By: Dr. Jo Ann Santiago, Triple-S Associate Medical Director

 

What’s happening with HIV in Puerto Rico?

Puerto Rico continues to face many challenges in the fight against HIV. Although treatments have improved and there is more information available, the island still has one of the highest HIV rates in the United States and its territories. This situation constitutes a public health emergency that requires immediate attention and a renewed focus on prevention strategies.

Currently, over 17,000 people are living with HIV in Puerto Rico, and around 500 new cases are diagnosed each year. What’s concerning is that many people only find out they have HIV when the infection is already in its advanced stages, which makes treatment more difficult and increases health risks.

Who is at risk?

Certain groups are more likely to contract HIV, including:

  • Men who have sex with men (MSM): They account for nearly 60% of new cases each year.
  • People who use injectable drugs: They represent 20% of new diagnoses, a higher rate than in many parts of the U.S.
  • Transgender women: It is estimated they are 34 times more at risk than the general population.
  • Sex workers: Often living in difficult conditions and facing discrimination.
  • Youth aged 13 to 29: This is the fastest-growing age group for new HIV cases.

What makes HIV prevention difficult?

Several factors in Puerto Rico complicate prevention efforts:

  1. Economic challenges: Many people lack access to healthcare or education, especially in rural or low-income areas.
  2. Stigma and discrimination: Misconceptions about HIV still exist, which makes some people afraid to get tested or seek help.
  3. Natural disasters: Hurricanes and earthquakes have disrupted healthcare services, leaving many without access to treatment.
  4. Injectable drug use: Sharing needles remains a significant transmission route, and harm reduction programs are limited.

What can be done to prevent HIV?

To protect more people, several strategies need to be strengthened:

Comprehensive sex education
It’s essential to teach young people early on about their bodies, sexuality, and how to take care of themselves. Education should be clear, science-based, and age-appropriate.

Access to prevention methods
Condoms and medications like PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) are highly effective in preventing HIV. They should be available for free or at low cost, especially in vulnerable communities.

Harm reduction programs for people who use drugs
Exchanging used needles for new ones, offering counseling, and helping support addiction recovery to prevent new infections.

Testing and early diagnosis
The earlier HIV is detected, the better it can be treated. Bringing rapid testing to schools, communities, and public events allows more people to learn their status.

Fighting stigma
It’s crucial to talk about HIV with respect. Campaigns should help change negative perceptions, support those affected, and encourage everyone to care for themselves without fear or shame.

What else is needed to improve the situation?

  • Joining forces: Government, private sector, community organizations, schools, health centers, communities, and families must work together.
  • More investment: Prevention is cheaper and more effective than treating the disease in its later stages.
  • Listening to communities: The most affected communities should be part of the solution by helping design, implement, and evaluate prevention strategies.
  • Using technology: Digital platforms and social media can help inform, educate, and dispel myths about HIV.

The fight against HIV in Puerto Rico needs a renewed commitment to prevention. Only by working with clear plans, real information, and a focus on the most affected populations can we control this disease that has impacted so many families. The time to act is now—to strengthen every part of the prevention effort and build a future with very few new cases.

Know your status: Getting tested saves lives!

Getting an HIV test isn’t something to fear. It’s a way to care for yourself and the people you love. Your health is power.

Take the step—do it today!

 

 

TSS-MKT-5867-2025-B

May 1, 2025