The problem

An estimated 33,000 people die from AIDS-related causes in the Latin America and Caribbean region each year. About 35% of people who are newly diagnosed with HIV in the region have advanced HIV disease (AHD), a more developed stage of infection in which a person’s immune system is severely weakened.

AHD puts a person at high risk of opportunistic infections like tuberculosis (TB), cryptococcal meningitis and histoplasmosis, among others. Point-of-care diagnostic tests for these diseases are available on the market but often not implemented in lower-level health settings and national health information systems do not usually capture information on preventable HIV deaths and their causes. Uptake of new treatments and other health care innovations is delayed in the Latin America and Caribbean region and research is needed to guide AHD delivery models to expand services.

Our response

New antigen-based rapid diagnostics can detect severe opportunistic infections, such as TB, histoplasmosis or cryptococcosis in people living with HIV, enabling earlier access to treatment. Recent World Health Organization guidelines also support shorter prevention and treatment options for many of these opportunistic infections. This project will help accelerate implementation of innovative AHD health technologies through catalytic donations and country review programs in 11 countries, implementation research in five countries and via supply chain interventions at PAHO. The project also supports community engagement activities to improve demand. Advocacy with partners and multiple stakeholders will help to continuously improve AHD services across project countries.