In the Caribbean, an estimated 230,000 men, women and children live with HIV (UNAIDS 2008). With an HIV prevalence rate second only to sub-Saharan Africa, AIDS is the leading cause of death among adults aged 15 to 44 in the region. Substantial socio-economic disparities compound the HIV epidemic as the highest-risk populations confront significant barriers of access to health information and services. Since CARISMA’s inception in 2005 the project has targeted its HIV/AIDS prevention efforts at those groups most vulnerable to new infections, including: disadvantaged youth, Spanish and Creole-speaking migrants, and sex workers. Now in its second phase, CARISMA has broadened its focus to include family planning, anti-stigma and discrimination campaigns as well as the general promotion of sexual health and reproductive rights.