June 7, 2013
Note: In the United States, Caribbean-American HIV/AIDS Awareness Day is June 8. For this observance, Caribbean-American leaders sponsor diverse activities to create awareness of the HIV/AIDS epidemic and the health status of Caribbean-Americans within their specific communities. The observance also draws attention to the HIV/AIDS epidemic in the Caribbean. For more information, go to www.ncahaad.com.
Across the globe, countries are making historic gains towards ending the AIDS epidemic and ushering in an AIDS-free generation. They are doing so by using science, innovation, and evidence-based strategies to help save lives. According to the UNAIDS World AIDS Day Report 2012 [PDF 1.13MB], the Caribbean region has the sharpest declines in the number of new HIV infections worldwide since 2001, with a drop of more than 42%. For example, in Suriname, the rate of new HIV infections fell by an estimated 86%, the rate in the Dominican Republic declined by 73%, and in Haiti the rate fell by 50%. From 2009-2011, the number of children acquiring HIV infection has declined significantly (32%). Apart from high-income countries, the Caribbean is the only region with high coverage levels for effective antiretroviral treatment to prevent mother-to-child transmission, though coverage varies from country to country, with some countries exceeding the regional coverage level of 79%. Not surprisingly, the countries of the Caribbean also experienced a 48% decline in AIDS-related deaths. The Dominican Republic had 61% fewer people dying from AIDS-related causes, while Guyana, Haiti, Jamaica, and Suriname saw a greater than 40% reduction.
Although tremendous progress has been achieved in the Caribbean region, and we have the tools needed to achieve an AIDS-free generation, many challenges remain. The Caribbean has higher HIV rates than any region outside of sub-Saharan Africa [PDF 270KB], though the epidemic is relatively small -- in 2011, 230,000 people were living with HIV [PDF 270KB]. AIDS is the leading cause of death among people between the ages of 20 and 59 [PDF 9MB]. The HIV epidemic varies across the region but is mostly concentrated in key groups [PDF 270KB], such as men who have sex with men and sex workers. Studies have shown that men who have sex with men account for an estimated 30% of new HIV infections in Jamaica [PDF 270KB], making this the group at the highest risk of HIV infection. Prevalence rates in the general population range [PDF 3.73MB] from a low of 1% in Suriname to a high of 2.8% in the Bahamas. HIV affects young women 1.2 to 3 times more than young males in the Bahamas and Barbados, while in Jamaica, Suriname, and Trinidad & Tobago the reverse is true.
The Caribbean region is characterized by high levels of interdependence and migration between countries. Although HIV rates appear to be declining in the general population, they continue to remain high in key, hard-to-reach groups. It is critical to help those already affected by HIV/AIDS and to prevent the further spread of disease in the region.
U.S. government agencies, such as the Department of Health and Human Services, Centers for Disease Control and Prevention, and USAID, through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), support countries in the Caribbean to implement and expand high-quality integrated HIV/AIDS care and treatment services; expand effective prevention programs to halt new infections; strengthen and expand high-quality laboratory services; develop and maintain robust health information systems; strengthen surveillance systems; and ensure impact and accountability.
The gains we've made are impressive, but our work is not done. A historic opportunity is before us -- achieving an AIDS-free generation.
Editor's Note: In a previous blog post, Gregorio Millett (formerly of the White House Office of National HIV/AIDS Policy) touched on some of the issues and shared data on the scope of the epidemic for Caribbean Americans. You can also learn more about the HIV/AIDS awareness days here.
Rachel Albalak, Ph.D., is the director of the Caribbean Regional Office, Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention. Jean Wysler Domercant, M.D., M.P.H., is the acting director of Clinical Services, Haiti, Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention.