Caribbean marks World AIDS Day with gains against AIDS deaths, but prevention progress has slowed

CARIBBEAN REGION--On the occasion of World AIDS Day 2025 on December 1, new regional data show that the Caribbean has made some of the strongest gains in the world in reducing deaths from AIDS, even as progress on preventing new HIV infections has slowed and important gaps remain in services and funding.

According to the Pan American Health Organization (PAHO), an estimated 2.8 million people were living with HIV in Latin America and the Caribbean in 2024. Within that total, the Caribbean, though small in population, continues to carry a heavy share of the regional burden.

The Caribbean has reduced AIDS related deaths from about 12,000 in 2010 to around 4,800 in 2024, a drop of roughly 60 percent, which UNAIDS identifies as the steepest decline among the eight global regions it tracks. This progress reflects expanded access to antiretroviral therapy, better prevention of mother to child transmission, and stronger community based responses across many islands.

At the same time, new HIV infections in the Caribbean have fallen by only about 21–22 percent since 2010, and UNAIDS notes that there has been very little change in the annual number of new infections over the last five years, signaling a worrying plateau. Almost 90 percent of new infections in 2023 occurred in just four countries, Haiti, the Dominican Republic, Jamaica and Cuba, with Haiti alone accounting for more than one third of new cases in the region.

Taken together, these figures mean the Caribbean still has one of the highest HIV prevalence rates in the world, with UNFPA estimating that between 350,000 and 590,000 people in the region are living with HIV and that adult prevalence lies between 1.9 and 3.1 percent, second only to sub Saharan Africa. In at least a dozen Caribbean countries, national HIV prevalence has remained at or above 1 percent for years, which is a threshold for a generalized epidemic.

PAHO and UNAIDS are using this World AIDS Day to warn that late HIV diagnosis remains a major cause of preventable illness and death in the Caribbean. Many people are still being diagnosed at advanced stages of infection, which reduces the benefits of treatment for their own health and leaves more time in which the virus can be unknowingly transmitted to others. Regional partners are calling for earlier testing, rapid initiation of antiretroviral therapy, and easier access to comprehensive care, especially for key populations that face stigma and discrimination.

For the Dutch Caribbean and St. Maarten, publicly available, up to date data are limited, but PAHO’s Health in the Americas profile for St. Maarten reports that the estimated HIV incidence rate in 2020 was 0 new diagnoses per 100,000 population, a figure that reflects very small absolute numbers in a small population rather than an absence of risk. Regional health experts stress that islands with low numbers still need sustained prevention, testing, and treatment efforts, because even a small rise in new infections can rapidly shift trends in such settings.

Despite the measurable progress against AIDS related deaths, global funding cuts are creating serious risks. UNAIDS has warned that recent disruptions in international HIV financing have already forced some services to scale back or close, interrupting treatment and prevention programs around the world and threatening to slow or reverse gains in regions like the Caribbean that have worked hard to reduce deaths.

Caribbean health agencies and civil society groups are using World AIDS Day 2025 to renew calls for:

• sustained and predictable funding for HIV services,

• earlier and more widespread testing,

• stronger protection and support for key populations, and

• better country level data, including for smaller territories such as the Dutch Caribbean islands.

Their message is that the region has shown it can turn the tide on AIDS deaths, but ending AIDS as a public health threat will require the same level of urgency, investment, and regional solidarity to drive down new infections and close the remaining gaps in care.

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