Sex Differences in Advanced HIV Disease at Presentation in Care Among People Living With HIV in Latin America and the Caribbean.

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), 53% of all people living with HIV (PWH) globally were women and girls, and 45% of all new HIV acquisitions are among women and girls []. While the number of new acquisitions and AIDS‐related deaths has decreased more rapidly in women compared to men across all age groups, and women generally experience better HIV outcomes, with 91‐83%–78% meeting the 95‐95‐95 targets versus 83‐72%–67% in men, significant regional differences persist []. In Latin America and the Caribbean, despite a 28% decline overall in deaths from 2010 to 2023, the number of AIDS‐related deaths among women has increased in Costa Rica, El Salvador, Mexico, Panama, Paraguay and Peru []. Up to 2024, the decline in overall deaths from 2010 was reported at 31%, but the figure among women was not updated []. Around the world, policies for monitoring and controlling HIV have been tailored to the specific needs of each country based on HIV prevalence patterns and, in some settings, funding structures such as donor‐supported programmes []. Some countries are considered to have a generalized epidemic (>1% HIV prevalence in the total population), and others have a concentrated epidemic (total prevalence <1% but significantly higher in key populations) []. Most of the countries in Latin America and the Caribbean have concentrated epidemics; consequently, policies have largely focused on key populations (including men who have sex with men, sexual workers, transgender people), while females and girls are perceived as being at lower risk of HIV acquisition and are offered fewer screening and prevention services []. In addition, gender inequalities persist in Latin America, including gender‐based violence, discrimination, marginalization, poverty and denial of rights, as well as lack of sexual and reproductive health services []. Domestic or sexual violence, having a stable partner [], older age, lower educational attainment and unemployment [, ] are also associated with a higher risk of late HIV diagnosis in females.