On February 14, 2001, the heads of state of the countries of the Caribbean made a pivotal decision: they agreed to form a regional partnership to fight against AIDS. The need for action had long been apparent. As a region, the Caribbean has one of the world’s highest levels of HIV/AIDS prevalence, second only to sub-Saharan Africa. The epidemic has spread among the heterosexual population, hitting young women particularly hard. AIDS today is one of the main causes of death in this region.
“The AIDS epidemic in the Caribbean has come to a critical point,” UNAIDS Director Peter Piot told the newly created Pan Caribbean Partnership against HIV/AIDS. “People who carry the virus cannot wait another decade. We must act now.” The Caribbean has pledged to bring down the number of new infections, to facilitate the creation of better public health tools, and to adopt a more comprehensive approach for treating infected people.
The partnership has increased funding for HIV/AIDS in the Caribbean. Similar to what occurred in Brazil 15 years ago, the Caribbean is now showing strong political leadership and social mobilization. The region is participating actively in the discussions for the new Global Fund for AIDS. In a few countries, there is talk of universal coverage for treatment of HIV/AIDS in the near future. In other countries, governments are requesting loans to pursue new strategies. According to a recent study conducted by the University of the West Indies, an effective response that provides care for the 360,000 people who carry the virus and promotes prevention would cost $260 million annually. This figure is 10 times the amount currently being invested.
In October 2001, the 10th International Conference of Persons Living with HIV/AIDS was held in Trinidad and Tobago. The purpose of this meeting was to make people with AIDS the main advocates in prevention campaigns and in the struggle for free and universal treatment and care. “Perhaps the main theme of this conference was stigma and discrimination,” said Yolanda Simon, coordinator of the Caribbean Network of Persons Living with AIDS. “We hope that one of the achievements has been opening up a dialogue that, once and for all, breaks up the conspiracy of silence that continues to mask the AIDS epidemic.”
UNAIDS reports have warned that the spread of AIDS among the heterosexual population in the Caribbean is mainly due to precocious sexual activity and multiple sexual partners. Surveys show that in some countries, 25 percent of all adults polled confess to becoming sexually active before 14 years of age, and 50 percent before 16 years of age. In some countries, the infection rate of teenage girls is five times higher than that of boys in the same age group, in part because these girls are having sexual relations with older men.
Though HIV prevalence rates vary considerably from country to country, they are alarmingly high in some cases. In Haiti, for example, an estimated 5 percent of the population is HIV-positive; in the Bahamas, the level is around 4 percent; and in Guyana and the Dominican Republic, 3 percent. Another factor that must be taken into account is that many people in the Caribbean are not aware that they carry HIV, either because it is too difficult to obtain a test or because they fear the social ostracism that a positive result would bring.
Should the objectives of the new Pan Caribbean Partnership be attained, 90 percent of young people between the ages of 15 and 24 will have gained access by 2005 to public services that reduce the risk of infection. This should make it possible to bring down the prevalence of HIV/AIDS in this age group by 25 percent. The partnership also set the goal of achieving a 50 percent reduction of mother-to-child transmission by the year 2003.