ADVANCING A STRONG RESILIENT RESPONSE: Latin America and the Caribbean’s Approach to HIV in 2025

UNAIDS LAC UPDATE - DECEMBER 2025

In 2025, Latin America and the Caribbean faced a convergence of challenges in the HIV response with abrupt reductions in international funding, a deepening prevention crisis among key populations, price barriers to access HIV prevention technologies—including twice yearly injections to prevent HIV – 

and scarcity of investment in community-led services and community engagement. Despite these headwinds, the region has demonstrated resilience, innovation, and a steadfast commitment to equity and human rights.

We invite you to learn more about HIV in the region, and how these key pillars are guiding the regional response: investing in HIV and sustainability, innovation and prevention access, and community empowerment.

Investing in HIV and Sustainability

The 2025 funding crisis has thrown the AIDS response into turmoil all over the world and in the region, with massive disruptions to HIV prevention and community-led services, particularly for the most vulnerable. Sudden cuts in international HIV assistance have deepened existing funding shortfalls, with the Organization for Economic Co-operation and Development (OECD) estimating that external health assistance is projected to drop by 30–40% in 2025 compared with 2023.

Since February 2025, UNAIDS has called on leaders to reaffirm solidarity and maintain international assistance, as domestic financing cannot grow fast enough to fill the gap. Although Latin America is the region with the highest level of national funding for the HIV response, most of it is focused on treatment, while in prevention the gap remains. Therefore, commitments to urgent and meaningful debt restructuring are essential to release resources currently tied up to limited fiscal space in most countries.

In response, the region has prioritized sustainability. A unified Sustainability Index and Roadmap tool, developed with the Global Fund to Fight AIDS, Tuberculosis and Malaria, the United States President’s Emergency Plan for AIDS Relief (PEPFAR), and the Central American Integration System Council of Ministers of Health, is now guiding Central American Integration System (SICA) countries through turbulent times.  

We recently joined Ministers of Health of SICA countries to solidify commitment to increasing national investments for the HIV response, and our Regional Director joined the Minister of Finance of Guatemala in calling for sustained support and government financing in this article published in the context of World AIDS Day 2025.

Guatemala has focused on strengthening civil society’s capacity in public budgeting, while the Dominican Republic has implemented cost analysis processes for civil society organizations. The UNAIDS Rapid AIDS Financing Tool (RAFT) is supporting decision-making in Guatemala, Jamaica, El Salvador, and the Dominican Republic as partners adapt to reduced international cooperation.

Innovation, Integration and Prevention Access

Prevention services, which were already under strain before the funding crisis, have been hit hardest. Reductions in access to tools to prevent HIV, such as PrEP and self-testing for key populations, have left a growing protection gap for hundreds of thousands.

Although innovation is gaining momentum, most countries in the region have been excluded from the list of countries allowed to access patent-free twice-yearly injections to prevent HIV, such as lenacapavir. UNAIDS Regional Support Team for LAC and our country teams have been vocal about the need for these new technologies to be accessible and affordable.

The region is making efforts to accelerate the rollout of new prevention tools, including national guidelines for pre-exposure prophylaxis (PrEP) and the development of the Elimination of Mother-to-Child Transmission Plus (ETMI Plus) 2025–2030 strategy in Guatemala, with support from UNAIDS, the Pan American Health Organization/World Health Organization (PAHO/WHO), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), civil society, and the Global Fund.

In June 2025, Central America took a decisive step toward health equity with the approval of a cross-border HIV action plan, anchored in the Central American Integration System (SICA) Council of Ministers of Health (SE-COMISCA) Resolution 16-2023. Developed over 18 months, the initiative aims to guarantee that people on the move—often among the most vulnerable—can access quality HIV services wherever they are. The plan prioritizes harmonized care, robust data tracking, and binational agreements to uphold commitments across borders. Led by SE-COMISCA’s Regional Coordination Mechanism, and backed by UN partners, the strategy is already being recognized as a blueprint for other subregional health and migration efforts in Latin America and the Caribbean.

In August 2025, Brazil brought together experts and organizations, including UNAIDS, the Pan American Health Organization (PAHO), the United Nations Office on Drugs and Crime (UNODC), and the Ministry of Justice, to address the persistent stigma and discrimination faced by people living with HIV in the country’s penitentiary system. The collaboration led to the development of a questionnaire and an ethical-methodological guide, designed to identify barriers to prevention, diagnosis, and care. Special attention was given to gender issues, with a focus on the disproportionate impact these barriers have on women.

Since 2022, Argentina has positioned itself as a model for local government leadership through the creation and strengthening of municipal HIV programs, focusing on combination prevention strategies and intersectoral training. Since its launch in November 2024, the National Network of Municipalities Committed to the HIV Response now includes 61 municipalities. The network aims to share best practices and coordinate efforts across municipalities, with support from UNAIDS, the United Nations Development Programme (UNDP), PAHO, and national authorities.

Turning to Peru, the CRECE project, short for “Resilient and Empowered Communities Combating Exclusion”, marks a bold new chapter in the region’s fight for equality and human rights. Launched in April 2025 with support from Global Affairs Canada and led by UNAIDS, this three-year initiative targets some of Peru’s most marginalized groups: LGBTIQ+ people, sex workers, and migrant women. Backed by a $2.3 million USD investment, CRECE is tackling discrimination head-on by strengthening grassroots organizations, training public servants, and rolling out innovative campaigns to counter hate speech and promote dignity.

