The Caribbean region has the second highest prevalence HIV rate in the world after sub-Saharan Africa, with an estimated adult prevalence rate of 1 percent and approximately 250,000 people living with HIV. The HIV/AIDS epidemic is concentrated both geographically and by sub-populations. Five out of the 11 countries (i.e., Jamaica, Trinidad & Tobago, Guyana, Suriname, Bahamas, and Barbados), covered by the President's Emergency Plan for AIDS Relief (PEPFAR) Caribbean Regional Program, account for approximately 95 percent of all new HIV infections. Sexual intercourse is the predominant mode of HIV transmission in the region, and data show that key populations (KPs) such as men who have sex with men, transgender persons, and sex workers bear the highest HIV/AIDS burden in the Caribbean. Rates of HIV infection in these sub-populations are among the highest in the world. Stigma and discrimination in the Caribbean is pervasive and severely limits KP access to critical life-saving services and drugs. This lack of access increases the risk of both acquiring HIV and transmitting it to one’s sexual partner(s).

In 2015, the U.S. Agency for International Development (USAID) Eastern and Southern Caribbean (ESC) launched its new Caribbean HIV/AIDS Prevention and Elimination (HoPE) Project. HoPE is a 5-year, $46 million health project aligned with USAID/ESC’s Regional Development Cooperation Strategy (RDCS, 2015-2019) goal of: “Safer, more prosperous Caribbean Communities.” The HoPE project is implemented in Jamaica, Trinidad & Tobago, Guyana, Suriname, Bahamas, and Barbados and aims to “Increase the use of HIV services to reduce the rate of HIV transmission in target key population communities.” The ultimate purpose of the HoPE project is to improve KP health outcomes, prolong lives, and reduce KP’s capacity to transmit the virus to their partners – ultimately setting the course for accelerated attainment of an AIDS-free generation.

Activities

• Improve quality of prevention, care, and treatment services for KPs
• Increase KPs access to and use of high quality prevention, care, and treatment services
• Improve enabling environment for delivery of sustainable HIV/AIDS services for KPs
• Expand and improve the targeting of HIV prevention, care, and treatment efforts to address vulnerabilities at the individual, community, and structural levels
• Support national and regional partners to implement and evaluate stigma reduction programs
• Provide capacity building support for LGBTI communities to better support and service members