CARICOM’s fresh approach to HIV

HIV and vulnerable populations were among the issues addressed by Caribbean Community leaders last week.

The 33rd Regular Meeting of the Conference of Heads of Government held in St. Lucia, brought into focus opportunities for success in the region’s AIDS response as well as challenges with respect to the protection of children and other key groups.

The meeting acknowledged the importance of programmes to prevent mother-to-child HIV transmission. Several countries are on track to meet a 2015 elimination target of 95 per cent coverage for antenatal care, testing for HIV and skilled attendance at birth, in addition to a transmission rate of below two per cent. Still, this form of HIV infection accounts for between eight and ten percent of transmissions in the Caribbean as a whole.

In order to sustainably eliminate new HIV infections in children, HIV services have to be more fully integrated into the health care system, including pre- and post-natal care. There must be concerted measures to address stigma and improve confidentiality within the health care setting so that women’s anxiety about real or perceived discrimination is reduced. Women should be empowered to access timely antenatal care, testing, life-saving treatment and follow-up services.

“We are sitting on a success,” said Dr. Ernest Massiah, Director of the Joint United Nations Programme on HIV and AIDS Caribbean Regional Support Team. “Most of the Organisation of Eastern Caribbean States countries are close to reaching elimination targets and it shows that the Caribbean region can achieve results in the HIV response.”

While cautioning against complacency, the heads also called for “stepped-up efforts with regard to public awareness and interventions targeted at populations most at risk”. The resolution comes at a critical time. Many countries face severe budget constraints as international donor funding steadily dwindles.

In order to get the best value for a diminishing dollar, country programmes must directly address the needs of groups with the highest HIV risk.

“It is time for us to be honest about vulnerable populations including men who have sex with men, sex workers, women and young people. We need to have changes in laws and programmes to allow these populations to get the services they need to protect themselves and their partners and to have all the rights of citizenship,” Massiah asserted.

He insisted that it is not viable to continue pumping money into generic prevention efforts targeted to the general population.

The meeting particularly focused on the vulnerability of young people. It noted the low age of sexual initiation and high rates of child sexual abuse that are commonplace throughout the Caribbean. The Heads of Government agreed on the need for “a holistic approach to the issue including parenting education, public sensitisation, and legislative reform to better protect children”. They also stressed the importance of dealing appropriately with both perpetrators and those who fail to report abuse.

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