Caribbean lagging in eliminating HIV/AIDS

The Caribbean has fallen behind the 2020 goals needed to end the AIDS epidemic by 2030.

A new report, titled Seizing the Moment, by the Joint UN Programme on HIV/AIDS (UNAIDS) said while there have been many gains in the region, much more work needs to be done with regard to suppression.

UNAIDS Caribbean director Dr James Guwani said progress across testing for and treatment of HIV/AIDS in the region had slowed down. He said the Caribbean needed an additional 61,000 people on treatment to reach the 2020 goals and this may not happen.

He was speaking at the launch of the 2020 Global AIDS Update Caribbean on Tuesday.

The targets set for 2020 worldwide were that 90 per cent of people living with HIV should know their HIV status, of whom 90 per cent are on antiretroviral (ARV) treatment and 90 per cent are virally suppressed, known as 90-90-90.

Guwani said to accelerate progress, Caribbean countries need to increase testing, put those who have HIV/AIDS on treatment regimens, and follow up with testing to ensure the viral load has decreased.

He said women were more likely than men to access treatment but were still susceptible to gender inequality, with gender-based violence being a major challenge. He said it was time to meet men where they were so they would be able to access services.

Discriminatory attitudes towards those with HIV/AIDS were still high, he said, although levels were declining.

Even before covid19, the Caribbean was at 42 per cent of the 2020 targets, and covid19 had affected the treatment of those infected, as clinics were not open.

CARPHA executive director Dr Joy St John the global efforts to produce a vaccine for covid19 have been swift, akin to those for HIV/AIDS. She said there have been no reports of supply-chain issues of ARVs or medications for the treatment of HIV/AIDS in the covid19 period, in stark contrast with persistent procurement issues for equipment and supplies for covid19.

Treatment of HIV/AIDS during the covid19 period, she explained, included extended prescriptions and visits by community organisations for those who did not have access.

Key points from the report were:

New HIV infections have decreased by 29 per cent since 2010, and AIDS-related deaths have decreased by 37 per cent.

Key populations and their sexual partners account for 60 per cent of new HIV infections in the region.

Half the people living with HIV in the region have suppressed viral loads.

Fifty-seven per cent of new infections in the region are among men, and 26 per cent are among gay men and other men who have sex with men. Mother-to-child (vertical) HIV transmission has decreased by almost 50 per cent since 2010.

The report said roll-out of comprehensive prevention interventions is also incomplete in the region, as the Bahamas and Barbados are still the only countries with national programmes providing pre-exposure prophylaxis (PrEP) through the public health sector. NGOs are providing PrEP in the Dominican Republic, and it is available in Jamaica and Suriname through the private sector and pilot studies.

The report can be accessed at https://www.unaids.org/sites/default/files/media_asset/2020_global-aids-report_en.pdf

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