HIV/AIDS in Bolivia affects less than 1% of the population. The U.S. Agency for National Development reports that this puts the country at the lowest in HIV prevalence within Latin America and the Caribbean region. Officials reported the first diagnosis of HIV in 1985. Although HIV prevalence has remained low, it disproportionately affects marginalized populations. Two populations that are disproportionately affected are men who have sex with other men (MSM) and transgender women. Societal stigma and prejudice against these groups have resulted, necessitating a response that addresses these specific issues. According to UNAIDS, infection rates have steadily declined since 1993 and reached about 0.16 per 1,000 people as of 2024. Death rates have also steadily declined since 2011. As of 2024, the death rate is about 0.04 per 1,000 people.

Background on HIV/AIDS

According to the World Health Organization (WHO), HIV is a virus that targets the immune system by attacking white blood cells. Bodily fluids from an infected person can spread HIV. This can include blood, breast milk, semen and vaginal fluids. Antiretroviral therapy treats HIV. Without treatment, HIV can develop into AIDS.

The Response

The United Nations developed UNAIDS, the Joint Programme on HIV/AIDS, to lead the global effort to eradicate it. UNAIDS’ main focus is to advocate for affected communities, provide technical support, collect data on the illness and assist countries that are most affected. The joint program in Bolivia has carried out various efforts to address HIV through prevention, testing and treatment. Community-based programs, supported by the Joint Programme, have provided access to HIV prevention packages in 2023 to MSM and transgender women. Furthermore, the Triple X (Xpressa, eXplora and eXige) campaign has run a social media initiative aimed at increasing condom usage. It has reached 111,000 young people and resulted in a 12% increase in condom distribution within the public health system in one year. Additionally, the government has developed national guidelines for pre-exposure prophylaxis with support from the World Health Organization (WHO) following its adoption of the preventive drug regimen.

Impacts of People in Poverty With HIV

People who live with HIV/AIDS in Bolivia face conditions conducive to poverty, such as food insecurity and unstable livelihoods face major obstacles in managing their treatment, indicating a connection between economic struggle and HIV-related health outcomes, according to a study performed by Palar and a team. The Pan American Health Organization (PAHO) states that more than a third of Bolivia’s population lived below the national poverty line in 2021, indicating economic strain that reflects the hardships patients described in the study.

Palar’s team determined that time conflicts with their jobs prevented many participants from getting their doses, the stigma of HIV caused the loss of jobs and that many HIV patients struggled to balance their treatments with expectations from informal or unpredictable employment. The study observes that these conditions directly impact antiretroviral adherence, especially for those who lack a stable income or consistent access to food. The team also notes that a food-assistance pilot program has helped ease these pressures through improving patients’ nutritional stability. This has helped patients take their medication correctly.

Addressing Disparities and Prejudices

Fighting HIV/AIDS in Bolivia importantly involves addressing the disparities within the populations it affects and the prejudices surrounding the disease. Capacity-building training and catalytic funding have supported civil society organizations in Bolivia to strengthen the HIV response, address stigma and discrimination and protect human rights. As UNAIDS reported, the Bolivian Network of People Living with HIV and the Ministry of Health have introduced a pulsometer, a pilot stigma and discrimination self-assessment tool, to gather data on stigma and discrimination directed toward people living with HIV and key populations within the healthcare system. This aims to address barriers to accessing services.

In 2022, officials created an essential care standard for vulnerable communities and integrated it across 3,000 health facilities. As UNAIDS outlined, this protocol includes guidelines that prevent stigma, ensure adherence to care and diagnosis standards for HIV and promote condom use. In an effort to decriminalize HIV transmission, REDBOL and the community-centered organization Asociación Un Nuevo Camino have created a project to modify the 2008 HIV law. Advocates organized social dialogues to pressure Congress.

Looking Ahead

Although HIV is not an epidemic among the general population in Bolivia, it is prevalent within concentrated communities. The government and external organizations have made consistent efforts to address and treat this disease. HIV carries significant societal stigma and prejudice; as such, the response has acknowledged discrimination against marginalized groups. The response has addressed the disease itself and has also worked to undo prejudice and discrimination toward marginalized communities.

– Sasha Banaei

Sasha is based in San Diego, CA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr