World AIDS Day 2025 - Q&A with Dr. Robert Paulino-Ramírez
Published in Social Sciences, Sustainability, and General & Internal Medicine
About the Researcher
How does your research relate to the SDGs?
My research aligns closely to the Sustainable Development Goals (SDGs), particularly 3, 10 and 17, which are aimed to advocate for good health and well-being, reducing inequalities, and establishing partnerships for the goals. Through studies on HIV prevention, stigma reduction, and access to care among vulnerable populations, I aim to strengthen equitable health systems and advance the UNAIDS 95-95-95 targets, focused in LMIC countries. Our implementation projects, such as stigma-reduction interventions (FRESH and its Spanish version CREEV), PrEP/PEP/DoxyPEP adoption studies, and evaluations of diagnostic innovations for HIV and TB, contribute to reducing health inequities and promoting universal access to quality healthcare.
Why did you decide to go into your field of research?
I chose to focus on HIV and infectious diseases because they reveal the profound intersection between biology, social justice, and human dignity. Early in my medical training, I witnessed how stigma, misinformation, and systemic barriers could be as harmful as the virus itself. This realization inspired me to pursue research that not only improves diagnostics and prevention tools, but also transforms the way healthcare systems treat people—with respect, compassion, and evidence-based care.
How has knowledge of HIV and AIDS developed over the course of your career?
When I began my career, HIV research in the Caribbean primarily focused on treatment access, and epidemiological studies to untangle the epidemic. Over time, the field has evolved to include implementation science, behavioral and structural determinants, and community engagement as essential pillars of the response. We now understand that ending the HIV epidemic requires integrating biomedical advances, what we called an “HIV Toolbox”—such as PrEP, PEP and recently the scientific breakthrough in HIV prevention; the long-acting ART—along with social interventions that address stigma, gender inequities, and mental health. The shift from a purely clinical model to a people-centred and equity-driven approach has been transformative.
What challenges do those from low- and middle-income countries in particular face?
One of the main challenges, and in my opinion the most crucial, is the lack of research funding. Research in most Latin American countries is still seen as a luxury, not a necessity. Many researchers in the Global South have to rely on external funding mechanisms that don't always reflect local needs and don't close the existing knowledge gap in those regions. There is also the persistent issue of brain drain and insufficient local research capacity. Moreover, community mistrust in science and health leaders, stigma, and structural inequalities—rooted in poverty and discrimination—continue to undermine HIV prevention and care. Despite these barriers, local innovation and resilience have driven remarkable progress, particularly through South-South collaborations and community-based approaches.
What are your hopes for progress in the future?
My hope is that we can have a future where we eliminate HIV, but first we must ensure that people have access to life-saving treatments. Even though programs offer these treatments, the stigma is still so intersecting that even healthcare providers don't realize its impact. A world where we can work alongside communities to provide answers to their needs—nothing about them without them. I envision a new generation of regional researchers leading locally driven studies, ensuring that evidence from the Global South informs global policy. Ultimately, the goal is not only to end the HIV epidemic but also to build more just, inclusive, and compassionate health systems that reflect the dignity of every person.
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