Effective Strategies for HIV Prevention and Management in Latin America

Key Developments in HIV Pre-exposure Prophylaxis (PrEP)

PrEP has emerged as a critical biomedical intervention for preventing HIV transmission, particularly in populations at high risk. In Latin America, there has been a reported 9% increase in new HIV infections from 2010 to 2023, highlighting the pressing need for effective prevention methods (Rolle et al., 2025). Various antiretroviral drugs have shown high efficacy in preventing HIV, with emtricitabine/tenofovir and the newer emtricitabine/tenofovir alafenamide being among the most utilized oral options. Additionally, innovative methods such as the dapivirine vaginal ring and injectable formulations like Cabotegravir offer alternative preventive strategies.

Despite these advancements, the implementation of PrEP in Latin America has faced significant barriers. Some countries, including Brazil, Mexico, and Colombia, have made strides in increasing PrEP uptake, while others lag severely behind, often due to a lack of awareness, political instability, inadequate funding, and outdated policies (Rolle et al., 2025). A systematic approach to overcoming these challenges is essential, focusing on education, policy reform, and resource allocation to ensure that at-risk populations can access these life-saving interventions.

Current Status of PrEP Access

A survey of HIV providers across the United States has indicated a growing acceptance of PrEP among high-risk populations, with increasing discussions around its use in pregnant individuals (Daka et al., 2025). However, the disparity in access remains pronounced, particularly in rural areas and among marginalized populations. Innovative outreach programs, community-based education, and collaborations with local health organizations are vital to enhance PrEP access and utilization.

Importance of Antiretroviral Therapy (ART) in HIV Care

ART has been a cornerstone in managing HIV, enabling individuals to achieve viral suppression and live healthy lives. The introduction of second-generation integrase strand transfer inhibitors (INSTIs) such as dolutegravir and bictegravir has revolutionized treatment regimens, offering more effective options with fewer side effects (Rolle et al., 2025).

ART Regimens and Their Impact

Data has shown that switching to regimens containing bictegravir/emtricitabine/tenofovir alafenamide can yield favorable outcomes in terms of weight management and metabolic health, which are essential considerations in long-term HIV care (Rolle et al., 2025). Furthermore, the ongoing assessment of ART regimens is crucial, particularly in populations experiencing adverse effects such as weight gain, which can lead to treatment discontinuation.

Challenges in ART Management

Despite these advancements, challenges remain in ART adherence and management, particularly in populations with comorbidities. A survey of HIV providers highlighted inconsistencies in ART strategies when managing patients with additional health concerns. Providers frequently rely on clinical judgment to tailor ART regimens, which can lead to variations in treatment approaches (Daka et al., 2025). The need for standardized guidelines that encompass the complexities of treating individuals with multifaceted healthcare needs is paramount.

Challenges in Implementing HIV Prevention Strategies

Implementing HIV prevention strategies in Latin America faces numerous challenges, including socio-economic disparities, cultural stigma, and limited healthcare infrastructure. Many high-risk populations, such as men who have sex with men (MSM), sex workers, and transgender individuals, often encounter barriers to accessing prevention and treatment services.

Socio-economic Barriers

Socio-economic factors play a significant role in hindering access to HIV prevention methods. Many individuals from marginalized communities lack the financial resources to access appropriate healthcare services, including PrEP and ART (Rolle et al., 2025). Programs that offer subsidized healthcare, mobile clinics, and community health worker initiatives can help bridge the gap in access.

Cultural Stigma and Discrimination

Cultural attitudes toward HIV and those affected by it can also impede effective prevention strategies. Stigma surrounding HIV leads to reluctance in seeking testing and treatment, resulting in higher rates of transmission. Public health campaigns that focus on reducing stigma and educating communities about HIV can foster a more supportive environment for individuals seeking care.

The Role of Innovative Treatments in HIV Management

Innovation in HIV treatment continues to be a significant focus, with ongoing research into new pharmacological interventions and treatment modalities. Recent studies have explored the potential of long-acting injectable therapies and therapeutic vaccines to enhance patient outcomes and reduce the burden of daily medication adherence.

Long-acting Injectables

Injectable options such as Cabotegravir and Rilpivirine have demonstrated efficacy in maintaining viral suppression, providing an alternative for patients who may struggle with daily pill regimens (Rolle et al., 2025). These long-acting therapies offer the promise of greater convenience and improved adherence, particularly for individuals with busy lifestyles or those facing challenges in medication management.

Therapeutic Vaccines

Research into therapeutic vaccines aims to enhance the immune response in individuals living with HIV, potentially leading to sustained viral control without continuous ART (Bailón et al., 2025). These innovative treatments hold the potential to revolutionize HIV care, offering hope for a future where individuals can maintain their health without lifelong dependency on antiretroviral medication.

Enhancing Access to HIV Prevention in High-Risk Populations

To effectively combat the HIV epidemic in Latin America, it is essential to enhance access to prevention measures, particularly among high-risk populations. Strategies that prioritize outreach, education, and community engagement can significantly improve access to PrEP and ART.

Community-Based Interventions

Community health programs that engage with local populations can help raise awareness about HIV prevention and treatment options. Initiatives that involve peer educators, culturally relevant materials, and accessible testing services can empower individuals to take charge of their health and seek preventive measures.

Policy Reform and Advocacy

Advocating for policy changes that prioritize HIV prevention funding and resource allocation is crucial. Collaboration between government agencies, non-governmental organizations, and community stakeholders can lead to the development of effective policies that support comprehensive HIV prevention strategies.

FAQs

What is PrEP and how does it work?

PrEP (pre-exposure prophylaxis) is a preventive treatment for individuals at high risk of contracting HIV. When taken consistently, PrEP can reduce the risk of HIV transmission by up to 99%.

Who should consider taking PrEP?

Individuals who are at high risk for HIV, including those with multiple sexual partners, those whose partners are living with HIV, and those who engage in injection drug use, should consider PrEP.

What are the side effects of ART?

Common side effects of ART may include nausea, diarrhea, fatigue, and weight gain. However, these vary depending on the specific medications used.

How can I access HIV prevention services in Latin America?

Access to HIV prevention services can be improved through local health clinics, community health workers, and outreach programs that provide education and resources to at-risk populations.

References

1. Rolle, C.-P. M., Garrett, J. A., Patel, K., Hinestrosa, F., & DeJesus, E. (2025). Change in weight and BMI associated with switching to bictegravir/emtricitabine/tenofovir alafenamide versus a dolutegravir-based regimen among virologically suppressed adults living with HIV through 144 weeks. Retrieved from https://pubmed.ncbi.nlm.nih.gov/11902965/

2. Daka, V., et al. (2025). A United States HIV provider survey of antiretroviral therapy management in people living with HIV with co-occurring conditions. Retrieved from https://doi.org/10.1186/s12981-025-00724-w

3. Bailón, L., et al. (2025). Safety, immunogenicity and effect on viral rebound of HTI vaccines combined with a TLR7 agonist in early-treated HIV-1 infection: a randomized, placebo-controlled phase 2a trial. Retrieved from https://doi.org/10.1038/s41467-025-57284-w

4. Updates on HIV Pre-exposure Prophylaxis in Latin America: Available Drugs and Implementation Status. (2025). Retrieved from https://pubmed.ncbi.nlm.nih.gov/11892447/

5. Validation Study of Scores Predicting Hepatocellular Carcinoma Risk in Chronic Hepatitis B Patients Treated With Nucleos(t)ide Analogues. (2025). Retrieved from https://pubmed.ncbi.nlm.nih.gov/11887419/