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Caribbean's HIV/AIDS Update 2019: New Infections, Deaths, and Prevention Services

This report provides an update on the HIV/AIDS situation in the Caribbean, including the number of new infections, AIDS-related deaths, and the provision of assisted partner notification services. It also highlights key populations affected by HIV and their access to prevention services.

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Caribbean's HIV/AIDS Update 2019: New Infections, Deaths, and Prevention Services

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  1. GLOBAL AIDS UPDATE 2019 • REGION PROFILES • CARIBBEAN

  2. Provision of assisted partner notification services, Caribbean, 2018 No Yes • Source: 2019 Global AIDS Monitoring.

  3. Number of new HIV infections and AIDS-relateddeaths, and incidence-prevalence ratio Caribbean, 2000–2018 New HIV infections AIDS-related deaths Incidence-prevalence ratio 16 700 000 500 000 Number of AIDS-related deaths Percentage change in new HIV infections since 2010 Percentage change in AIDS- related deaths since 2010 2018 Incidence- prevalence ratio Number of new HIV infections 450 000 Incidence-prevalence ratio 14 • 600 000 400 000 12 • 500 000 350 000 10 300 000 • 400 000 -16% -38% 4.6% [3.2–7.0%] 8 250 000 • 300 000 200 000 6 150 000 • 200 000 4 100 000 3 • 100 000 2 50 000 0 0 0 2000 2010 2018 2000 2010 2018 2000 2005 2010 2015 2018 • New HIV infections • AIDS-related deaths • Incidence-prevalence ratio • Target value Source: UNAIDS 2019 estimates.

  4. Percentage change in new HIV infections, by country, • Caribbean, 2010–2018 10 7 5 0 0 -5 -4 Per cent -7 -10 -15 -14 -17 -20 -20 -25 -23 -23 -30 Bahamas Cuba Guyana Haiti Dominican Republic Suriname Barbados Jamaica Belize Source: UNAIDS 2019 estimates.

  5. HIV prevalence among key populations Distribution of new HIV infections (aged 15–49 years), by population group • Caribbean, 2014–2018 • Caribbean, 2018 Sexworkers 6% 60 50 40 30 20 Peoplewho injectdrugs 2% Percent Gay menandother men who havesex with men 22% Remaining population 53% 18.1 10 Transgenderwomen 5% 8.9 2.0 2.4 0 Clients of sex workers andsex partners of other key populations 12% Sex workers, n = 9 Gay men and other men who have sex with men, n = 10 People who inject drugs, n = 0 Transgender people, n = 4 Prisoners, n = 6 Source: UNAIDS Global AIDS Monitoring, 2014–2018. Source: UNAIDS special analysis, 2019.

  6. Estimated size of key populations, Caribbean, 2018 National population size estimate Local population size estimate Insufficient data No data • Source: Global AIDS Monitoring, 2018; United Nations, Department of Economic and Social Affairs, Population Division. World population prospects: • the 2017 revision. 2018 (custom data acquired via website).

  7. HIV testing and treatment cascade, Caribbean, 2018 400 000 350 000 300 000 Gap to reaching the first 90: 59 800 Gap to reaching the first and second 90s: 86500 250 000 Number of people living with HIV Gap to reaching all three 90s: 109 000 200 000 72% [60–86%] 150 000 55% [42–67%] 100 000 41% [28–52%] 50 000 0 People living with HIV who know their status People living with HIV on treatment People living with HIV whoare virally suppressed Source: UNAIDS special analysis, 2019; see annex on methods for more details.

  8. 90–90–90 country scorecard: Caribbean, 2018 90–90–90: 85–89% 65–72% 70–84% 40–64% 50–69% 25–39% Less than 50% Less than 25% 90% and above Viral load suppression: 73% and above Source: UNAIDS special analysis, 2019.

  9. Percentage of people living with HIV with a low CD4 count at initiation of antiretroviral therapy, Caribbean, 2018 90 80 70 60 50 Per cent 40 30 20 10 0 Antigua and Barbuda Bahamas (2017) Barbados Cuba Dominican Republic Grenada Guyana Haiti Jamaica Saint Kitts and Nevis Saint Lucia Suriname Trinidad and Tobago (2017) CD4 <200 CD4 <350 Note: Data shown come from surveys, which are typically conducted in areas with high prevalence and needs and may not be nationally representative. Source: 2019 Global AIDS Monitoring.

