Central America and the Caribbean

In Central America and the Caribbean island states, access to antiretroviral therapy is extremely limited. In Guatemala, an estimated 185 people have access to antiretroviral drugs, out of an estimated number of over 50,000 living with HIV and AIDS. In 1999, HIV infection was detected in 2% to 4% of pregnant women tested at antenatal clinics in urban areas. Overall, health expenditures are only US$64 per person per year in Guatemala. In Guyana, HIV was detected in 3.2% of blood donors -- a population generally thought to be at low risk. In contrast, surveillance among urban sex workers in Guyana in 1997 showed that 46% were infected.

The Caribbean basin has one of the most severe HIV/AIDS epidemics outside of Sub-Saharan Africa. This is particularly evident in Haiti. Approximately 6% of pregnant women in Haiti tested positive for the virus in 1996. Infection rates approaching 8% were found in some Haitian antenatal clinics in 1993. Currently, UNAIDS/WHO estimates that 40% of female sex workers in the capital, Port-au-Prince, are HIV positive. In the Dominican Republic, which makes up the rest of Hispaniola Island, prevalence rates for women in 1995 ranged from 1.2% to 4% in both major and nonmajor urban areas, suggesting a generalized heterosexual epidemic. In Santo Domingo, the capital and principal city, HIV infection rates among sex workers increased from 1% in 1986 to 11% in 1993. In 1994 and 1995, 5% to 6% of sex workers tested were HIV positive.