The Caribbean Public Health Agency (CARPHA) was established by the Caribbean Community (CARICOM) by combining five Caribbean Regional Health Institutes (RHIs): The Caribbean Environmental Health Institute (CEHI)
The Caribbean Epidemiology Centre (CAREC); The Caribbean Food and Nutrition Institute (CFNI); The Caribbean Health Research Council (CHRC)
The Caribbean Regional Drug Testing Laboratory (CRDTL).

World AIDS Day: Know your status, Get Tested, End AIDS

The Caribbean region joins the global effort to ensure that no child is born with HIV or congenital syphilis. To date, six CARPHA member states have succeeded in being certified for eliminating the Mother to Child Transmission of HIV and syphilis.

CARPHA Executive Director Dr C James Hospedales said, “although significant gains have been made to turn the tide against this globally devastating disease, new HIV infections in the Region totalled 15,000 in 2017. More than 9,500 persons are reported to have died from AIDS-related illnesses in the Caribbean.” He further stated, that challenges remain, and efforts must continue in order to sustain and improve upon the progress that has been achieved.

Globally, there are an estimated 36.9 million people living with HIV. CARPHA serves all of the English and Dutch-speaking countries in the Caribbean region, as well as Haiti, with a total population of between 17 and 18 million persons. The CARPHA Member States (CMS) are currently estimated to have an average HIV prevalence of ~1.3%, which equates to about 230,000 people living with the disease, in this Region. Over the two last decades, the HIV epidemic in the Caribbean has seen an 18% decrease in numbers of new infections, and a 23% decrease in numbers of deaths from conditions related to advanced HIV Infection (AIDS). These improvements are largely due to the invaluable support of development partners, coupled with the diligent and dedicated work of the persons working in HIV Prevention Treatment and Care programmes in each member state.

The Caribbean, however, continues to have the highest HIV prevalence in the Western Hemisphere and the second highest in the world, after Sub Saharan Africa. A key feature of Caribbean epidemic is that it demonstrates a higher percentage of women than men among the HIV infected persons in the adolescent (10 – 19 yr) and the, overlapping, young-adult (15 – 24 yr) age groups. This characteristic is not seen among older adults (50+) or when all persons above 15 years of age are taken collectively, suggesting a disproportionately higher rate of infection among younger women in Caribbean populations. This due to a combination of factors, including the fact that women have a higher risk of contracting HIV with each unprotected sexual encounter; and that women in socio-economically disadvantaged situations may feel less empowered to insist on safer-sex practices.

“Know your status” is the theme for World AIDS Day 2018. The campaign calls for raising awareness about the importance of knowing one’s status, and for the removal of all barriers to accessing HIV testing. Countries are encouraged to ensure that the rights of people living with HIV/AIDS are not violated, and that discrimination based on HIV/AIDS is not only reduced, but ultimately eliminated. This duty of care and non-discrimination on the part of health professionals towards patients extends to many conditions, whether is diabetes, HIV, old-age, or cancer, for example.

Dr Hospedales has said that “the only way to do this is to make sure that everyone knows their HIV status and ensures that their status is managed properly, in order to prevent the spread of new infections, and give themselves the best chance of having a normal life.” He urges “if you are negative, stay negative by avoiding risk-taking activities. If you are positive, live positively, stay on treatment and disclose to your loved ones. Persons living with HIV can lead normal healthy lives if they are diagnosed early and if they stick faithfully to their treatment plans.”

Access to HIV testing is a human right. However, many barriers to HIV testing remain. Stigma and discrimination are very common in the Caribbean and can deter people from taking an HIV test and getting treatment for the disease. This is due to a lack of education about the subject, false beliefs about transmission and HIV associated sexual practices. Some persons living with HIV continue to be shunned by family, peers and the wider community, while others report discriminatory behaviour towards them in healthcare and education settings, erosion of their human rights, and psychological damage.

The management of HIV/AIDS is a priority public health issue for CARPHA. The Agency in collaboration with partners, has identified activities that focus on reducing the impact of HIV/AIDS on key populations by recognising and addressing the barriers that people living with HIV must overcome to obtain adequate health care. CARPHA has supported new initiatives to expand access to HIV testing. And as part of the global strategy embraced by Caribbean governments, communities are engaged in making testing for HIV/AIDS more accessible to key at-risk populations. This strategy is aimed at ensuring that persons, not only know their status, but are treated appropriately, so that the virus is reduced to undetectable levels so that it can no longer be transmitted to others.

Dr Hospedales said “The fight against HIV/AIDS cannot be achieved in isolation. Strong collaborative action is needed to address the stigma that still exists. CARPHA will continue to work closely with Member States and regional and global partners to end AIDS as a public health threat by 2030.”

World AIDS Day is held on December 1st of every year. This year will mark its 30th anniversary.