Held every year on December 1st, World AIDS Day is a date for people to think about and act upon the global HIV epidemic. HIV continues to have a devastating impact on millions of people around the world including the Caribbean. While HIV infection can be prevented, HIV transmission continues to occur. Knowing your HIV status and safe sex is key to helping reduce the spread of AIDS in the African-American and Caribbean communities.
Here are some staggering facts:
1. While blacks represent approximately 14 percent of the U.S. population, they account for almost half of people living with HIV in the U.S. (46 percent, or an estimated 545,000 persons), as well as nearly half of new infections each year (44 percent, or an estimated 21,200 infections).
2. Approximately one in 16 black men will be diagnosed with HIV during their lifetime, as will one in 32 black women.
3. Among blacks, men account for 70 percent of new HIV infections. Women account for 30 percent.
4. An analysis by the Black AIDS Institute found that if black America were its own country, it would rank 16th in the world in the number of people with HIV ahead of Ethiopia, Botswana, and Haiti.
HIV/AIDS in the Caribbean
HIV-related stigma and discrimination are extremely common in the Caribbean. In some cases, prejudice towards people living with HIV is linked with homophobia; sex between men carries a high risk of HIV transmission and, as elsewhere, people in the Caribbean often associate HIV with homosexuality, despite the fact that the majority of infections occur through heterosexual sex.
In 2009 an estimated 17,000 people in the Caribbean became infected with HIV, and around 12,000 died of AIDS. After sub-Saharan Africa, the Caribbean has a higher HIV prevalence than any other area of the world, with 1 percent of the adult population infected.
With HIV, because its seen as a gay thing, theres a lot of shame. If someone finds out they are positive, theyre afraid that everyone will assume they are gay, so its best to keep it to yourself. HIV Positive man, Jamaica“
HIV prevalence amongst men who have sex with men (MSM) varies between Caribbean countries. In Cuba MSM account for 80 percent of all reported HIV cases. Dominica (70 percent), Trinidad and Tobago (20 percent) and the Dominican Republic (11 percent) report a high percentage of infection among this group. Homophobia and cultural taboos about sex between men are major barriers to reaching this group with prevention campaigns. A good example is Jamaica, where groups attempting to provide HIV-related services to men who have sex with men have faced harassment from both the public and the police. In November 2005, Steve Harvey, head of Jamaica AIDS Support – a group that works with gay and bisexual people affected by HIV was kidnapped and killed when it was discovered that he was homosexual.
In other cases, HIV is stigmatised because of general cultural taboos about sex, and unfounded fears that infection can be passed on through everyday contact.
Preventing HIV in the Caribbean
Numerous different approaches have been taken to preventing HIV in the Caribbean. Some programs have achieved significant success, but the barriers of poverty and insufficient resources and cultural taboos continue to limit HIV prevention throughout the region.
Condom use among men and women aged between 15-49 in the Caribbean has increased over the last few years. This is promising, as an increase in the use of condoms in the Dominican Republic, was accompanied by a decrease in HIV prevalence.28 However, for this to occur in other Caribbean countries prevention programs need to be scaled up, as condom use by both men and women is still less than 50 percent in nearly all reporting countries.
In Barbados and the Bahamas, a combination of increased voluntary counselling and testing services and improved access to antiretroviral drugs has helped to significantly reduce the rate of mother-to-child-transmission
There is still a long way to go before HIV and AIDS are under control in the Caribbean. Gaps exist in testing, treatment and prevention programs, and stigma and discrimination are having a devastating effect. National responses to the crisis are generally lacking, though often as a result of weak public infrastructures and human capacity, rather than a lack of political will. Additionally, monitoring and reporting of the epidemic is consistently poor, which makes it difficult to gain an understanding of the crisis and consequently holds back HIV prevention campaigns.
Here are some very simple things we can do to stop the spread of HIV/AIDS in our communities:
Get the facts Arm yourself with basic information: Are you at risk? How is HIV spread? How can you protect yourself? Take control You have the facts; now protect yourself and your loved ones. There are three essential ways to reduce your risk:
- Dont have sex (i.e., anal, vaginal or oral)
- Only have sex (i.e., anal, vaginal or oral) if youre in a mutually monogamous relationship with a partner you know is not infected
- Use a condom every time you have anal, vaginal or oral sex. (Correct and consistent use of the male latex condom is highly effective in reducing HIV transmission.) Put yourself to the test Knowing your HIV status is a critical step toward stopping HIV transmission, because if you know you are infected, you can take steps to protect your partner
SOURCES: Avert.org; CDC.gov
