Bolivia

Key Results in 2022-2023

New evidence and capacity building of healthcare providers in prisons improved access to HIV services among people in prisons.
Communities were empowered to play a pivotal role in expanding HIV services and improving the sustainability of the HIV response.
A pilot stigma and discrimination self-assessment tool introduced in the healthcare system help generate critical data to reduce stigma and discrimination towards people living with HIV and key populations.

Joint Programme Results

In 2022-2023, Bolivia continued to scale up HIV prevention, testing and treatment services for key populations with significant support from the Joint Programme. For instance, 13 592 men who have sex with men and 1746 transgender women accessed combination HIV prevention packages in 2023 through community-based programmes supported by the Joint Programme (UNDP). Additionally, the Tripple X (Xpresa, eXplora, eXige) social media campaign aimed at increasing condoms usage reached 111 000 young people and resulted in a 12% increase in condom distribution within the public health system in a year (UNFPA). Following the Government’s adoption of pre-exposure prophylaxis (PrEP), national guidelines for PrEP were developed with support from the Joint Programme (WHO).

A situation analysis of HIV services in prisons revealed that drug use was one of the main risk factors for HIV transmission among people in prisons. It also showed that although all prisons provide HIV treatment services to people living with HIV, some of the prisons did not offer rapid HIV tests. Additionally, the majority reported low adherence to antiretroviral treatment due to multiple factors including social, economic and individual factors. In response to the low number and capacity of health professionals in penitentiary facilities, capacity building initiatives implemented by the Joint Programme further strengthened HIV services and care for people living with HIV in prisons, including those using drugs, and promoted their human rights (UNODC).

HIV incidence per 1000 uninfected populations

Source: AIDSinfo

AIDS mortality per 1000 population

Source: AIDSinfo

Progress towards 95-95-95 targets

Source: AIDSinfo

Community-based initiatives continued to play a major role in improving access and adherence to HIV services. For instance, 1023 people living with HIV accessed community-led support services in 2023 ensuring their adherence to treatment, thanks to the Joint Programme’s support to civil society organizations (UNDP). As part of the Soy Clave regional initiative, civil society organizations in Bolivia were empowered through capacity building training and catalytic funding to scale up the community-led HIV response; address stigma, discrimination and human rights violations; and advocate for social contracting (UNAIDS Secretariat).

A pilot stigma and discrimination self-assessment tool (Pulsometer) was rolled out in partnership with the Bolivian network of people living with HIV (REDBOL) and the Ministry of Health to collect critical data on stigma and discrimination towards people living with HIV and key populations in the healthcare system, and thus address the barriers to access services (WHO, UNAIDS Secretariat). In 2022, an integral care standard for LGBTQI+ populations was developed and is now implemented in 3000 health facilities. This comprehensive standard incorporates guidelines aimed at preventing stigma, ensuring adherence to care and diagnosis protocols for HIV, and consistently promoting condom use within the LGBTQI+ community (UNFPA). Finally, working towards decriminalizing HIV transmission, REDBOL and the community-based organization Asociación Un Nuevo Camino (ASUNCAMI) developed a proposal to modify the 2008 HIV Law. While no consensus has been reached yet, social dialogues were organized to leverage support from Senators of the Congress.

To further expand HIV services and strengthen the sustainability of the HIV response in Bolivia, US$ 13 million was mobilized from the Global Fund for the 2023-2025 period.