While the Caribbean has embraced the power of antiretroviral treatment and viral suppression to prevent HIV infections in newborns, there is inadequate understanding among the general public about how successful treatment can also reduce sexual transmission.
At the opening ceremony at the Coco Palm Hotel earlier this week at the 15th annual Caribbean Cytometry & Analytical Society’s (CCAS) expert summit, “From Care to Cure – Towards the Elimination of HIV”, launched in St Lucia, Professor Clive Landis said despite their achievements in tackling the HIV epidemic, they were not done.
“Everyone in society must know and understand and believe that HIV is not a death sentence and further, understand that persons living with HIV who have suppressed virus due to treatment are not infectious.”
He said treatment as prevention was an approach to HIV treatment which formed the basis of a global commitment to end the AIDS epidemic by 2030 as part of the Sustainable Development Goals.
He said it hinged on the finding that diagnosing and treating people early and lowering the level of the virus in their blood to undetectable levels (viral suppression) virtually eliminated the risk that they would transmit HIV to others. UNAIDS Director for Latin America and the Caribbean Dr César Núñez said that through the 2016 Political Declaration on ending AIDS, United Nations members states agreed to adopt a Fast-Track strategy that involved increasing prevention, testing and treatment services while working to eliminate stigma and discrimination. Núñez showed data where the Caribbean must accelerate progress if it was to meet the targets that would set it on track to end the Aids epidemic by year 2030.
According to the UNAIDS 2018 Global Aids Update, there were an estimated 310,000 people living with HIV in the Caribbean at the end of 2017. Seventy-three per cent of people living with HIV in the region were aware of their status. Of all people living with HIV, 57 per cent were on treatment and 40 per cent were virally suppressed.
“Here in the Caribbean, the Aids response is at a precarious point. There has been partial success in saving lives and stopping new HIV infections, but the pace of progress is not matching global ambition,” he said. Nunez said the Caribbean must increase its use of proven strategies such as community-led services for early diagnosis, enrolment in treatment, retention in care and treatment adherence. Combination prevention must be a priority, with more countries making use of the full arsenal at our disposal to reduce new infections including biomedical, behavioral and structural interventions.
“Make no mistake, stigma and discrimination and restrictive laws and policies continue to be the biggest obstacle to ending Aids in the Caribbean, particularly for young people and members of key population communities.”
Nunez said addressing these issues required financial investments, but Caribbean AIDS response was experiencing a funding crisis. He said between 2006 and 2017 international resources in the region decreased by 16 per cent.
He said in 2017 just under half of the money needed to finance the achievement of the Fast Track programme in the region was not available.
“Even as we negotiate with international partners, we must send the message to governments within the region that there must be full funding for the AIDS response. This is no longer a stand-alone request. It is part of states’ commitment to universal health coverage.