AIDS in the Caribbean

In 2009, approximately 240,000 people in the Caribbean were living with HIV. The only other region in the world with such a high infection rate is in Africa, south of the Saharan desert.  There are many reasons the epidemic has hit the Caribbean so strongly. These reasons include poverty, sexual partners, gender, and prostitution.  In response to the high number of people with HIV, the Caribbean government and people have responded with ways to contain the spread of HIV, as well as to help those with the disease.

Where did HIV in the Caribbean Originate and Which Gender Has the Highest Infection Rate?

It is impossible to trace back exactly where HIV began in the Caribbean.  However, in 1982, the first case of AIDS was documented in Jamaica. Soon after, infections of HIV were found in homosexual and bisexual men living in Tobago and Trinidad.  These first cases of AIDS/HIV were seen mainly in men, but by 1985 both women and men were reporting infections. Heterosexual sex is actually the leading cause of HIV/AIDS in the Caribbean, disproving the often held belief that HIV/AIDS is a disease that only occurs in homosexual or bisexual men.  HIV currently infects more women than men, and the new cases of HIV are occurring in a higher number of women than men.  Besides Africa, the Caribbean is the only place in the world where a higher number of girls and women (than boys and men) have HIV.

In Which Age Group is HIV the Leading Cause of Death and Which Caribbean Countries Are Most Affected by HIV/AIDS?

HIV is the main cause of death, in the Caribbean, in adults who are between the ages of 15-44 years old. However, new HIV/AIDS infections have been decreasing, from 2001-2009. Within the countries of the Caribbean, there are variations in the number of people infected with HIV. The countries with the highest number of people suffering from HIV/AIDS include Tobago, Trinidad, Haiti, Guyana, Bahamas, and Belize.  In these countries, over 2% of the population is infected with HIV. Barbados and Jamaica also have a high rate of HIV infections, affecting around 1.5% of the population. Lastly, the HIV infection rate in Cuba is less than 0.2% of the population, but still impacts a large number of people.  Unfortunately, despite the high numbers of people in the Caribbean with HIV, many people of the world do not realize the Caribbean needs HIV/AIDS activism and support.  The epidemic of HIV/AIDS in the Caribbean is often forgotten because of the other areas of the world where the disease is present, such as Asia and Africa

How Have Social Factors Increased The Spread of HIV/AIDS? 

Social factors are a main component in how HIV/AIDS has spread throughout the Caribbean.  Unfortunately, those suffering from poverty are more likely to get an HIV infection. This is due to their limited education, inability to read/write, and unemployment. Other social factors that increase the spread of HIV/AIDS are inequalities between men and women, and inequalities between heterosexuals and homosexuals. In many cases, the public is not educated about HIV/AIDS which increases the spread of HIV/AIDS from lack of basic prevention knowledge. Lack of understanding about the disease and fear can cause discrimination against people who are currently suffering from the debilitating virus.  Discrimination also occurs when those infected with HIV are job hunting, looking for a place to live, or wanting to be in a public area (like a park or bus stop).

Risk groups for HIV/AIDS?

Gender: Women 

Caribbean women between the ages of 24-44 years old are more likely to get be infected by HIV than men. In developing countries, women are more likely to get HIV (leading to AIDS) because of their low position in society. A consequence of this is partially the increased risk of rape, unprotected sex, and sexual violence against women and girls. Also, biologically, semen contains more of the virus than vaginal fluids which causes more women than men to become infected with HIV. The increased risk of unwanted sexual contact for women, and the high risk of contracting HIV violates not only women’s’ physical bodies but their right to a healthy life. In younger woman and, unfortunately, teenaged girls, prostitution is common between these younger aged females and older males. This can cause increased risk of HIV transmission, especially if the paid transaction does not involve using protection.

Sexual Preferences

HIV/AIDS is transmitted through sexual contact, and sexuality (as well as) sexual preferences are important considerations. Most people believe HIV/AIDS occurs more often in male homosexuals, which does occur, but the data proving statement remains unclear.  In terms of data, the percentages of HIV rates between men who have sex with men are 11.7%, 18%, and 33.6% in the Caribbean countries of Dominican Republic, Suriname, and Jamaica respectively. The data might be skewed because many people are afraid of admitting their sexuality because homosexuality remains illegal in many Caribbean nations. The fear of laws preventing men from having sex with men has increased the AIDS/HIV epidemic due to lack of education and fear over going to get tested for the disease. Also, many homosexual or bisexual men are married to woman (or have sexual relations with women) sometimes unknowingly causing the spread of HIV.

Which Cultural Factors Influence HIV Transmission? 

One major cultural factor influencing the transmission of HIV involves sexual patterns within the culture. In other words, perhaps due to societal or cultural pressure, many of the youth in Caribbean states report-having sex prior to 15 years old. The younger age can increase the transmission of HIV, in addition to many people having more than one sexual partner.

Prostitution and tourists traveling to the Caribbean for sex partners increases the risk for HIV transmission. The increased risk and rate of HIV transmission is due to lack of condom use, and at risk behaviors for those being paid for relations.  Unfortunately HIV for sex workers is very high, especially in Guyana (30.6%), Jamaica (9%), and the Dominican Republic  (5-12%).

Drug use can increase the risk of HIV infections, especially when needles are shared to transmit drugs.  This method of transmitting HIV is less likely to occur, compared to transmission related to unprotected sexual content. The countries in which drug use is often the main cause of HIV infection are Bermuda and Puerto Rico.


Economic impact

How Do Economic Factors Influence the Spread of HIV/AIDS?

The cost of HIV treatment is expensive for individuals infected with the disease. The economy of the Caribbean can be affected by individuals in the workforce, or looking for jobs, while infected with HIV/AIDS. Due to disease progression and lack of proper treatment, there are less workers due to death from HIV/AIDS or severe illnesses resulting from the disease.  The industries affected by the HIV/AIDS epidemic include farming, tourism, industry, and others. Individuals in poverty are at a greater risk for AIDS/HIV for many reasons. These reasons include no information about what causes HIV/AIDS.  An individual, unaware of the risks, will be less likely to get work if suffering from HIV/AIDS. This will lead to increasing health problems because of lack of funding for medication or other treatment the individual needs to survive. Unfortunately, there is a vicious cycle where lack of education leads to poverty which  causes health problems or risky behaviors and finally results in diseases like HIV. Once an impoverished poor individual has HIV, the economic impact is greater because of the social stigma surrounding the disease.  The fear or prejudice against people with HIV/AIDS can lead to a lack of jobs, and eventually an overall economic decrease for Caribbean countries.

Examples by country

HIV and AIDS in Haiti

 How has Haiti been Affected by HIV/AIDS?

About 3% of the adult population of Haiti is infected with HIV/AIDS. The disease was thought to have begun due to prostitution between male tourists and local Haitian men. However, the disease easily became transmitted to females and heterosexuals. The cause of the transmission to heterosexuals was due to HIV in blood transfusions and unprotected sex. Unfortunately, in addition to unprotected sex causing HIV/AIDS, many children were born to females who had HIV. Other diseases, such as tuberculosis, can be deadly to individuals already suffering from HIV/AIDS. Luckily, the observant doctors and nurses of the health care system swiftly identified HIV/AIDS as causing major health problems among people who lived in Haiti.  Immediately the Haitian Red Cross screened blood transfusions for HIV/AIDS.  Also, people with AIDS/HIV were able to obtain antiretroviral medications. The Haitian Red Cross and other health care organizations provided national education and awareness about HIV/AIDS.   Along with other preventative measures, Haiti is addressing the epidemic of AIDS/HIV with success, and hopefully this will mean a promising future decrease in the spread of the disease.

HIV and AIDS in Barbados

How Is Barbados Affected by HIV/AIDS?

