Current Situation

Prevention of HIV and other sexually transmitted infections among key populations in Latin America and the Caribbean is heavily reliant on US funding. Recent decisions by the United States Government indicate that efforts to support prevention among key populations will not receive funding resources. This has led to significant disruptions in and challenges for HIV services in the region.

Immediate risks and disruptions

1. Humanitarian assistance: Transnational projects aimed at migrant populations have been suspended. Despite a waiver announced on February 1 allowing continued provision of some HIV services, resumption of humanitarian services has been hindered due to the absence of PEPFAR and USAID staff.
2. Service delivery: The suspension of US funding has affected the delivery of various HIV services, including those provided by civil society organizations, government entities, and United Nations agencies. NGOs are particularly vulnerable to the US funding cuts.
3. Impact on key populations: The US funding cuts have led to stress, depression, anxiety, and uncertainty among people living with HIV and key populations. There is a significant concern about the risk of being left without antiretroviral treatment, access to PrEP, and other essential services.
4. Funds allocated for non-contingency humanitarian assistance were primarily focused on the humanitarian crises in Haiti and Venezuela, Colombia's post-conflict challenges, and the Northern Triangle crisis (Guatemala, Honduras, El Salvador). Although these funds were not intended for a direct response to HIV, their absence deepens the structural vulnerability of migrant and other vulnerable populations—including people affected by conflict in Colombia—and puts them at risk of exploitation, human trafficking and survival sex, all of which increase vulnerability to HIV. 

Politically relevant updates

1. Emergence of extreme positions: In many countries in the region, outbursts of homophobia, transphobia and discrimination against people living with HIV have intensified. Many parliamentarians in the region have taken advantage of the situation to gain political leverage by attacking key populations.
2. Media Representation: Actions targeting societal enablers are being shown in the media as examples of waste of money and corruption.

Civil society impact and resilience:

• Survey Findings: A survey conducted by the civil society organization "Corresponsales Clave" (Key Correspondents) with 49 organizations from various countries in the region revealed that US funding cuts have led to significant disruption of services for key populations and emotional distress among people living with HIV and key populations.
• Community Response: Despite the challenges, civil society organizations and community leaders are working to ensure the sustainability of the HIV response by optimizing health services.
• UN Response: The offices of the UN Resident Coordinators are intensifying the search for non-traditional donors and making bilateral approaches with embassies to identify funding opportunities. UNAIDS and PAHO are working together to deliver technical assistance to optimize health services in three areas: integration of HIV services in primary health care, optimization of service delivery models, and facilitation of community response to HIV.
• UNAIDS is carrying out joint analyses with the Global Fund to align the resources of national grants destined to the strengthening and resilience of health e-services with the principles mentioned above. 

Additional Insights

• Regional Progress: The Caribbean has made substantial progress against HIV since 2010, with a 22% decrease in new HIV infections and a 57% decrease in AIDS-related deaths. Latin America is the most autonomous region of the Global South in terms of national funding for HIV treatment, but there are still major gaps in prevention and social enablers. Therefore, continued funding is a necessary strategy for a smooth transition towards full sustainability of the HIV response in the region.
• Funding Challenges: The critical impact of the US funding cuts has exacerbated existing challenges in the HIV response across Latin America and the Caribbean.