An estimated 230,000 people were living with HIV in the Caribbean in 2007 (about three quarters of them in the Dominican Republic and Haiti), while an estimated 20,000 people were newly infected with HIV, and some 14,000 people died of AIDS during this period. HIV surveillance systems are still inadequate in several Caribbean countries, but available information indicates that most of the epidemics in the region appear to have stabilized, while a few have declined in urban areas. The latter trend is especially evident in the Dominican Republic and Haiti. In the Dominican Republic, for example, HIV prevalence declined from 1.0% in 2002 to an estimated 0.8% in 2007.

The main mode of HIV transmission in the Caribbean is unprotected heterosexual intercourse, paid or otherwise. However, sex between men, although generally denied by society, is also a significant factor in several national epidemics.