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HIV and STI Prevention and Care in Latin America
Bridging the Gaps: Strengthening HIV and STI Prevention and Care in Latin America 

Released: November 22, 2024

Expiration: November 21, 2025

Emilia M. Jalil
Emilia M. Jalil, MD, PhD
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Key Takeaways
  • The HIV response in Latin America is hindered by structural barriers, financial limitations, social inequalities, and persistent stigma, all of which significantly affect HIV prevention and care, particularly among vulnerable populations.
  • Inequalities within and among Latin American countries hinder timely access to STI diagnosis and treatment, highlighting the urgent need for enhanced surveillance, prevention efforts, screening programs, and stronger public health policies.

ID Week 2024 featured important discussions on addressing the regional challenges related to HIV and sexually transmitted infections (STI) in Latin America. Latin American countries face profound barriers in responding to HIV and other STIs.

Challenges in HIV Prevention and Treatment in Latin America 
The lecture presented by Dr. Valdilea Veloso during IDWeek 2024 showed that in Latin America, healthcare professionals struggle to ensure early HIV diagnosis, timely linkage to HIV care, and sustained antiretroviral therapy (ART) adherence. In 2023, more than one quarter of the people with HIV in Latin America were not receiving ART. The Latin American region was also one of the few where new HIV infections were increasing.

The more vulnerable populations suffer the most from HIV in Latin America. STIs also disproportionately affect these populations, highlighting the overlap between the challenges of HIV and STI prevention and care.

Latin America is falling short of the 95-95-95 HIV targets, with limited access to HIV testing, high rates of late diagnosis, and a substantial gap in achieving the 2025 pre-exposure prophylaxis (PrEP) coverage goal. Significant disparities exist in PrEP access, with the majority of current users concentrated in Brazil. Young people, racial and ethnic minorities, individuals with lower education, and transgender women face the greatest barriers, resulting in poorer outcomes across the PrEP continuum.

One of the major barriers to the HIV response in Latin America, emphasized by Dr. Veloso, was the “financial determinant” related to underfunding. Also, the HIV epidemic disproportionately affects those struggling with poverty and social inequalities in Latin America. Brazilian data highlighted the link between food insecurity and nonadherence to both PrEP and ART, as well as the positive impact of cash transfer programs in reducing AIDS-related morbidity and mortality. Finally, Dr. Veloso highlighted how initiatives, such as task shifting, alternative delivery services, and peer support, may help reach and engage diverse populations.

Challenges in STI Management in Latin America
Another lecture, presented by Dr. Alexis Holguín Ruiz, focused on STI management in Latin America. STIs pose a serious public health issue across the region, with rising rates of syphilis, growing antimicrobial resistance against gonorrhea, and limited resources for etiologic diagnosis and epidemiologic surveillance.

As with HIV, STIs place a significant burden on young individuals, sexual and gender minorities, and indigenous populations. Various factors such as stigma, discrimination, socioeconomic inequality, migration, and restrictive policies contribute to limited access to prevention, testing, and treatment services. When compounded with biological and social determinants, these barriers increase the STI burden among vulnerable populations.

Inequalities among Latin Americans hinder access to STI diagnosis and treatment. In several parts of Latin America, symptom-based management is still used for STI diagnosis. This approach may lead to misdiagnosis and undetected infections, because asymptomatic cases are overlooked, thereby contributing to the continued transmission of STIs. Dr. Holguín Ruiz concluded by emphasizing the urgent need to improve epidemiologic surveillance, prevention, screening, and treatment of STIs in Latin America.

Interestingly, both presenters highlighted the importance of public health policies, political leadership, and financial investment to support an effective response to both HIV and STIs.

Your Thoughts?
What do you think is the most important factor to decrease HIV and STIs in Latin America? Get involved in the discussion by posting a comment below!