Compared to Haiti, less people in Barbados have HIV, but the percentage is still high at 1.5 percent of the adult population. In the early 1980s, HIV cases were being diagnosed in Barbados. Barbados HIV/AIDS prevention is different than the prevention in Haiti. In Barbados, the government helped people with HIV/AIDS, and in Haiti the help was from non-government controlled agencies. The government provided a center for information about HIV/AIDS (education), widespread testing, and confidentiality to prevent bias or negativity.  The Barbados government has helped the people of Barbados during the HIV/AIDS epidemic. This is impressive because the government’s help began during a time of economic problems and negative attitudes toward people infected with HIV/AIDS.

HIV and AIDS in Jamaica

How Has Jamaica Been Affected By The HIV/AIDS Epidemic?

Similar to Barbados, the rate of the adult population with HIV/AIDS is 1.5 percent in Jamaica. Jamaica is different than Barbados because young women and young female children (14 years old) are dying from AIDS (due to HIV).  The number one cause of death in young women and girls in Jamaica is AIDS.  As with other countries of the Caribbean, luckily, the government and private healthcare companies have helped those with HIV/AIDS. The government wants to lower the negative attitude toward people who have HIV/AIDS. Also, the government and private health care systems have focused on providing condoms, screening blood for disease (blood donations), and increasing the number of treatment facilities.  More measures are needed to help people of Jamaica fight AIDS/HIV, but the government has provided a great starting point.

HIV and AIDS in Cuba

Is HIV/AIDS Common in Cuba?

The rate in Cuba is 0.07 percent, which is low compared to the rest of the Caribbean region, but prevention of HIV/AIDS is still needed. Interestingly, the first cases of HIV/AIDS in Cuba occurred in men who were heterosexual, most likely due to unprotected sex. Then, the disease began to appear in homosexual men. Unfortunately, today in Cuba, homosexual men are likely to get HIV/AIDS when condoms are not used. In Cuba, HIV/AIDS is mainly transmitted through un-safe sex, and not through blood transfusion or drug use.

In Cuba, the government and private organizations, created the Working Group For Confronting And Fighting AIDS. This group was the beginning of Cuba’s fight against HIV/AIDS.  To protect Cubans from blood infected with HIV/AIDS, blood products are carefully screened.  Additionally, health care centers were developed for HIV-positive patients to obtain education and health care appointments.

Recent Responses to the HIV/AIDS epidemic in the Caribbean

More recently, the Caribbean has joined together to stop the HIV/AIDS epidemic and make defeating the spread of the disease a priority. The Caribbean countries have come together and formed the Pan-Caribbean Partnership Against AIDS (PANCAP). This organization unites the Caribbean region and makes a difference in the lives of those with HIV/AIDS. PANCAP realizes the harm of a negative attitude toward people suffering from HIV/AIDS. Taking control of the disease involves changing the negative attitudes and focusing on providing HIV-positive people the care they need. Also, the organization wants to educate the people of the Caribbean and provide medical treatment for those who are HIV-positive.

The Caribbean countries have provided help to those with HIV/AIDS by decreasing the cost of medication and making it easier to obtain disease treatment. HIV in children from mothers has been lowered due to providing testing. Aex-education and greater access to birth control are two other methods being used to lower the risk for HIV/AIDS in the population.

Future and Current Challenges To Preventing HIV/AIDS

There are huge improvements being done by the governments of Caribbean countries, but there are still problems controlling the spread of HIV/AIDS. One problem is the lack of money countries have to provide medicine and other resources to those with the disease. Also, problems with technology and communication between the countries hinder proper education on the causes of HIV/AIDS to prevent the spread of infection.  Politics and society in some countries still view those with HIV/AIDS negatively.  It’s important to remember diseases are complex processes (especially HIV/AIDS) and more medical and nursing research needs to be done to find out ways to decrease the disease rate among Caribbean countries. Overall, all people who are suffering from HIV/AIDS need to be shown compassion, respect, and care.