BOZEMAN, Montana — For decades, the Caribbean has suffered from high rates of HIV/AIDS infections. Influenced by numerous factors, including unequal healthcare access and social stigmas, the region has the second-highest HIV prevalence in the world. Currently, around 330,000 people in the archipelago have a diagnosed HIV infection with many more cases likely remaining undiagnosed. Despite alarming rates of infections, however, the region has seen promising improvements since prioritizing the overall goal of eliminating AIDS by 2030.
What is HIV?
To understand the magnitude of this epidemic for Caribbean residents, it is important to understand HIV/AIDS as a disease and how current programs are combatting this problem. In short, HIV is a virus that attacks the body’s own immune system. The normal progression of HIV leads to AIDS, which results in a depleted immune system, and therefore, increased susceptibility to other illnesses. There is no complete cure for HIV but treatments called antiretrovirals are incredibly effective at slowing the progression of AIDS.
Since 2010, the region has made incredible progress in combatting its HIV crisis. The most recent analysis from the Pan-American Health Organization (PAHO) reports the following statistics:
- New HIV infections have dropped by 29% between 2010 and 2019, resulting in nearly 5,000 fewer new annual infections in 2019 versus 2010.
- Of those who are HIV-positive, 63% are receiving antiretroviral treatment as opposed to only 22% in 2010.
- The proportion of children with HIV receiving antiretroviral treatment grew from 42% in 2017 to 44% in 2019. Children being treated with antiretrovirals at a young age is vital as most have been infected at birth from HIV-positive mothers.
- Rates for HIV-positive mothers receiving treatment rose to 86% in 2019 from only 42% in 2010.
- Annual HIV/AIDS-related deaths decreased from about 11,000 in 2010 to 6,900 in 2019.
The 90-90-90 Program
The Joint United Nations Programme on HIV/AIDS (UNAIDS) established the program. The goal of this program is for 90% of people with HIV to know their positive status, for 90% of those infected to be receiving antiretroviral therapy and for 90% of those receiving therapy to have viral load suppression, which indicates that the treatment is working. Unfortunately, the Caribbean has not quite reached this goal. However, data from 2019 reports the numbers at around 77-81-80 — substantially higher than global averages. UNAIDS projects that regions that can successfully hit this 90-90-90 mark are on track towards eliminating AIDS by 2030.
Moving Forward During The Pandemic
The recent COVID-19 pandemic has proven a major barrier for medical care worldwide. A coalition of organizations is, therefore, pushing for HIV self-testing to combat the issues presented by this pandemic. Not only is HIV self-testing both safe and reliable, but the individual can also discover their results in private. PAHO and World Health Organization (WHO) coordinators are encouraged by the early acceptance of this “In Your Hands” self-testing program as a solution not only to problems faced during the pandemic but as a solution to reach groups of people who could not get tested or were reluctant due to potential social backlash.
Increasing the number of Caribbean residents being tested would also increase awareness and allow for antiretroviral treatment to be more effectively distributed to those who may not have been aware of their positive status beforehand. This provides an exciting new outlook on the Caribbean goal of reaching the 90-90-90 milestone in a commitment to eliminating AIDS by 2030 in this historically underserved region.
– Jackson Thennis