Feature story

Progress in Caribbean HIV response, yet punitive laws continue to hamper access to services for most vulnerable

01 November 2010

Former UN Secretary-General Kofi Annan (left), UNAIDS Executive Director Michel Sidibé (centre) and Hon Sarah Wescot-Williams, Prime Minister of St Maarten. Credit: UNAIDS

At the 10th annual general meeting of the Pan-Caribbean Partnership Against HIV and AIDS (PANCAP), held in St Maarten, Netherlands Antilles, UNAIDS Executive Director Michel Sidibé joined former UN Secretary-General Kofi Annan and Caribbean leaders to take stock of progress, challenges and lessons learned in the regional response to the HIV epidemic over the past decade.

In his remarks at the opening of the meeting, Mr Sidibé congratulated leaders across the region for keeping HIV high on the development agenda and highlighted the critical role that PANCAP can play in accelerating the HIV response. “PANCAP is the tool for helping us make the call for social justice in the Caribbean,” he said.
According to a new UNAIDS report, The Status of the HIV epidemic in the Caribbean, there were between 210 000 and 270 000 people living with HIV in the Caribbean in 2008. Haiti and the Dominican Republic account for about 70% of all people living with HIV in the region. In the English-speaking Caribbean, Jamaica is the country most affected by the epidemic, with an estimated 27 000 people living with HIV.

The report cites a number of achievements in the regional HIV response. More than 90% of pregnant women in 11 Caribbean countries are now tested for HIV every year. About 52% of pregnant women receive services for the prevention of mother-to-child transmission of HIV, which led to an 18% reduction in new HIV infections among children in 2008.
Governments across the region provided antiretroviral treatment to 51% of people in need in 2008—up from just 1% in 2004.  Greater access to antiretroviral treatment is saving lives: since 2001, AIDS-related deaths have dropped by about 40% in the region.

Criminalization of homosexuality

Two-thirds of countries in the Caribbean continue to criminalize homosexuality. Where homophobia is institutionalized in the law, stigma and discrimination against men who have sex with men is pronounced. Homophobia blocks access to HIV prevention programmes and impacts the quality of care for people living with HIV.

Homophobia hurts wherever it haunts—from classrooms to courtrooms

Michel Sidibé, UNAIDS Executive Director

“Imagine yourself as a gay man in such an environment. How confident would you feel about getting an HIV test, or asking for information on prevention or treatment?” asked Mr Sidibé. “Homophobia hurts wherever it haunts—from classrooms to courtrooms,” he added.

HIV prevention not reaching key populations

Among men who have sex with men, HIV prevalence varies from an estimated 6.1% in the Dominican Republic to 32% in Jamaica. HIV prevalence among female sex workers—another key affected population in the region—varies from 2.7% in the Dominican Republic to 27% in Guyana.
According to the UNAIDS report, HIV prevention programmes reach less than 40% of men who have sex with men and less than 50% of female sex workers in the region. Meeting participants agreed that expanding HIV services for those most vulnerable to infection would be critical to an effective regional HIV response.