highest level of any world region. Nicaragua achieved universal access to ART, and Argentina, Brazil, the Dominican Republic, Mexico, and Uruguay had near universal coverage.
HIV-tuberculosis (TB) co-infection is a major concern in Latin America and the Caribbean, as TB is endemic in the region. According to the World Health Organization, TB-HIV co-infection in 2010 was high in several countries, including the Bahamas, Belize, Brazil, the Dominican Republic, Guyana, Haiti, Jamaica, Suriname, and Trinidad and Tobago. HIV-TB co-infection complicates the care and treatment of both diseases, and multidrug-resistant strains of TB are a growing concern.
The economic and social impacts of HIV/AIDS in Latin America and the Caribbean are significant. Illness, disability, and death associated with HIV/AIDS affect populations at multiple levels, particularly the most economically active segment of the population. The cost of addressing HIV can divert resources away from investments critical to national economic development, and the potential loss of productive labor could threaten the economic growth of countries in the region with more pronounced epidemics.