HIV/AIDS in Guatemala - National Response

National Response

According to the 2003 AIDS Program Effort Index, a tool developed by the United States Agency for International Development (USAID) to measure the collective effort put into an effective HIV/AIDS response by individuals and domestic and international organizations, Guatemala had a score of 52, which is an improvement from the score in 1996 but still slightly lower than the average score of 55 for Latin America and the Caribbean region. It ranked highest in the areas of political support and prevention programs.

The NAP has been responsible for surveillance of the epidemic since 1984. However, sentinel surveillance was not established until 1998. Over the past several years, the Guatemalan government has taken concrete steps to address the HIV/AIDS epidemic. A national strategic plan was produced for 1999 to 2003. At the end of 2005, Guatemala adopted a new national HIV/AIDS policy, along with a new strategic plan for 2006 to 2010. The plan charges the NAP with coordinating national responses, including those from civil society. UNAIDS works with the NAP, and USAID provides technical assistance to implement the national strategic plan and establish key universal access targets. Decentralization of AIDS care and prevention services throughout the country is an important priority.

In recent years, the NAP has improved communication with civil society and other institutions to coordinate national efforts. This has resulted in the establishment of NAP-led technical committees with multisectoral participation to address such issues as standardizing diagnosis, treatment, and care. Moreover, the Country Coordination Mechanism serves as an inter-institutional coordinating body, aimed at better implementing Global Fund projects. Guatemala is also implementing the Regional HIV/STI Plan for the Health Sector 2006–2015 of the Pan American Health Organization (PAHO). The Plan is designed to assist health services and systems in the Americas to more effectively respond to the HIV epidemic and prevent STIs.

Antiretroviral treatment (ART) coverage has expanded over the years, and currently, 76 percent of identified HIV-infected men and women who need treatment receive ART, according to the NAP. The recent WHO/UNAIDS/UNICEF report Towards Universal Access estimates that 52 percent of HIV-infected people who need treatment receive ART. However, because the expansion and decentralization of services has been slow, people living with HIV/AIDS (PLWHA) must travel long distances to obtain treatment, imposing cost burdens on them. There are major challenges in extending both prevention and care coverage outside the capital and other main cities. Furthermore, discrimination against PLWHA and vulnerable groups such as commercial sex workers and MSM remains a significant barrier to a more effective AIDS response in Guatemala. USAID has supported a national campaign focusing on the diversity of PLWHA to help break down barriers of stigma and discrimination (S&D) and promote respect for human rights related to HIV/AIDS.

Guatemala receives significant support from the Global Fund to expand prevention, care, and treatment activities among vulnerable groups and in priority geographic areas of the country. The objectives of the Global Fund are to expand prevention activities and ART services from the capital city to regions with the highest HIV incidence; to improve coordination among civil society organizations working in HIV/AIDS; and to reduce mother-to-child transmission of HIV by expanding voluntary screening and counseling for pregnant women. Bilateral donors, including USAID and European countries, also provide support for prevention, treatment, care, and health system improvement initiatives.