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Anales de la Facultad de Ciencias Médicas (Asunción)

versão impressa ISSN 1816-8949

An. Fac. Cienc. Méd. (Asunción) vol.55 no.2 Asunción ago. 2022 


End the AIDS Epidemic in Paraguay by 2030 - Quo vadis?

1Ministerio de Salud Pública y Bienestar Social, Programa Nacional de VIH/SIDA/ITS. Asunción, Paraguay.

HIV remains a major public health problem worldwide. According to calculations by the World Health Organization (WHO) and UNAIDS, at the end of 2020, some 37.7 million people infected with HIV in the world. In the same year, some 1.5 million people became infected, and 680,000 died of AIDS-related causes. It is important to consider that during 2020, 28.2 million people were receiving antiretroviral therapy worldwide and 73% of new cases received treatment. Currently, no region of the world has not been affected by this pandemic. In Latin America in 2020, 2.1 million 1.4 million-2.7 million people were living with HIV, while there were approximately 100,000 66,000-150,000 new infections. Paraguay has an HIV epidemic concentrated in certain population groups. In the general population, the prevalence of HIV infection is 0.5%, however, in 2020, a prevalence of 31.7% was found in trans women and 1.5% in women sex workers. In the MSM population (men who have sex with other men) the prevalence of HIV infection was 21.9% in Asunción and Central, 9.9% in Alto Paraná, and 1.6% in Caaguazú.

In this epidemiological context, incredible scientific advances have been achieved with a vast accumulated experience in terms of program execution; In addition to the scientific part and the experience, the following elements are of the utmost importance: political commitment, community activism, progress in human rights, global solidarity and the new resources derived from all of this have given us a historic opportunity to end the AIDS epidemic as a public health threat by 2030. Despite all that has been achieved to date, there is still a long way to go to achieve the ultimate goal: ending the AIDS epidemic.

UNAIDS has developed a rapid response approach to reach targets by 2030. "The targets include that 95 percent of all people living with HIV know their HIV status, that 95 percent of people who know they have the infection have access to treatment, and suppress the viral load of 95 percent of people on treatment. They also include reducing new HIV infections by 75 percent and achieving zero discrimination".

The first goal presents the opportunity for • people diagnosed with HIV to access care and achieve viral suppression; • People who test negative but are at risk are referred to prevention services. New HIV infections are expected to decline substantially, especially among the most affected population groups, and discriminatory laws and practices in health care are to be eliminated.

In Paraguay in 2017, 1,443 people with HIV were diagnosed and in 2020, 1,201 people with HIV. This 17% decrease in diagnoses could be due to the effect of the COVID19 Pandemic, such as confinement, suspension of attention in general clinics, deviation of target personnel to areas of reinforcement in the attention against COVID19, which generated difficulties in access to HIV diagnosis in health services, however, it is important to evaluate the trend in the number of new diagnoses in the following years to have adequate information about the evolution of the epidemic in Paraguay. However, in that same year, 9 children born to mothers with HIV were diagnosed, being the mother-child transmission route, which implies that Paraguay still presents important challenges to achieving early detection of HIV infection in pregnant women so you can prevent infection in children.

About the following objectives "that 95 percent of people who know they have the infection have access to treatment and suppress the viral load of 95 percent of people on treatment", 2020 43% and 19% respectively accessed treatment and viral load suppression in Paraguay. The gaps identified in the care cascade could have different explanations. First, they are possibly due to problems in adherence to antiretroviral treatment and its abandonment. This indicates that Paraguay must strengthen access to treatment not only as an essential care strategy for people living with HIV but also as a prevention strategy since people with undetectable viral loads do not transmit the virus to their partners.

However, it is important to recognize that, despite the existing gaps, the country has a trajectory of improvement in access to antiretroviral treatment in Paraguay, which increased from 32.3% to 44.0% in the last 5 years, which means that 4,000 more people have started treatment in this period.

In summary, it is necessary to carry out specialized and high-impact prevention; speed up HIV testing; strengthen treatment and retention programs at the regional level, as well as programs to combat discrimination; and achieve a constant commitment to the respect, protection and promotion of human rights and gender equality. If fulfilled, the AIDS epidemic would end as a threat to public health.


1. ONUSIDA. Estadísticas mundiales sobre el VIH. 2021. Disponible en: ]

2. ONUSIDA. Latin America. 2022. Disponible en: ]

3. Aguilar G. Boletín sobre la infección por el VIH y las ITS en Paraguay, 2020 ANÁLISIS EN LA POBLACIÓN GENERAL Y EN LOS GRUPOS DE POBLACIÓN CLAVE 2022. Disponible en: ]


5. Garcia-Fernandez L, Novoa R, Huaman B, Benites C. Continuo de la atención de personas que viven con VIH y brechas para el logro de las metas 90-90-90 en Perú. Rev Peru Med Exp Salud Publica 2018;35(3):491-6. Disponible en: ]

6. Aguilar G, Kawabata A, Samudio T, Rios-Gonzalez CM, Aguilar G, Kawabata A, et al. Comportamiento epidemiológico del VIH en Paraguay, 2017. Rev Salud Publica Parag. 2018;8(2):9-14. Disponible en: [ Links ]

Received: July 08, 2022; Accepted: July 12, 2022

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