A summary on the current status of AIDS in the Caribbean was presented at the Eighth Annual General Meeting of the Pan Caribbean Partnership against HIV and AIDS (PANCAP) which was held on 29-31 October 2008, in Montego Bay, Jamaica, under the theme, Leadership: Uniting Vision and Purpose.

The three-day meeting attracted some 170 registered and specially invited guests drawn from 29 countries of the English, Dutch, French and Spanish Caribbean, 33 regional agencies, 15 bilateral and multilateral agencies and 10 development partners.

The current status of HIV and AIDS in the Caribbean was presented as follows:

"The Caribbean has the second highest HIV prevalence rate in the world after sub-Saharan Africa. An estimated 230,000 persons in the Caribbean are living with HIV and AIDS, which is one of the leading causes of death among persons in the 25-44 age group.

The HIV epidemic in the Caribbean is due mainly to heterosexual transmission, although transmission occurs through homo/bisexual intercourse, mother-to-child and injecting drug use.

The epidemic in the Caribbean can be described as “ generalized”. However, during recent times, some countries in the region namely Haiti, Dominican Republic, The Bahamas and Barbados have recorded significant declines in HIV rates among antenatal attendees. In sub-populations such as men who have sex with men (MSM), and commercial sex workers (CSW), HIV infection rates are disturbingly high.

The Caribbean has responded to the epidemic at the regional level as well as the national level. At the regional level the Heads of Government established the Pan Caribbean Partnership against HIV and AIDS to lead the regional HIV and AIDS response. The CRSF was developed and significant funds raised to support the regional response. Country level responses have realized some success. For example, there have been gains in reducing HIV transmission from mothers to their babies; there is dramatic decline in mortality and morbidity; HIV testing and counselling are widely available; and high level of awareness and condom use has increased.

Despite the tremendous achievements, sexual patterns in the Caribbean contribute to the continued spread of HIV. Many persons are at increased risk of infection due to social vulnerability arising from poverty, illiteracy, unemployment, gender inequity and sexual orientation. The Caribbean response to HIV has also been challenged by the lack of technical capacity to manage HIV programmes and deliver high quality prevention programmes to vulnerable populations and young people. Another major challenge is identifying the many persons infected with HIV who are unaware of their status. The absence of an enabling environment creates serious problems for persons who are HIV positive and in need of services.

As a region, controlling the spread of HIV requires greater emphasis on prevention. This strategy can be facilitated by more enlightened policies. There is need to: Expand HIV testing; educate in and out of school youths; promote positive images; promote prevention options such as abstinence, condoms (male and female), fidelity, voluntary counselling and testing, and behaviour change communication."

 

The meeting discussed the new developments in the areas of prevention, care and treatment, especially the failures of vaccines and microbicides to prevent the transmission of HIV infection. It also discussed the results of recent trials that male circumcision in high prevalence settings significantly reduces the chance of men acquiring HIV infection. Additionally, the meeting discussed the evidence that combination prevention, such as ensuring safe blood supply; expanding voluntary counselling and testing; promoting behaviour change; ensuring access to prevention commodities and services, works. Also discussed were the impact of new antiretroviral therapies on improving health of persons living with HIV and AIDS by as much as two decades.

Overall it reaffirmed the need to focus on the tried and proven means of prevention, especially focusing on a combination of methods, as no one method by itself is effective.
 

Source: PANCAP Communications Unit