New UN report shows HIV epidemic has slowed considerably in the Caribbean

In the Caribbean region, new HIV infections were reduced by a third from 2001 levels

Jorge Luis Baños - IPS

The number of people living with HIV has also declined slightly since the early 2000s

UNITED NATIONS, CMC – The Report on the Global AIDS Epidemic 2011 released here Monday by the United Nations shows that the Caribbean continues to have the second highest regional HIV prevalence after sub-Saharan Africa, but that the epidemic has slowed considerably since the mid-1990s.

It said that in the Caribbean region, new HIV infections were reduced by a third from 2001 levels and that HIV incidence has decreased by an estimated 25 per cent in the Dominican Republic and Jamaica since 2001, while in Haiti it has declined by about 12 per cent.

“Slowing HIV incidence and increasing access to HIV prevention services for pregnant women have led to a steep decline in the number of children newly infected with HIV and in AIDS-related deaths among children,” the report said, noting that unprotected sex is the primary mode of transmission in the Caribbean.

It noted that the number of people living with HIV has also declined slightly since the early 2000s and that increased access to antiretroviral therapy has led to a considerable drop in mortality associated with AIDS. More people than ever are living with HIV, largely due to greater access to treatment, the report noted.

“At the end of 2010, an estimated 34 million people were living with HIV worldwide, up 17 per cent from 2001. This reflects the continued large number of new HIV infections and a significant expansion  of access to antiretroviral therapy, which has helped reduce AIDS-related deaths, especially in more recent years.”

It said that the number of people dying of AIDS-related causes fell to 1.8 million in 2010, down from a peak of 2.2 million in the mid-2000s. A total of 2.5 million deaths have been averted in low- and middle-income countries since 1995 due to antiretroviral therapy being introduced, according to new calculations by UNAIDS.

It said that much of that success has come in the past two years when rapid scale-up of access to treatment occurred; in 2010 alone, 700 000 AIDS related deaths were averted.

The proportion of women living with HIV has remained stable at 50 per cent globally, although women are more affected in sub-Saharan Africa (59% of all people living with HIV) and the Caribbean (53%).

There were 2.7 million new HIV infections in 2010, including an estimated 390 000 among children.

“This was 15 per cent less than in 2001, and 21 per cent below the number of new infections at the peak of the epidemic in 1997. The number of people becoming infected with HIV is continuing to fall, in some countries more rapidly than others. HIV incidence has fallen in 33 countries, 22 of them in sub-Saharan Africa, the region most affected by the AIDS epidemic,” the report noted.

UNAIDS Deputy Executive Director Paul De Lay said  that behavioural changes, which include the use of condoms, having fewer sexual partners, and young people waiting longer before becoming sexually active, were the main causes for progress in Africa.

De Lay said that scientific breakthroughs have shown how people receiving treatment also become less infectious with time, decreasing the risk of infection for their partners and lowering the chances of transmission from mothers to newborns.

He said the progress in recent years is notable since it has occurred in spite of funding cuts due to the global economic crisis. Last year, funding from donor countries went from US$7.6 billion to US$6.9 billion, representing a 10 per cent reduction.

“One of the things that the report focuses on is how countries can spend the amount they have now in a much smarter way so they get more impact,”  De Lay said, expressing concern for the decrease in funding not only from international donors but from foundations and internal institutions in countries with high infection rates.

In addition, UNAIDS stressed in its report that although the data points to incremental progress, a transformative response is needed to meet the 2015 targets set by member states in June through the Political Declaration on HIV/AIDS, and to support the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths in the near future.

“We need to move from a short-term, piecemeal approach to a long-term strategic response with matching investment,” said Michel Sidibé, Executive Director of UNAIDS.

“The world faces a clear choice: maintain current efforts and make incremental progress, or invest smartly and achieve rapid success in the AIDS response,” says the UNAIDS report, calling for an increase in smart strategies and commitment from countries.

The report also maps a new framework for AIDS investments, which focuses on getting high impact and high-value strategies.

The framework is based on several elements, including focusing interventions for populations at higher risk such as sex workers and people who inject drugs; promoting behavioural change programmes; and increasing treatment and care for people living with HIV.


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