With a series of economic and political crises throughout the past decade, Venezuela has become increasingly vulnerable to the rampant spread of HIV with little public accessibility to safe-sex materials and practices. The nation has faced extreme shortages of antiretroviral therapy (ART) in both pharmaceutical and clinical settings, leading to inflated treatment rates. Although there are around 110,000 people expected to be living with HIV/AIDS in Venezuela as of 2020, only 55% have proper access to complete and consistent viral regimens. Tens of thousands of individuals are continuously defenseless to this chronic, deadly virus with many forced to migrate to surrounding nations in the hope of receiving life-saving treatment plans.

Deterioration of Health Care Systems

Venezuela was previously considered one of the most well-suited nations in South America to deter the severity of the HIV/AIDs crisis, instituting free, centralized ART treatment through government funding in 1990s. However, when faced with newfound economic challenges in the early 2010s—the price of oil, a leading export of the nation, drastically plummeting worldwide—many mechanisms necessary for proper maintenance of its healthcare systems began to deteriorate. Hospitals could no longer upkeep effective follow-up and control measures with inaccurate estimations of affected patients.

Amid economic upheaval, the monthly price for ART rose to around $95-100 per month, a burdening cost for low-income citizens. From 2011 to 2015, there was a 75% increase in HIV-related deaths, the greatest amount since 2000. By 2017, there were no hospitals containing ART drugs to distribute, with 85% of pharmacies facing drastic drug shortages. Only 26% of people with HIV were able to acquire regular ART regimens, and more than 90% of individuals who had registered for ART treatment directly through the government did not receive it.

Barriers to Prevention of HIV/AIDS in Venezuela

HIV is a chronic, rapidly evolving virus, with ART serving as a long-term health necessity for those impacted. As many found themselves depleted of sufficient ART treatments, whether due to the heightened cost or sheer unavailability across the nation, they resorted to other temporary strategies to improve their condition: partaking in intermittent treatments or partial-self dosing, oftentimes utilizing expired medication.

Recent research showcased at the 19th European AIDS Conference in 2023 indicated that intermittent dosing of ART drugs increased the overarching rate of virological failure, leading to “concerningly higher” rates of resistance to this therapy. Although intermittent treatment may be beneficial in the short-term, shaping into the next-best option for those unable to obtain regular ART dosages, its long-term sustainability is undermined by these unintended, potentially life-threatening consequences. Even with the 67% coverage of ART for people with HIV reached by 2022, only 7% have obtained an undetectable (un-transmittable) status, speaking to the continued demand for full, regular ART dosages.

The primary preventative measure for HIV/AIDs is the usage of condoms, allowing for the practice of safe sex without the possibility of transmitting the virus. However, inflation has caused the price of condoms in Venezuela to escalate to over three times the monthly minimum wage. Education on HIV prevention is still stigmatized, especially for LGBTQ+ individuals, leading to an inability to navigate and employ fundamental safety measures.

Marginalized Communities

The presence of HIV/AIDS in Venezuela has disproportionately affected marginalized groups, highlighting the ongoing discrepancies in ART access. In 2022, there are an estimated 15,000 transgender individuals in Venezuela, with an HIV prevalence rate of around 35.8%, according to the Humanitarian Practice Network (HPN). Additionally, men who have sex with men (MSM) were found to have an HIV prevalence rate of 23.3%, contrasting the national 0.5% of the total population in Venezuela. Alongside other systemic barriers, many have noted the lack of enforcement of anti-discrimination laws instated throughout the Venezuelan health care system, leaving many LGBTQ+ individuals deprived of proper viral regimens.

The Warao people, the second-largest indigenous group in Venezuela, are another demographic experiencing the severity of the HIV/AIDs crisis. There is an overall prevalence rate of 10% among their population, although many doctors have suggested this rate may be as high as 35% among males. Removed from ART and other treatment measures that can properly manage the virus, many HIV-positive members of the community have ultimately passed away after developing end-stage AIDs.

Solutions for HIV/AIDS in Venezuela

Without acquiring the necessary ART from the government, many people with HIV in Venezuela have been forced to migrate to surrounding nations with more inexpensive treatment options, according to the HPN. And yet, as they relocated, another issue of xenophobia arose: while ART was now objectively more accessible, there were new barriers to treatment including health prejudice and discrimination.

In 2020, UNAIDS established a partnership with UNESCO to allow Venezuelan migrants “health education, prevention, and health promotion,” centering a future-oriented approach to ending the HIV/AIDs crisis. This collaboration emphasizes the physical and mental well-being of Venezuelan migrants, promoting sex education curriculums that prevent the onset of violence and discrimination. Activists have similarly focused on improving care for those living with HIV, such as Nilsa Hernandez, founder of Valientes Por La Vida (Brave for Life). A Venezuelan herself, she crossed the border to Brazil to continue receiving ART after being depleted of immunity for over two years. Hernandez hopes to support other migrants with HIV with guidance on adapting to life in Brazil, providing them with the necessary resources to navigate the country while obtaining access to viral regimens.

The rebuilding of Venezuela’s health care system—with international organizations continuously supporting migrants and other marginalized groups—reveals a hopeful path to mitigating HIV/AIDs in Venezuela by 2030.

– Eileen Lincoln

Eileen is based in Fairfax, VA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr