Until recently, Caribbean states characterized the HIV & AIDS epidemics as generalized, rather than concentrated among high-risk populations. This was largely because of stigma and discrimination against vulnerable populations. As a result, an effective response to the spread of the virus among groups such as sex workers, and from sex workers to the wider population, has been lacking. The consequences are striking: for example, in Guyana, Jamaica, and the Dominican Republic, HIV prevalence among female sex workers is estimated to be 17%, 5%, and 2% respectively. By comparison, overall adult prevalence is much lower in all three countries, ranging from 0.9% (Dominican Republic) to 1.7% (Jamaica).
Where there are programmes, these have traditionally been aimed almost exclusively at female sex workers. However, the sex worker community also includes men who sell sex to women, men who sell sex to men, and transgender sex workers.