Late HIV Detection Raises Risks, Warns PAHO

Early HIV diagnosis in Latin America and the Caribbean could prevent thousands of deaths linked to AIDS, according to the Pan American Health Organization (PAHO). The organization is urging governments to expand testing, treatment, and prevention ahead of World AIDS Day 2025. The agency reported that about one-third of people with HIV in the region are diagnosed late, often when their immune system is significantly weakened.

Jarbas Barbosa, Director, PAHO, says that progress has been made in expanding access to antiretroviral therapy and introducing simplified treatment regimens, but late diagnosis continues to drive preventable mortality. “Every year, 38,000 lives are lost in the Americas from causes related to HIV. Behind each figure is a story, a family, a dream cut short,” he says, noting the importance of early testing and expanded access to pre- and post-exposure prophylaxis.

PAHO estimates that 2.8 million people were living with HIV in Latin America and the Caribbean in 2024. Regional trends show mixed results: the Caribbean reduced new infections by 21% since 2010, while Latin America registered a 13% increase. Deaths linked to AIDS declined from 42,000 to 27,000 in Latin America and from 12,000 to 4,800 in the Caribbean. However, about 14% of people with HIV in Latin America and 15% in the Caribbean remain unaware of their status, contributing to late diagnoses and susceptibility to opportunistic infections, including tuberculosis, cryptococcosis, and histoplasmosis.

PAHO is promoting expanded rapid testing, immediate antiretroviral initiation after diagnosis, and wider use of PrEP and PEP among people at risk. New long-acting options such as injectable lenacapavir, administered every six months, are being considered as national programs look to broaden prevention strategies. With Unitaid support, the agency is implementing a project to strengthen diagnostics for advanced HIV disease and improve access to treatment for opportunistic infections.

Efforts to improve HIV detection are also supported by new technological developments. Tecnológico de Monterrey and the Translational Institute of Genomic Singularity (ITRASIG) recently inaugurated the Genomic and Clinical Innovation Unit in Mexico City, a facility designed to advance precision medicine and strengthen national diagnostic capacity. The unit can process up to 14,000 genetic tests per day and aims to support early detection of viral, bacterial, and fungal outbreaks. Initial projects include a portable platform to measure HIV-1 and CMV viral loads in low-infrastructure settings, a molecular alternative to Gram staining for rapid identification of bacterial infections, and an AI-based system for comprehensive sepsis diagnosis.

Cecilia Bañuelos, Head of Innovation, Ministry of Economy, says that the new unit is intended to translate scientific knowledge into products with practical applications. She emphasizes the need for transdisciplinary collaboration to address health challenges beyond the laboratory. Located within the Innovation District in Tlalpan, the facility brings together government, academia, and industry to support precision-medicine research. The first phase includes ITRASIG-donated equipment for diagnosing HIV, Gram-positive, and Gram-negative infections, and sepsis. Future plans include portable genetic-diagnostic tools through the NanoLuci platform, paired with Pablo A.I., a Mexican-developed system for clinical decision support.

The issue of delayed HIV diagnosis also reflects broader public-health efforts to reduce vulnerabilities linked to sexual violence. In Mexico, where seven in 10 women have experienced violence, the Ministry of Health highlights new measures to improve care for survivors during the International Day for the Elimination of Violence against Women. Guidelines for the care of sexual abuse and assault instruct health personnel to provide immediate services without requiring survivors to file a complaint, says Minister of Health David Kershenobich. The government is also working to expand national availability of HIV post-exposure prophylaxis and strengthen coordination with state authorities to ensure timely access.

PAHO’s World AIDS Day campaign, “Zero AIDS Deaths by 2030,” reinforces the need for regional coordination as governments deploy new technologies and strengthen health-system responses. On Dec. 5, PAHO will present the Regional Alliance for the Elimination of HIV in the Americas, a collaborative initiative intended to accelerate innovation and support the region’s 2030 elimination goals.