Participants at the six-day International AIDS Conference, gathering more than 22,000 people, said it was very complicated for men to access AIDS tests and potential treatment in the region with the second highest figure of HIV/AIDS cases worldwide at one percent of the population.
The figure represents more than a quarter of a million people and is second only to Sub-saharan Africa.
Half of Caribbean men have had multiple sexual contacts with a member of the same sex, and between 80 and 90 percent have had sexual relations with another man at least once, according to figures from psychologists in Jamaica and Trinidad and Tobago.
"It will not be possible to have effective HIV/AIDS prevention in the Caribbean if we don't decriminalize (sexual) relations between men," said Michael Kleinmoedig, a West Indian journalist and social activist.
Stigma and discrimination, a problem worldwide for people with HIV/AIDS, were particularly bad in the region.
"Human rights are limited for those who have (sexual) relations with men. They are not recognized as a valid group by law and many countries silence them and deny them their rights," Kleinmoedig said.
Many of them are married and have children.
Moreover, some 20 percent of those with HIV in the region, mainly women, contracted the virus through their partner, said Peter Figueroa, director of epidemiology and AIDS for the Jamaican government.
On a rare positive note for the region, he highlighted universal access to AIDS treatment in Cuba.
Some 33 million people around the world are infected with HIV, 90 percent of whom live in developing countries.