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Review
. 2025 Apr 11:54:103070.
doi: 10.1016/j.pmedr.2025.103070. eCollection 2025 Jun.

HIV pre-exposure prophylaxis in Latin America: Public policies, healthcare systems and human rights

Herta de Oliveira Alexandre  1 , Sofia Gruskin  2 , Adriano Massuda  3 , Maria Rita Bertolozzi  4 , Aluisio Cotrim Segurado  1
Affiliations
Review

HIV pre-exposure prophylaxis in Latin America: Public policies, healthcare systems and human rights

Herta de Oliveira Alexandre et al. Prev Med Rep. .

Abstract

Objective: In concentrated HIV epidemics, combination prevention is recommended for key populations, including pre-exposure prophylaxis (PrEP). Our study analyzes PrEP's integration as a public policy in Spanish, Portuguese and French-speaking Latin American countries.

Methods: We reviewed documents published through December 2024 from Ministries of Health, international organizations, relevant non-governmental organizations, and collected data on countries' human development index (HDI), healthcare system organization/expenditures, assessing compliance with human rights standards.

Results: PrEP policies are described in 16 out of 20 countries reviewed. In Argentina, Brazil, Chile, Colombia, Cuba, El Salvador, Haiti, Mexico and Peru, PrEP is provided to key populations. In Costa Rica, Guatemala, Panama and Paraguay, PrEP is available through research or pilot projects. In the Dominican Republic, Ecuador, and Honduras, PrEP is being scaled up, but specifics remain unclear. Other countries have limited access to PrEP or no available information. Broad PrEP distribution occurs generally in countries with higher healthcare expenditures relative to gross domestic product and high HDI. However, its distribution free of charge is not correlated with universal access to public healthcare. Attention to human rights standards was noted in policies from Argentina, Brazil, Chile, Cuba, Ecuador, El Salvador, Haiti, Mexico, Peru and Uruguay, covering rights to healthcare access, information, informed decision-making, participation, equality, privacy, accountability, and benefits of scientific progress.

Conclusions: As of December 2024, PrEP policies exist in some Latin American countries, but are limited or unavailable in others. Achieving universal healthcare and adhering to human rights norms can improve access/use of this essential HIV prevention tool.

Keywords: HIV; Healthcare expenditures; Healthcare systems; Human rights; Latin America; Pre-exposure prophylaxis.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
HIV Pre-exposure Prophylaxis Implementation Status in Spanish, Portuguese, and French-speaking Latin American Countries as of December 2024. footnote: NGOs: non-governmental organizations; PEPFAR: The United States President's Emergency Plan for AIDS Relief.
See this image and copyright information in PMC

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