HIV/AIDS has spread rapidly in Nicaragua during the past five years, and the epidemic is on its way to becoming a public health emergency. After years of downplaying the magnitude of the situation, the government has finally turned its attention to addressing HIV/AIDS, as evidenced by the recent publication of the much-awaited 2006–2010 national strategic plan on HIV/AIDS.

However, according to the Public Health Watch report HIV/AIDS Policy in Nicaragua: A Civil Society Perspective, Nicaragua must take more incisive, comprehensive, and systematic measures. The government must create a mechanism for monitoring and evaluating its progress toward preventing and controlling HIV/AIDS; develop implementation guidelines to coordinate national and international efforts, including those of civil society organizations; and conduct a comprehensive national HIV-prevalence survey, which would provide reliable data on the extent of the spread of HIV.

In addition, several factors are preventing full integration of HIV/AIDS treatment and prevention services, according to the report. Hospitals frequently lack the capacity and staff to properly care for people living with HIV/AIDS, and services remain highly concentrated in the capital, with serious gaps in coverage in rural areas. The range of available prevention services is also limited by cultural norms, which foster discrimination against sex workers and men who have sex with men—two groups at elevated risk for HIV.

In order to strengthen the national response to HIV/AIDS, the report recommends several strategies, including: increasing the effectiveness of the Nicaraguan Commission to Fight AIDS to coordinate and monitor HIV/AIDS activities and to allow meaningful participation of civil society in policy processes; implementing a comprehensive epidemiological surveillance system to identify high-risk groups and developing programs to target these groups with prevention, treatment, and care services; building the capacity of the health care sector to improve the delivery of HIV/AIDS-related services; and improving legal protection for people living with HIV/AIDS.

The complete report is available for download below.