Preventable yet persistent: 14 years of HIV diagnoses in Chile reveal gaps in the prevention of vertical transmission

Abstract

Introduction: Human Immunodeficiency Virus (HIV) remains a significant public health concern at both global and national levels, despite advances in antiretroviral therapy and prevention strategies. In Chile, although robust policies such as the GES system are in place, a critical gap persists in integrated longitudinal analyses that would enable a comprehensive understanding of HIV epidemiological trends across demographic and temporal variables. Methods: A quantitative, observational, longitudinal, and descriptive study was conducted using secondary data from the Public Health Institute. Confirmed diagnoses were analyzed using descriptive statistics by year, sex, age, and region. Results: During the study period, 70,349 individuals were diagnosed with HIV in Chile. A marked concentration was observed among men (83.8%) and young populations (15–29 years), with peak values between 2018 and 2019 followed by a subsequent decline. However, the most critical finding was the confirmation of 80 cases in infants under one year of age, along with 154 cases in children under five. Discussion: Our findings reveal failures in the prevention of mother-to-child transmission, a largely preventable condition, thereby calling into question the real-world effectiveness of current public health strategies. Conclusion: Although overall epidemiological patterns remain consistent with expectations, the persistence of cases in infants under one year of age represents the most significant concern, highlighting structural gaps in the implementation of public policies. Addressing this issue requires strengthening timely diagnosis in pregnant women and ensuring effective preventive interventions.