  10. Knowledge of status among key populations, Caribbean, 2016–2018 100 90 80 70 60 Per cent 50 40 30 20 10 0 Belize Dominican Republic Haiti Jamaica Saint Vincent and the Grenadines Suriname Sex workers Gay men and other men who have sex with men Transgender people • Note: Data shown come from surveys, which are typically conducted in areas with high prevalence and needs and may not be nationally representative. Source: Global AIDS Monitoring, 2016–2018.

  11. Percentage of key populations who reported receiving at least two prevention services in the past three months, Caribbean, 2016–2018 100 90 80 70 60 Per cent 50 40 30 20 10 0 Dominican Republic Saint Vincent and the Grenadines Suriname Sex workers Gay men and other men who have sex with men People who inject drugs Transgender people • Note 1: The use of an asterisk (*) indicates that data for marked countries come from programme data (which tend to show higher values due to the use as a denominator of the number of key population members that are linked to the programme) and not from a survey. • Note 2: Possible prevention services received among sex workers, gay men and other men who have sex with men and transgender people: condoms and lubricant, counselling on condom use and safe sex, and testing of sexually transmitted infections. Possible prevention services received among people who inject drugs: condoms and lubricant, counselling on condom use and safe sex, and clean needles or syringes. Source: Global AIDS Monitoring, 2016–2018.

  12. Viral load suppression among adults (15 years and older) living with HIV, by sex, Caribbean, 2018 100 90 80 70 60 Per cent 50 40 30 20 10 0 Antigua and Barbuda Barbados Belize Cuba Dominica Dominican Republic Grenada Guyana Jamaica Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Suriname Females Males Source: UNAIDS specialanalysis, 2019.

  13. Number of countries with public policies for delivery of HIV prevention services recommended by World Health Organization, by key population, Caribbean • Note: Number of countries in the region (n = 16) Source: HIV prevention in the spotlight: an analysis from the perspective of the health sector in Latin America and the Caribbean, 2017. Washington (DC): Pan American Health Organization, UNAIDS; 2017.

  14. Cascade of services for preventing vertical transmission, numbers of new HIV infections and transmission rate, Caribbean, 2018 9000 86% [68– >95%] 8000 7000 6000 47% [40–59%] Number 5000 4000 Transmission rate: 14%[10–16%] 3000 2000 1000 0 Births to women living with HIV Women receiving antiretrovirals to prevent vertical transmission Infants tested by eight weeks of age New child infections Any birth to women living with HIV Children newly infected with HIV Source: UNAIDS 2019 estimates; 2019 Global AIDS Monitoring.

  15. Percentage of infants receiving HIV testing in the first 4–6 weeks, Caribbean, 2018 100 90 Per cent 80 70 60 50 40 30 20 10 0 Antigua and Barbuda Bahamas Dominica Dominican Republic Grenada Guyana (2015) Haiti (2015) Saint Lucia Source: 2019 Global AIDS Monitoring.

  16. Percentage of men and women aged 15–49 years with discriminatory attitudes towards people living with HIV Percentage of ever-married or partnered women aged 15–49 years who experienced physical and/or sexual violence by an intimate partner in the past 12 months Caribbean, 2013–2016 Caribbean, most recent data, 2013–2017 80 18 People who would not buy vegetables from a shopkeeper living with HIV 16 70 People who think children living with HIV should not be allowed to attend school with children not living with HIV 14 60 12 50 10 Per cent Per cent 40 8 30 6 20 4 10 2 0 0 Jamaica Haiti Dominican Republic Belize Guyana Cuba Dominican Republic Haiti Cuba Source: Population-based surveys, 2013–2017, countries with available data. Source: Population-basedsurveys, 2013–2017.

  17. HIV resource availability, by source, Caribbean, 2010–2018, and projected resource needs by 2020 700 600 Domestic (public and private) 500 United States (bilateral) US$ (million) 400 Global Fund Other international 300 Resource needs (Fast-Track) 200 100 0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2020 Source: UNAIDS 2019 resource availability and needs estimates.

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