PORT-OF-SPAIN, Trinidad & Tobago: The Caribbean has made important progress in the HIV/AIDS fight, with a 43 per cent reduction in AIDS-related mortality between 2001 and 2008, and an 18 per cent reduction in new HIV infections among children over the same period.
There’s also been significant expansion of programs to prevent mother-to-child transmission of HIV, with four countries reaching 95 per cent coverage, statistics show.
But stigma and discrimination, homophobia and a punitive legal environment continue to undermine efforts to reach universal access goals towards HIV prevention, treatment, care and support across the Caribbean.
That was the subject of a recent UNAIDS-sponsored meeting in Trinidad where representatives of government and civil society, people living with HIV, UN agencies and development partners from across the Caribbean met to review progress made towards achieving universal access to HIV prevention, treatment, care and support targets.
Political leaders were candid about the challenges and underscored the need to engage young leaders and do things differently as the AIDS response enters a new era.
“Fear, denial, ignorance, stigma and discrimination are still very prominent in the region. It is a barrier to condom use, even accessing HIV treatment and care,” said Rodger Samuel, Minister in the Office of the Prime Minister.
“The old approaches do not seem to be working, especially with the new generation. If we do not get our youth involved, ‘getting to zero’ will be an immensely hard task.”
There are an estimated 260,000 people living with HIV in the Caribbean. Less than half of those in need of antiretroviral treatment are receiving it.
Overall, HIV now affects more women than men in the region. However, there is considerable variation between countries. For example, 60 per cent of people living with HIV in the Bahamas are women. But in Cuba and Suriname, 69 per cent of people living with HIV are men.
“The HIV response shines a spotlight on inequality and violations of human rights, and compels us to act,” said UNAIDS Deputy Executive Director, Management and External Relations, Jan Beagle. “We must remove punitive laws that are blocking access to critical HIV services. The law should work for the HIV response, not against it.”
There are 11 countries in the region that criminalize sex between people of the same sex, and 13 that criminalize sex work. Five countries, territories and areas continue to impose restrictions on the entry, stay and residence of people living with HIV.
Participants also discussed the need to increase investment in stigma and discrimination reduction programs to secure the rights of people living with HIV. Kinsley Reid, Coordinator for the Greater Involvement of People Living with HIV, Jamaica, emphasized this by saying “people living with HIV need more than medicines”.
During the last decade, the Caribbean region received more than US$1.3 billion in external funding for HIV. While some countries already fund their national programs entirely from domestic resources, others will be under increasing pressure to reduce program delivery costs and secure new resources as current sources of funding decline.
Director of the UNAIDS Regional Support Team for the Caribbean, Ernest Massiah, said it will be imperative to clearly identify the efficiencies in the region, and “be ruthlessly honest about dropping what doesn’t yield us results”.