InterPress News Service (IPS) - June 4, 1998
Wesley Gibbings

Consultant to the United Nations Programme on HIV/AIDS, Christine Norton, reports gloomily in a paper prepared for this week's regional conference on HIV/AIDS strategies in Port of Spain that HIV infection is "spreading rapidly among the youth of the Caribbean".

This assertion is consistent with recently released statistics on the incidence of the deadly infection among young Caribbean people. It is estimated that as many as 310,000 persons are living with HIV/AIDS in the wider Caribbean. The Bahamas and Barbados rank among the "very high prevalence" countries of the world.

AIDS has already overtaken traffic accidents as a major cause of death and the UNAIDS Report on the Global HIV/AIDS Epidemic of December 1997, lists Belize, Guyana, Suriname, Dominican Republic, Jamaica and Trinidad and Tobago among the "high prevalence" countries.

The situation among young females is of particular concern and it has been learnt, for example, that one out of every three women infected with HIV in Trinidad and Tobago in 1996 was a teenage girl between the ages of 15 and 19. Girls outnumber boys 5:1 for HIV infections and 4.5:1 for AIDS. Regionally, by the end of 1996, there were 827 cases of AIDS among 20- 24 year-olds and 1,623 among 25-29 year-olds.

World figures for the phenomenon are disturbing. It is estimated that 7,000 young people between the ages of 10 and 24 get infected with HIV every day -- five young persons every minute.

Experts here point to a number of factors that may explain the disturbing trends and figures in the Caribbean. The bottom line, though, appears to be the fact that despite public information campaigns and other programmes, sexual activity among teenagers, some unprotected, remains high.

The median age for the commencement of sexual activity in Trinidad and Tobago, for example, is 16. In Dominica, the figure is close, 15.7. In some countries, consensual sexual intercourse with girls that age would not, in any case, be illegal.

The age of consent in Suriname and Guyana is 12. In Trinidad and Tobago, if the girl is a Hindu, 14, and, 12, if she is a Muslim. In Belize, a girl, if married, can have sex at age 14.

Keiran O'Cuneen, head of the European Commission Delegation in Port of Spain, says sex education for young people has to be one of the strategies being employed by regional governments in combating the problem.

"Actions which reduce poverty and inequality, improve the economic, social and legal status of women, and encourage more liberal attitudes to condom use and sex education for young people are all likely to impact on peoples' vulnerability to infection with HIV," O'Cuneen says.

Trinidad and Tobago's Health Minister, Hamza Rafeeq, also proposes a comprehensive menu of activities which make greater use of combined regional resources.

He argues that the situation requires "broader inter-sectoral action" and that the Caribbean must unite to do so since "we simply cannot afford to fritter our resources away on isolated and uncoordinated efforts that are likely to be sub-optimal".

In that regard, there has been no shortage of regional plans. There is a paper trail of resolutions and plans of action dating back to the June 1988 Eleventh Meeting of the Caricom (Caribbean Community) Conference of Ministers Responsible for Health which discussed the screening of blood donations and securing the rights of HIV infected individuals.

Since then there have been no fewer than eight major regional conferences which have dealt with the issue from a number of different perspectives. Caricom consultant, Sheila Samuel, proposes that the next step should monitor and evaluate current policies, identify and address new and unmet development needs and "establish and facilitate harmonisation of a regional policy supportive to HIV/AIDS efforts".

This however may not meet the expectations of some policy makers. For his part, Rafeeq insists that the effort "must go beyond exchanging information". He says it is time more resources are shared and that the use of available laboratory facilities are optimised.

UNAIDS consultant, Claudette Francis, says there must also be a change in mind-set. "Fifteen years into the epidemic, the continuing denial and lack of adequate attention to issues concerning people living with HIV/AIDS has further deepened the discriminatory response of society toward HIV/AIDS and toward the affected communities," she argues.

"While the divide between the sero-positive and sero-negative population may have been inadvertently created, the redress of this situation needs to be deliberate, swift and inclusive," she says.

O'Cuneen agrees, but concedes that there are some difficult areas to transact. He says HIV/AIDS oriented public policy "can pose extreme political dilemmas". He says while the disease deals with "very personal, private and culturally varied behaviours" programmes to address it may not tend to generate a lot of public support.

The EC representative adds that the impact of the epidemic is "largely hidden from public view until HIV has spread widely, manifest in increasing numbers of people suffering from AIDS".

"So, at the very time when public investments in prevention are needed, they may not be easily justifiable," O'Cuneen says.

He says he also recognises the fact that an AIDS epidemic "brings with it conflicting demands -- for investment in prevention at the same time as spending on the care of those people already infected ... whilst not neglecting the needs of people who are suffering from other diseases".

Norton also concedes that it is no easy task. "Governments, communities and families each have a role to play and must join forces in a sustained effort to reduce the impact of HIV/AIDS," she says. (end/ips/he/wg/cb/98) .

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