Urgent Warning: One-Third of New HIV Diagnoses in Latin America & Caribbean are Advanced
A concerning new report from the Pan American Health Organization (PAHO) reveals that approximately one-third of individuals diagnosed with HIV in Latin America and the Caribbean receive their diagnosis when the disease is already in an advanced stage, significantly compromising their immune systems and threatening their lives. This finding, released in conjunction with World AIDS Day on December 1st, underscores the critical need to bolster HIV detection, treatment, and prevention strategies across the region.
PAHO emphasizes that early diagnosis, the immediate initiation of antiretroviral treatment (ART), and access to comprehensive care are paramount to preventing progression to advanced HIV disease, saving lives, and combating the pervasive stigma surrounding the virus. The organization is urging Latin American and Caribbean nations to intensify efforts to ensure broader access to quality testing and medical care for all.
Currently, roughly 14% of people living with HIV in the region are unaware of their serological status. Recent data from 2024 indicates that 2.8 million people are living with HIV in Latin America and the Caribbean, according to PAHO. However, the epidemic’s evolution presents a stark contrast between subregions. While the Caribbean has successfully reduced new infections by 21% since 2010, Latin America has experienced a 13% increase during the same period. Mortality rates have decreased – from 42,000 to 27,000 AIDS-related deaths in Latin America and from 12,000 to 4,800 in the Caribbean – but remain a significant concern.
“Our region has made significant progress, from expanding access to long-acting medications to adopting simplified treatments that transform lives,” stated Jarbas Barbosa, director of PAHO. “Even so, the fight does not end. Every year, 38,000 lives are lost in the Americas due to causes related to AIDS. Behind each figure there is a story, a family, a truncated dream.”
The Caribbean’s 21% reduction in new infections since 2010 stands in contrast to the 13% increase observed in Latin America over the same timeframe. Globally, UNAIDS estimates that 40.8 million people were living with HIV in 2024, with 31.6 million accessing antiretroviral treatment. While this 77% coverage represents substantial improvement, it falls short of the international goal of 34 million people under treatment by 2025.
During the past year, there were 1.3 million new HIV infections and 630,000 AIDS-related deaths reported worldwide. Since the beginning of the epidemic, there have been 91.4 million diagnoses and 44 million deaths. Despite a 70% decrease in mortality since 2004, UNAIDS stresses that approximately one person dies every minute from AIDS-related causes globally.
Global statistics reveal disparities based on gender and age. In 2024, women and girls accounted for 45% of new cases, and 120,000 children aged 0 to 14 contracted the virus – a 62% decrease since 2010, though still below established targets.
In Latin America, ART coverage reaches 71% of people with HIV, a figure lower than both the global average and the African region, where access to treatment has expanded more rapidly. The situation is particularly alarming among children, with only 44% receiving treatment, and pregnant women, where only 56% access medications to prevent mother-to-child transmission, compared to a global rate of 84%.
These gaps disproportionately affect vulnerable populations, including men who have sex with men, transgender individuals, sex workers, and people who inject drugs. Barriers to care include discrimination, social stigma, legal restrictions, and insufficient investment in targeted health services.
In response, PAHO proposes reinforcing three key priorities: a sustained expansion of access to rapid diagnostic tests, the immediate initiation of ART upon diagnosis, and widespread availability of PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) for individuals at high risk. Barbosa emphasized that the region has already embraced simplified treatment regimens and long-lasting medications, but accelerated progress is essential.
The emergence of long-acting injectable medications, such as lenacapavir, represents a revolutionary advancement in prevention, requiring only two annual doses to maintain protective effects and improve adherence, particularly for those with limited access to healthcare. Modern antiretroviral treatment can suppress the viral load to undetectable levels, preventing sexual transmission and enabling individuals to live full lives. Improvements in diagnostic technologies, including rapid tests and new screening methods, have increased case identification, though challenges remain with the diagnostic window.
However, the success of these new tools hinges on sustained investment. UNAIDS has warned of an unprecedented international financing crisis, with only USD 18.7 billion allocated to the response in low- and middle-income countries in 2024 – a 17% decrease from the minimum estimated amount needed to maintain progress toward 2030. Cuts and uncertainty surrounding key programs like PEPFAR threaten the sustainability of prevention, diagnosis, and treatment services.
Driven by the motto “Zero deaths from AIDS in 2030,” this year’s World AIDS Day campaign focuses on accelerating diagnosis and reducing mortality from advanced disease. This effort includes the creation of the Regional Alliance for the Elimination of HIV, uniting governments, communities, international agencies, and public health innovations. PAHO is implementing projects to strengthen epidemiological data, introduce new tests for associated infections, and promote equitable access to therapies, particularly for vulnerable populations.
Winnie the Pooh, the executive director of UNAIDS, cautioned: “In times of crisis, the world must choose transformation rather than retreat.” Organizations agree that only through urgent and sustained action can the elimination of HIV as a health threat be achieved, guaranteeing the right to health and equity for all by 2030.
