A RECENT report by UNAIDS shows that despite successes by individual countries, overall progress in the Caribbean to expand access to HIV services has slowed. Because of this, HIV targets set for 2020 will not be reached. The report, ‘Seizing the Moment,’ urges countries to act with greater resolve to reach those still left behind. Caribbean 2019 data showed that there were an estimated 330,000 people living with HIV in the Region at the end of 2019. Overall, Caribbean adult HIV prevalence was 1.1 per cent. In 2019, 77 per cent of people living with HIV in the Caribbean knew their status. This compares to the worldwide average of 81 per cent. Eighty-one percent (81 per cent) of diagnosed Caribbean people were on treatment last year. Eighty per cent (80 per cent) of those on antiretroviral therapy were virally suppressed. The global average was significantly higher at 88 per cent. Some countries have achieved elements of the 90–90–90 targets (90 per cent of people living with HIV aware of their HIV status; 90 per cent of diagnosed people on antiretroviral treatment and 90 per cent of those on treatment virally suppressed).

Barbados has reached the target for testing, while Guyana has exceeded it with 94 per cent of people living with HIV diagnosed. Since the first case of HIV/AIDS was recorded decades ago, millions of persons around the globe have died annually from the various symptoms associated with that disease. HIV/AIDS was, in its early stages, erroneously linked to homosexual behaviour because of its prevalence within the gay community, particularly amongst men who had sex with men. So widespread was this belief that at one point the disease was called the “gay cancer”, and also the “gay plague.” It has since been recognised that while homosexual couples and women are more at risk of contracting the disease, with more than half of the infected population being women, the disease is not particularly about who becomes infected. Despite public service messages, advertisements, and seminars hosted to educate persons on the dangers attached to having unprotected sex, there are still a substantial number of persons dying every year from AIDS-related complications. Millions of dollars are annually being spent to help sensitise the public on the disease — which was first diagnosed here in Guyana in the year 1987 — not only because of its ability to rob otherwise healthy persons of their lives and knock decades off a country’s national development, but also for its ability to “widen the gulf between rich and poor nations, and push already stigmatised groups closer to the margins of society.” A combination of factors, such as increased access to antiretroviral treatments; programmes focusing on youth development and reproductive health, and counseling, has since seen a constant decrease in the number of new cases each year. While Guyana and countries across the Caribbean still stand in second place under Sub-Saharan Africa — where new HIV/AIDS cases average 5000 every year, accompanied by at least 200 deaths — with new and more affordable treatment options now available, there has been a 70% reduction in AIDS-related deaths, compared to 15 years ago. Guyana also seems to be doing well in the fight against mother-to-child transmission of the disease, as a result of the Prevention of Mother to Child Transmission (PMTCT) programme, and may soon be able to boast of the public health achievement of eliminating mother-to-child transmission of HIV as Cuba did in June 2015.

For all the improvements over the years, however, doctors are now of the opinion that a newly formulated strategy needs to be put in place with the spread of the virus, as many persons across the country are taking comfort in its success rate of reduction and this has encouraged complacency, as many have stopped seeing the urgent need for protection, which has resulted in “a growing trend of new HIV cases.” There is an urgent need to sustain and intensify efforts in the fight against infection, so that its levels can be kept at a minimum, particularly amongst young people. Currently, statistics show that over 60 per cent of the new cases are isolated to young persons, showing the need for more education regarding the virus and its potential dangers amongst the young. Education on prevention aside, more also needs to be done in helping to eliminate or diminish levels of stigma and discriminative attitudes held towards those with the disease. Stigma in Guyana and around the world is often so strong that those who are infected, or suspect that they are, are often hindered from seeking treatment or learning their status and being educated on preventive measures. This creates a barrier which could potentially become life-threatening and significantly decrease the mental health of the person. While there has been some progress over the years with the monitoring and reduction of stigma within the workplace, as guidelines have been put in place to help in that respect, the stigma within the wider society is still largely in place; and, for the most part, will largely remain that way over the next few years. Thankfully, the same report alluded to earlier discriminatory attitudes towards persons living with HIV have been consistently declining in Guyana, decreasing to as low as 29.4 per cent in 2014, after being as high as 86.4 percent in 2000. Guyana is also among a number of countries that are close to achieving the 90-90-90 target for 2020, with 94 per cent of affected persons knowing their status, 73 per cent of those affected being on treatment and 87 per cent of those on treatment achieving viral suppression.