EULALEE THOMPSON
THE JOINT UNAIDS/World Health Organisation's recent report on the state of the global AIDS epidemic (The AIDS Epidemic Update, December 2005) points to the masking of the extent and intensity of the epidemic in some Caribbean states as a result of the lumping together of the region as the second most affected area after Africa.
The fact is that in a country like Cuba, the disease prevalence among adults is under 0.2 per cent. On the other hand, the prevalence in Barbados, Dominican Republic, Jamaica and Surinam is more than one per cent of the adult population; about two per cent in the Bahamas, Guyana and Trinidad and Tobago, and more than three per cent in Haiti. Breaking the data apart in this way can help countries identify some best-practice models. What's happening in Cuba, for instance? Their prevalence is so low.
In Cuba, according to the report, all pregnant women are tested for HIV and antiretroviral drugs are given to HIV-positive mothers-to-be. Therefore, fewer than 20 HIV-infected babies have been born in that country for the duration of the pandemic. Also, prevalence and deaths from AIDS are kept low in Cuba as a result of universal and free access to antiretroviral therapy. Some of this edge in Cuba, according to the report, is now being threatened by widening income inequalities and a growing sex industry.
HIV/AIDS IN JAMAICA
In Jamaica, the report states that unprotected heterosexual intercourse (sex between men and women) is the driving force behind HIV spread. The urban areas in Kingston, St. Andrew and St. James account for most of the recorded HIV infections.
The report further states that "HIV prevalence among pregnant women has remained at one to two per cent since the mid-1990s, although recent HIV surveillance at antenatal clinics suggests that prevalence might be declining slightly in parts of the country (in the parishes of St. Ann and St. James, for example)." (Ministry of Health Jamaica, 2004).
The report also indicates that there are signs that many Jamaicans are protecting themselves against HIV infection - about three-quarters of men say that they used a condom the last time they had sex with a casual partner, and the percentage of women reporting the same behaviour almost doubled from 1992 to 2000.
In Jamaica, Haiti, Dominican Republic and the Bahamas, the report points to some decline in HIV prevalence among pregnant women and to increased condom use among sex workers, and to the expansion of voluntary HIV testing and counselling.
OLD MEN AND YOUNG GIRLS
The report, however, presents the information on decline in prevalence with 'guarded optimism' as teenage girls, particularly in Jamaica, were two-and-a-half times more likely to be HIV-infected when compared with their male counterparts. Girls and young women are physiologically more susceptibility to infection, but the report said that more important in the spread is "the relatively common practice of younger women establishing relationships with older men."
SUB-SAHARAN AFRICA
The report said that the steepest increases in HIV infections have occurred in Eastern Europe, Central Asia and East Asia. Sub-Saharan Africa continues to be the most affected globally - with 64 per cent of the world's new HIV infections occurring there.
UNAIDS Executive Director Peter Piot said he is "encouraged by the gains that have been made in some countries and by the fact that sustained HIV prevention programmes have played a key part in bringing down infections. But the reality is that the AIDS epidemic continues to outstrip global and national efforts to contain it."
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GLOBAL SUMMARY OF THE AIDS EPIDEMIC, DECEMBER 2005
Number of people living with HIV in 2005
Total 40.3 million (36.7-45.3 million)
Adults 38.0 million (34.5-42.6 million)
Women 17.5 million (16.2-19.3 million)
Children under 15 years 2.3 million (2.1-2.8 million)
People newly-infected with HIV in 2005
Total 4.9 million (4.3-6.6 million)
Adults 4.2 million (3.6-5.8 million)
Children under 15 years 700,000 (630,000-820,000)
AIDS deaths in 2005
Total 3.1 million (2.8-3.6 million)
Adults 2.6 million (2.3-2.9 million)
Children under 15 years 570,000 (510,000-670,000)
The ranges around the estimates in this table define the boundaries within which the actual numbers lie, based on the best available information.
Source: UNAIDS/WHO AIDS Epidemic Update: December 2005.