The project also works to improve rights-based and gender-sensitive policies through evidence, advocacy, and community-led monitoring, while integrating local organizations into broader social movements for lasting impact. At a time when anti-gender narratives and restrictive laws threaten civil society, CRECE stands as a timely response—set to benefit more than 31,000 people in Lima, Callao, and Tumbes, and reinforcing Peru’s commitment to human rights, gender equality, global AIDS targets, and the Sustainable Development Goals.

In Ecuador, UNAIDS, PAHO, and partners stwearded a regional symposium, uniting national HIV programs, civil society, and technical experts from across Latin America. The meeting advanced on consensus around HIV prevention, advocated for the promotion of its integration into primary health care, and strengthened the sustainability of the response, with a strong focus on domestic financing and community leadership. The symposium also highlighted the Andean Regional Plan to Reduce HIV-related Stigma and Discrimination, aligning national and regional priorities. As part of UNAIDS’ ongoing support for the 30-year of Horizontal Technical Cooperation Group (known by its acronym GCTH in Spanish), wich is a regional platform of AIDS authorities and civil society networks, this event exemplified knowledge sharing, joint UN planning, and the inclusion of community voices in strategy setting.

And in Haiti, community police officers and first responders in the Grande Anse region received specialized training on HIV, gender-based violence, and prevention strategies. Led by UNAIDS and partners including the Organization of American States (OAS) and local community-led organization Serovie, the program strengthens law enforcement’s capacity to support vulnerable populations, promote safe practices, and foster trust. Officers are now better equipped to deliver prevention tools and information, putting communities at the center of public health and safety efforts.

Communities at the center

Community-led action remains at the heart of the regional response. But services for key populations, including men who have sex with men, sex workers, people who inject drugs, and transgender people, have been significantly impacted, threatening the hard-won progress in outreach and care.

In June 2025, UNAIDS led a high-level mission to Mexico to join national partners for the launch of the National HIV Response Network, groundbreaking platform uniting government, civil society, and international organizations to accelerate progress toward ending AIDS as a public health threat. Built on the pillars of prevention, treatment, and human rights, this collaborative initiative is poised to help Mexico close gaps in prevention, diagnosis, and treatment and to inspire the region in ensuring that no one is left behind on the path to 2030.

During the mission, UNAIDS engaged directly with civil society organizations active in CONASIDA, reaffirming the indispensable role of communities in shaping effective HIV governance. The team also met with members of the Chamber of Deputies, who are championing legislative reforms to decriminalize HIV transmission, an essential step to dismantle stigma and advance a response rooted in scientific evidence and respect for human rights. These efforts underscore Mexico’s renewed commitment to a multisectoral, inclusive, and rights-based approach to HIV, setting a powerful example for the region at a time when solidarity and innovation are more crucial than ever.

UNAIDS has also partnered with and supported community-led organizations with focus on capacity building and strategic policy advocacy. One great example is the project School of Leadership, a flagship initiative of the Regional Youth Network for LAC, has trained over 1,000 young people since it started a couple of years ago. Developed with support from UNAIDS, the United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), and the United Nations Environment Programme (UNEP), the Youth Network brings together more than a dozen organizations working across sexual and reproductive health, LGBTIQ+ rights, employment, gender empowerment, and environmental agendas.

Based on its experience with youth leadership training, the Regional Youth Network for LAC, in partnership with the NGO Más que Tres Letras (Colombia), has been a key implementer of the “Strengthening LGBTI Communities and Mobilizing Effective Alliances” project, through the launch of the School of Inclusive Journalism to empower LGBTIQ+ voices and promote ethical and inclusive narratives.

Other collaborative efforts to position the needs of women in the response, presenting data analysis showing progress and challenges since the Beijing Programme of Action was adopted 30 years ago.  UNAIDS supported community-led organizations that contributed to the Regional Conference on Women in México, resulting in the Tlatelolco Commitment, which includes specific references to women living with HIV, LGBTIQ+ populations, and social protection.

Through a multi-agency support from UNAIDS, UNICEF, UNFPA, and PAHO/WHO, ICW led a regional study on the experiences of women living with HIV in accessing breastfeeding information in Latin America and the Caribbean. The study documents how women with HIV experience health services as they navigate breastfeeding decisions for their children. The study report is in final stages of editing, with publication set for 2026.

At country level, initiatives like Proyecto Vida in Guatemala, MUDE in the Dominican Republic, and community-based HIV self-testing in El Salvador, have strengthened multisectoral responses to gender-based violence, legal empowerment, and access to justice and health services for key populations. In the Caribbean, thanks to the work of communities, Saint Lucia’s judiciary struck down laws criminalizing same-sex relations, and Jamaica’s “Beyond Labels” initiative is updating workplace policies and expanding HIV testing. Also, Community-led stigma surveys in Trinidad and Tobago and Guyana informed policy reforms.

In Haiti a UNAIDS-led initiative in the Grande Anse region equipped women living with HIV and sex workers with vital skills in cassava cultivation and agri-food entrepreneurship. Through targeted training and support, participants are learning to process and market cassava-based products, access microcredit, and adopt sustainable, eco-friendly practices. This project, coordinated by UNAIDS with support from UN Women and FAO, is driving economic empowerment and resilience for women at the heart of the community.

Our Call to Action

The UNAIDS Regional Support Team for LAC celebrates the leadership of all stakeholders in the region and urges partners to stand with Latin America and the Caribbean at this critical juncture.

Continued solidarity, investment in innovation, sustainability and integration of HIV in primary healthcare systems, and support for community leadership are essential to keep the goal of ending AIDS by 2030 within reach.

The choices made today will determine the future of millions across the region in the years to come! Join us as we engage in the vision that will be set forward by the new Global AIDS Strategy 2026-2031.