Overcoming Disruption, Transforming the AIDS Response

The United Nations Population Fund (UNFPA) states that the Caribbean has the highest incidence rate of reported AIDS cases in the Americas. With between 350,000 and 590,000 Caribbean people living with HIV/AIDS, the region has an adult HIV prevalence rate between 1.9% and 3.1%, second only to Africa (7.5% and 8.5%). Of that number, 83 per cent know their status and 68 per cent of them are on treatment. However, only 57 per cent of people living with HIV are virally suppressed and thus have a reduced risk of transmitting the virus to their sexual partners. As a region the Caribbean is facing a generalized epidemic. HIV/AIDS is well entrenched here, with a national prevalence of at least 1% in 12 countries, all of them in the Caribbean Basin. The most recent national estimates showed HIV prevalence among pregnant women reaching or exceeding 2% in eight countries: the Bahamas, Belize, The Dominican Republic, Haiti, St. Lucia, Suriname, and Trinidad and Tobago. Over thirty thousand people are living with HIV in Jamaica. This is a significant percent of the HIV population in the Caribbean region. The high rate of HIV cases should serve as a wake-up call for those of us who live in the Caribbean. However, as we enter the fourth decade since the onset of the virus, many of us who are older may have dropped our guards since the days when HIV was viewed as a painful death sentence. That sense of urgency mixed with fear has been replaced with complacency as more modern medications have emerged to manage HIV/AIDS. The development of new antiretroviral treatments has transformed HIV infection into a chronic but manageable health condition. Additionally, mortality rates due to AIDS have fallen throughout developed and developing societies. On December 1 the global community will commemorate World AIDS Day 2025, under the theme "Overcoming disruption, transforming the AIDS response", calling for sustained political leadership, international cooperation, and human-rights-centred approaches to end AIDS by 2030. The World Health Organization states that after decades of progress, the HIV response stands at a crossroads. Life-saving services are being disrupted and many communities face heightened risks and vulnerabilities. In 2025, a historic funding crisis is threatening to unravel decades of progress. Globally, HIV prevention services are severely disrupted. Sex as Currency. Isiuwa Iyahen, representative of UN Women stated, “Everyone is desperate. Men are desperate, women are desperate, everybody is desperate, but because of their disproportionate care needs, and also because they are more vulnerable to sexual violence, we have seen situations where women will then make difficult choices if they don’t have access to money or to shelter and a livelihood.” Iyahen added, “Women need money to be able to take care of themselves, their children, their family members, and if they’re taking care of elderly parents. If they’re in a situation where unscrupulous persons may decide to take advantage of that and trade or provide them with money in exchange for, unfortunately, sex, these are the kinds of situations that unfortunately can occur.” In a recent interview Sexologist Dr Sydney McGill said,” research shows disasters often push people toward sexual activity as a form of emotional relief, making it critical to ensure access to contraceptives and the provision of targeted support for vulnerable groups who may face pressure or coercion into trading sex for favours as they struggle to cope and survive.” Given also the displacement resulting from a natural disaster such as Hurricane Melissa which made landfall in Jamaica on October 28, the society must be mindful that sexual health is important in the recovery effort. Evidently, in such desperate conditions, condom usage might not be negotiable and this is problematic. Importantly, such a conversation though uncomfortable for some must be had to address the sexual needs. Structural Inequalities. Global political leadership is essential to advance policies that address structural inequalities and protect vulnerable populations. Among the spaces of structural inequalities are poverty, racism, gender inequality, and sexual oppression. The commemoration of World AIDS Day provides the perfect opportunity for us to revisit the messaging, especially with the proliferation of social media. Those who are tasked with developing public education campaigns must be intentional regarding the targeted groups as the HIV epidemic continues in large part unencumbered by formal public health and education programmes. We must be mindful that in many spaces frequently grounded in patriarchy there is a thriving culture of misinformation surrounding HIV/AIDS which oftentimes receives much traction on social media. As a result, the myths and misconceptions about HIV/AIDS must be countered with scientific data. This World AIDS Day calls for transformative and culturally practical solutions to improve access to HIV services, eliminate stigma and discrimination once and for all, and ensure the protection of rights for women, girls, and other marginalized communities that continue to face disproportionate barriers in accessing healthcare. On this World AIDS Day, gift yourself the peace of mind that comes with knowledge and find out your HIV status. Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues. waykam@yahoo.com @WayneCamo © #WorldAIDSDay