Costa Rica
- Population: 4.2 million
- People living with HIV: 6,000 – 21,000
- People receiving ART: 1,850
The Epidemic
Costa Rica’s HIV/AIDS epidemic is especially concentrated in the groups exhibiting sexual risk behaviour and is considered at an incipient stage. Most cases, an estimated 84%, are attributable to sexual transmission. According to the Ministry of Health, sex between men is a major factor in the epidemic in Costa Rica, where more than half of AIDS cases in 1998–2002 were among men who have sex with men, a significant percentage of whom also have sex with women. Bisexuality is therefore a significant channel for HIV transmission into the wider population. Notably, AIDS cases and AIDS mortality have declined in Costa Rica after access to antiretroviral therapy was expanded. The prevalence of HIV infection was estimated to be 0.6% in 2003. The annual incidence has held steady over the last few years at 400–500, a situation that has been characterized as a steady-state epidemic. Factors that negatively impact the progression of the epidemic include: the fact that Costa Rica is a country with mobile populations, both for transit passage and for migrants (especially from Nicaragua and Colombia); sex tourism is growing, including the commercial sexual exploitation of children and, since Costa Rican society is considered to be more liberal than other countries in Central America (in the sense that it does not prohibit sexual diversity), men who have sex with men visit or live within Costa Rica more freely.
