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CARIBBEAN: Still Fighting HIV Stigma After 30 Years

Peter Richards

PORT OF SPAIN, Trinidad, Sep 16 2010 (IPS) - An inescapable fact of living in societies that are as small and highly personalised as those in the Caribbean is that information travels very quickly and not always very accurately.

“The result usually is that privacy is, more often than not, a luxury and once a stigma of whatever kind attaches to you, there is little scope available for leaving one area of the society and migrating to another to, as it were, make a fresh start,” Barbados acting Prime Minister Freundel Stuart told delegates attending a two-day symposium on HIV/AIDS and human rights in the Caribbean this week.

As regional leaders get ready to attend the United Nations Millennium Development Goals (MDGs) Summit in New York next week, health officials say they are frustrated that Caribbean society still treats HIV differently from other diseases.

The director of the UNAIDS Caribbean Regional Support Team, Dr. Ernest Massiah, told IPS that the stigma associated with HIV is linked to long-held prejudices and rejection of what is perceived “as abnormal sexual behaviour and wrongful sexual orientation”.

“It is precisely these stigmas that threaten the public’s health. They prevent people from getting tested, getting and sharing their test result with others, and from seeking treatment, if needed. Unrecognised and untreated HIV can spread. In 2010, stigma and prejudice should have no place in Caribbean societies,” he added.

Susan Timberlake, a senior advisor on human rights and law with the Geneva-based Joint United Nations Programme on HIV/AIDS (UNAIDS), said that “unless we deal with the stigma and discrimination and the punitive legal environments that exist, we will not have an effective response to this HIV epidemic.”

She told reporters that this week’s symposium organised by the University of the West Indies in collaboration with the Pan Caribbean Partnership Against HIV and AIDS (PANCAP), UNAIDS, the U.N. Development Programme and AIDS203 “is a very important aspect of beginning to reorient the response in the Caribbean to deal better with these issues”.

“We are almost 30 years into this epidemic and we still have a major problem globally with stigma and discrimination against people living with HIV. It is prevalent in almost every country and that’s the bad news. The good news is that we now have tools by which to measure it,” she added.

But the global economic and financial crisis may prevent Caribbean countries accessing much needed financial support for HIV/AIDS programmes.

Grenada’s health minister, Ann Peters, who is also chair of PANCAP’s Regional Coordinating Mechanism (RCM), has noted that the organisation, established in 2001 to coordinate the Caribbean’s response to the HIV/AIDS epidemic, “now faces the stark reality of declining grant funds with huge adverse implications for its programmatic outreach”.

“For us in the Caribbean, the signals are worrying,” Peters said. “Currently, all Caribbean economies are reeling from the effects of the global downturn. At the same time, the economies of the developed world continue to struggle to break free of the global financial contagion that has precipitated a contraction in development assistance that in the past had buoyed entities such as PANCAP.”

To make matters worse, she told delegates at an RCM conference in Jamaica last week, the decision by development agencies to implement a new “eligibility criteria” for the allocation of their resources has also seriously affected middle-income regions such as the Caribbean.

“I cite these financial challenges not as a cry of despair or a bleating of helplessness or hopelessness. Rather, I do so to make the case for the Caribbean to once again assert its own toughness and to reach deep within its collective core to find the answers,” she said.

But there has been some good news for the region in recent years. Dr. Massiah notes that the number of AIDS-related deaths fell by 40 percent between 2001 and 2008. Over the same period, the number of new infections in children dropped by 18 percent and the number of new infections in adults by five percent.

“Significantly, in 2010, 51 percent of people living with HIV who need antiretroviral medication have access to it,” he added, even as he acknowledged that 49 percent of people who need the medication don’t have access to treatment and the number of new infections each year has not fallen significantly over the last 10 years.

Across the region, half of all persons with HIV are women and in some countries, women, many under the age of 30, account for almost 60 percent of all cases.

The UNAIDS official said that HIV now disproportionately affects young women, gay men and other men who have sex with men, transgendered persons, and sex workers across ethnicity, race and class barriers.

“And, there are still British colonial laws in place that criminalise sexual behaviours, reinforcing stigmas and making it difficult to respond comprehensively to HIV,” he said.

Stuart said that it was important for the Caribbean not to pretend that it “is a challenge we can afford to ignore” since a better understanding of the HIV/AIDS epidemic could lead to a more sympathetic treatment of persons living with the illness and that continued public education programmes at all levels would be “the ultimate and best guarantee of the observation and preservation of fundamental human rights for all”.

“The fact that infected persons are not only living longer but also seem to be leading normal lives raises necessarily and understandably the issue of the rights to the enjoyment of which these persons are entitled,” he added.

Dr. Massiah stressed that people living with HIV are productive citizens with the same right to protection under the law, access to health care and other services, and with the potential to make valuable contributions to Caribbean societies.

“In 2010, HIV is not about death, it is about people living and enjoying productive lives,” he added.

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