Are we progressing on HIV/AIDS control? World AIDS Day is commemorated every year on December 1. This is a special day for raising awareness and celebrating achievements such as increased access to treatment and prevention services. Most importantly, it is a great opportunity to ask ourselves the following question: what are we doing about it?
Despite the gains associated with antiretroviral treatments (ART) over the last decade, HIV/AIDS remains the leading cause of death among young and middle-aged adults in the Caribbean. Belize is considered the third most affected country in the region, with an adult HIV prevalence estimated in 2.1%. The cumulative number of reported HIV infections in Belize from 1986 to the end of 2009 was 5,045. During 2009, the total number of new HIV infections was 365 indicating a relative decrease when compared with new 425 cases in 2008.
The objective of this press release is to provide an overview of the different actions taken by many actors in responding to the crisis: The need for a coordinated response to HIV and AIDS has long been recognized. Most nations have established National AIDS Commissions (NAC), strategic plans, legislation and HIV-related programs and services. In Belize, the NAC is mandated by the government to play a key role in effectively coordinating multi-sector programs and strengthening national response to the epidemic.
1) HIV Prevention:
Voluntary Counseling and Testing (VCT): Most countries in the Caribbean have opened VCT centers, and international agencies such as the United Nations and funds like the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) have provided grants to expand such services in a number of countries, being Belize one of them with a successful experience.
Preventing Mother-To-Child Transmission (PMTCT) - a combination of increased voluntary counseling and testing services and improved access to ARV drugs has helped to significantly reduce the rate of mother-to-child-transmission. Belize counts with excellent results in this area.
Stigma and discrimination in the Caribbean: HIV-related stigma and discrimination are 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 often associate HIV with homosexuality, despite the fact that the majority of infections occur through heterosexual sex.
Reflections on gender inequality: Gender violence is another shadowy, destructive force that blocks progress on controlling the spread of HIV. Violence makes women and girls more vulnerable to HIV. It makes it difficult or impossible for them to negotiate condom use and even saying no to sex. It prevents women from getting adequate care and treatment services and to prevent HIV infections.
2) HIV/AIDS Care and Treatment services:
Governments across the region provided ART to 51% of people in need in 2008 - up from just 1% in 2004. In Belize, a total of 630 persons were on free ART provided by the government at the end of 2008, with a 49% of ART coverage out of the total estimated population in need of treatment. By the end of 2009, a total of 855 persons were on ART and the coverage rate of the estimated population in need was 61.3% at the end of 2009.
3) The way forward:
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 negative effect. Monitoring and reporting of the epidemic is consistently poor, which makes it difficult to gain an understanding of the trend of HIV in the region.
Since 2001, the Caribbean region has received approximately US $1.2 billion in grants to fight HIV/AIDS. Donors meeting in New York last October announced funding of US $11.7 billion for the Global Fund to Fight AIDS, Tuberculosis and Malaria for the years 2011-2013. These financial resources will allow the Global Fund to further support countries as they work to meet the Millennium Development Goals (MDG) related to health. Belize will start the implementation of Round 9 in December 2010, with an overall goal of to “Halt the spread of HIV with a special emphasis on young people 15–24”.
What can be done for the Caribbean to achieve the Millennium Development Goals for HIV by 2015?
•We must speak and educate young people openly, if we want that prevention efforts will have impact and prevent new cases of HIV, for young people to be able to speak about love, sex and sexual orientations in an open, free and informed way.
•HIV must no longer be stigmatized. People living with HIV are productive citizens with the same right to protection by the law, access to health care and other services. In 2010, HIV is not about death, it is about people living and enjoying productive lives.
•We must encourage and support the many citizen groups that are vital to the response to HIV. These groups support individuals and families, taking care of children, and providing counseling, friendship and solidarity, protecting the most vulnerable.
The Caribbean countries will join the initiative launched by United Nations towards the vision of zero new HIV infections, targeting the “hot spots” where HIV is most likely to spread. Communities have to be mobilized to fight stigma. HIV testing and treatment must be integrated into primary health care for the family.
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