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The Latin American and Caribbean (LAC) region has worked towards widely available treatment for people with HIV (PWHIV) within public health systems and, in Latin America, has relied principally on domestic financing to do so.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>While new methods of prevention are in the process of being incorporated into regional HIV programmes, the HIV cascade of care remains below the UNAIDS goals. Only 17 of the 32 LAC countries (53%) report on the three pillars. Only Chile achieved &gt;95% in two of the three pillars, with 95% of PWHIV knowing their status and 95% of people on treatment having a suppressed viral load. However, only 75% of those who know their status were on treatment. In the Caribbean, very little data is available, with all three cascade pillars missing for six of the countries. Only the Bahamas reached the 95% threshold for any of the cascade steps. Additionally, in the Caribbean, the viral suppression step of the cascade is much lower on average than in Latin America, with no countries reaching 80%. Biomedical HIV prevention with pre\u2010exposure prophylaxis (PrEP) and post\u2010exposure prophylaxis (PEP) is still being adopted and scaled up among populations in need. Scale\u2010up of prevention efforts remains hindered by structural limitations of the health system, legal and policy limitations such as continuing to require informed consent for HIV testing and policies that block task\u2010shifting, as well as persistent stigma. Recent reductions in international funding for HIV may adversely influence HIV programmes in LAC, which have relied on these for initial scale\u2010up of innovations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Accelerating differentiated and simplified delivery of PrEP and PEP, alongside sustained progress towards universal treatment coverage and viral suppression, are all essential for translating existing scientific advances into measurable progress towards HIV elimination in the region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70170","type":"journal-article","created":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T06:46:27Z","timestamp":1785048387000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Latin America and the Caribbean: Challenges and Opportunities for HIV Treatment and Prevention"],"prefix":"10.1002","volume":"29","author":[{"given":"Mateo","family":"Prochazka","sequence":"first","affiliation":[{"name":"World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2836-0174","authenticated-orcid":false,"given":"Kelika A.","family":"Konda","sequence":"additional","affiliation":[{"name":"Keck School of Medicine University of Southern California  Los Angeles California USA"},{"name":"Universidad Peruana Cayetano Heredia  Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5818-770X","authenticated-orcid":false,"given":"Omar","family":"Sued","sequence":"additional","affiliation":[{"name":"Pan American Health Organization  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hortencia","family":"Peralta","sequence":"additional","affiliation":[{"name":"Pan American Health Organization  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Boccardi","sequence":"additional","affiliation":[{"name":"UNAIDS  Brasilia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago S.","family":"Torres","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz Instituto Nacional de Infectologia Evandro Chagas  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Alonso","sequence":"additional","affiliation":[{"name":"Pan American Health Organization  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valdilea","family":"Veloso","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz Instituto Nacional de Infectologia Evandro Chagas  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Grinsztejn","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz Instituto Nacional de Infectologia Evandro Chagas  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103018(23)00150\u20109"},{"key":"e_1_2_7_3_1","unstructured":"Regional Profile: Latin America(UNAIDS 2025)."},{"key":"e_1_2_7_4_1","volume-title":"Caribbean \u2014 Regional Profile","year":"2025"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0272405"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/13596535211062396"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix939"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(23)00051-6"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/20499361231164030"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(19)30146-8"},{"key":"e_1_2_7_11_1","unstructured":"K.Gomez T.Poteat andS.Reisner HPTN 091: Integrating HIV Prevention Gender\u2010Affirmative Medical Care and Peer Health Navigation to Prevent HIV Acquisition and HIV Transmission for Transgender Women in the Americas: A Vanguard Feasibility and Acceptability Study(2023)."},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2101016"},{"key":"e_1_2_7_13_1","unstructured":"Pan American Health Organization HIV Epidemic and Response in Latin America and the Caribbean(2023)."},{"key":"e_1_2_7_14_1","unstructured":"UNAIDS Global AIDS Monitoring 2020\u20132024: UNAIDS Epidemiological Estimates(2024)."},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2023.100642"},{"key":"e_1_2_7_16_1","unstructured":"Caribbean Regional Strategic Framework 2019\u20132025.Pan Caribbean Partnership Against HIV and AIDS. 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