The global AIDS response has advanced considerably since the start of the epidemic 30 years ago. While there have been impressive achievements, the pace at which the changes are happening is not sufficient to reach the 2020 targets of 90% of people living with HIV knowing their status, 90% of people who know their HIV–positive status on antiretroviral therapy, and 90% of people on antiretroviral therapy with viral suppression. In 2018 approximately 79% of all people living with HIV knew their status, 78% of people who knew their HIV–positive status were accessing antiretroviral therapy, and 86% of people accessing treatment had suppressed viral loads. Among all people living with HIV globally, 62% were on treatment and 53% had suppressed viral loads.
In some areas the Latin American and Caribbean region has surpassed the global achievements, but there is considerable variability between the subregions. Latin America has surpassed the global achievements: 80% [62 – 99%] of people living with HIV know their status, 78% [67 – 84%] of people who know their HIV–positive status are on antiretroviral therapy, and 89% [74 – 96%] of people on antiretroviral therapy are virally suppressed. If the trends in Latin America continue, the 90–90–90 targets are achievable. However, in the Caribbean the estimates are 72% [60 – 86%], 77% [66 – 81%] and 74% [53 – 85%], respectively, which places the Caribbean at risk for not achieving the targets.
Due to increases in diagnosis, linkage to care of people with HIV, earlier initiation of treatment, and improved adherence, rates of new infections and mortality rates have improved over time. Globally since 2010 there has been an 16% decrease in new infections and a 33% decrease in AIDS–related deaths. While estimated new infections in Latin America have increased by 7%, they have decreased by 18% in the Caribbean, matching the global trend. AIDS–related deaths have decreased by 14% in Latin America and 38% in the Caribbean.