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In total, key populations and their sexual partners represented two thirds of new infections.9 Brazil has played a key leadership role in the reinvigoration of HIV prevention in Latin America.
However, the election of Jair Bolsonaro of the Social Liberal Party (PSL) as president in October 2018 could significantly reverse the progress made on HIV in Brazil and possibly the wider region, as well as deny human rights for many vulnerable populations.
According to the Observatory of Murdered Trans People, 2,016 transgender people were reported as murdered between 20 across the world, 1,573 (78%) of them were in Latin America and the Caribbean.24 The highest number of these murders occurred in Brazil, where 938 were reported.25 Such high levels of stigma and violence remain significant barriers to transgender people accessing HIV services.
HIV also disproportionately affects sex workers, although there are variations between country situations and genders.
In this part of the region, there was a large gap in awareness of HIV status at the start of the HIV testing and treatment cascade.4 In 2018, 72% of people living with HIV in the Caribbean were aware of their HIV status.
Of those who were aware, 77% were accessing antiretroviral treatment (ART).
Of those on treatment, 55% were virally suppressed.Young people are also disproportionately affected by HIV in the region.In 2017, gay men and other men who have sex with men accounted for 41% of HIV infections in Latin America, and key populations and their sexual partners represented more than three quarters of new infections overall.8 In the Caribbean, gay men and other men who have sex with men accounted for nearly a quarter of new infections in 2017.Sex workers are also frequently marginalised by social and religious institutions and subject to discrimination.For these reasons, many people who engage in sex work do so covertly.
Most other countries have prevalence ranging between 11% and 17%, although Bolivia, Mexico and Paraguay all report prevalence above 20% (25%, 21% and 21%, respectively).12 There are many reasons for high levels of HIV transmission among this group.