RECENT data from the Joint United Nations Programme on HIV/AIDS (UNAIDS) shows that the HIV epidemic in the Caribbean remains largely prevalent among key populations, such as sex workers; gay men and other men who have sex with men and clients of sex workers and other sexual partners. This is according to the UNAIDS special analysis, 2018, which also records data from 2017 and reports that stigma remains a major challenge to these groups accessing HIV services. According to the report, the second highest group of individuals contributing to new HIV infections in the Caribbean for 2017, is clients of sex workers and other sexual partners of key populations.

This group recorded 30 per cent prevalence, followed by gay men and other men who have sex with men, which saw 23 per cent prevalence. Also in the category were sex workers at 13 per cent; transgender women and people who inject drugs, both at 1 per cent and the general population which attained the highest at 32 per cent.

These categories, along with prisons, have been marked as key populations, meaning that due to specific higher-risk behaviours, they are at increased risk of HIV. Although progress has been made over the years, with the Caribbean recording an 18 per cent decline in the number of new HIV infections, the UNAIDS reports that the challenge of reaching key populations still remains.

Regarding the Caribbean, the report stated: “Gay men and other men who have sex with men, accounted for nearly a quarter of new infections in 2017. Efforts to reach men and boys, and particularly gay men and other men who have sex with men, are constrained by health services insufficiently tailored to their needs and limited community-based services. In total, key populations and their sexual partners represented two thirds of new infections in the region.”

Data separated by Caribbean country shows, that HIV prevalence among gay men and other men who have sex with men, is particularly high in Trinidad and Tobago standing at 32 per cent. This is followed by the Bahamas with 25 per cent and Haiti with 13 per cent while, Guyana was recorded 4.9 per cent prevalence. Among the transgender people, it is highest in Cuba with 20 per cent, and among prisoners it is highest in Dominica with 29 per cent.

Guyana, for these two categories records 8.4 per cent and 1.72 per cent respectively. When it comes to protection, the report highlights condom use amongst key populations in Guyana shows a 75.7 per cent prevalence for sex workers, and 64.4 per cent for gay men and other men who have sex with men.

While the report notes these challenges, it also places focus on the existing law and policies, awareness and social stigma that affect the availability and willingness of key populations to acquire treatment. “Key populations make up a small proportion of the general population. They also are reluctant to identify themselves, especially in environments where their actions or identities are considered socially or religiously unacceptable, or they are punishable under local law. This makes it difficult to collect quality data on the location and size of these populations, their attitudes and practices, their access to HIV services, and the incidence and prevalence of HIV among them,” the document explained.

In an aim to reducing the barriers of stigma and discrimination in the Guyana, the Pan Caribbean Partnership Against HIV/AIDS (PANCAP) had hosted a National Faith Leaders Consultation.

It engaged religious leaders from various faith-based denominations, stating that the country will not achieve its 2030 health targets unless there is respectful doctrine among key populations.

This includes, respecting religious doctrine while abstaining from discrimination against the Lesbian, Gay, Bisexual, and Transgender (LGBT) community, which can hinder them from seeking treatment for HIV.

Religious leaders are not the only groups engaged by PANCAP, which has the eventual aim of ensuring that all groups within key populations are emboldened to get themselves tested for HIV/AIDS, or make themselves available to receive treatment for the disease. When it comes to Guyana’s laws and policies, the report shows that Guyana was recorded as the only Caribbean country whereby parental consent is not needed for adolescents to access HIV testing.

The document was unable to provide data, on whether there are laws in Guyana criminalising the transmission of, nondisclosure of, or exposure to HIV transmission. Altogether, although the Ministry of Public Health’s National AIDS Programme Secretariat (NAPS) has reported Guyana as closer to meeting its UNAIDS 90–90–90 target, this is not the same when viewed collectively as the Caribbean.

While the region made progress over the years, a recent evaluation shows that the region is not progressing fast enough to meet its 2020 targets. However, regarding its individual 90–90–90 target, as of 2018, 86 per cent of all people living with HIV in Guyana now know their status; 74 per cent of those diagnosed are receiving sustained antiretroviral therapy (ART) while 65 per cent of those on ART have achieved viral suppression.