JIS News

Five years ago, a person would not willingly admit to having the HIV infection as the stigma surrounding the disease was so great, it was considered taboo. Today, while there are still reservations about publicly declaring the condition, individuals can feel more comfortable discussing the issue.
This is the stage Jamaica has reached since the Ministry of Health put in place certain measures to educate the public on the spread and control of this deadly disease. The year 2005 should yield even better results as the Global Fund recently pledged a grant of some US$23 million to assist Jamaica in its fight against HIV/AIDS, over the next five years.
Yitades Gebre, Senior Medical Officer/Executive Director of Jamaica HIV/AIDS Prevention and Control Project informs JIS News that Jamaica has already received US$2.3 million of this grant this year, with a projected US$3.9 million to be disbursed next year.
A sum of US$3.5 million will follow in the year 2006. This grant will be used to educate the public, provide treatment and preventive measures, as well as to implement a national policy to address issues relating to the HIV/AIDS.
According to statistics from the National HIV/STD Prevention and Control Programme, a total of 578 new AIDS cases were reported in Jamaica from January to June of 2004. Of this figure, 334 are males and 244 are females.
Dr. Gebre points out that about 1.5 per cent of the adult population is HIV positive with some 12 to 14 deaths being reported each week.
He notes that for the first time in 2004, there has been a significant decline, at least 27 per cent, in the number of persons dying from AIDS. This reduction, he says, is as a result of the Ministry’s Public Access Programme, which provides expensive anti-retroviral drugs and certain tests at a much lower cost.
Medications and tests, usually considered to be out of the reach of most patients, have become more affordable and accessible through the Public Access Programme.
Dr. Gebre explains that since June of this year, persons who experience severe financial difficulties, have been able to access the service free of cost, while for others, the cost is subsidized.
Currently, there are 500 patients enrolled in the programme, and Dr. Gebre says plans are in place to have that number increased to 1,000 by next year.
“The most important reason for the decline in AIDS death is the availability of anti-retroviral drugs for people living with HIV and AIDS. So many more persons are on treatment in 2004, compared to the previous years,” Dr. Gebre points out.
He notes that previously, medication was not readily accessible or affordable to the persons who needed it. However, since June of 2004, with donations from Lasco, and the Clinton Foundation, the Ministry of Health has been able to provide medication for as many as 500 persons over the last six months.
“We have also received a grant from the Global Fund, and through this mechanism the government provides treatment in the public sector, otherwise, in the past, people would have to get treatment from the private physicians and they have to find their own resources to buy drugs wherever they were available,” he tells JIS News.
Dr. Gebre says that generic drugs currently available on the market have helped significantly, as they are much cheaper than the brand name ones.
Explaining further how the Public Access Programme works, Dr. Gebre says the programme is a scaling up of treatment and care for people living with HIV/AIDS. “It’s primarily provided through the public sector such as health centres and hospitals. We have identified as many as 14 new treatment sites for anti-retroviral drugs, such as the Kingston Public Hospital, Bustamante Hospital for Children, University Hospital of the West Indies, the Centre for HIV/AIDS Research Education (CHARE),” Dr. Gebre notes.
He tells JIS News that there will be at least one treatment site for each parish. “In each of those parishes, in the regional hospital, we are expanding our treatment facilities and individuals can access treatment through these sites,” Dr. Gebre says.
One monthly anti-retroviral drug, which costs over $2,000 at private institutions, can be had at the subsidized price of a $1,000 through the Public Access Programme.
Dr. Gebre says there are at least 8,000 persons who need immediate treatment through the Public Access Programme. The others will be worked into the system over a period of time. “We are scaling up actually. We haven’t reached all the people who need treatment. It is about 8,000 who actually need immediate treatment, and then out of this 8,000 our target by June 2005 is to treat as many as 1,000 people. We will be able to exceed our target by then,” he adds. Currently there are over 22,000 reported cases of HIV/AIDS in Jamaica.
“Because of stigma and discrimination having to do with HIV and AIDS, people may not access services which may be life saving for them. One of the assumptions in the earlier days was that once treatment is available then the stigma and discrimination may decline, but stigma and discrimination still exist,” Dr. Gebre informs JIS News.
“We are trying to address and reduce this problem by providing educational campaigns, including the necessary supporting mechanism and legislation to reduce stigma and discrimination,” he adds.
He points out that close to 70 per cent of the transmission is from heterosexual encounters; bisexual and homosexual transmission is about 6 per cent, while 6 -7 per cent is from mother to child.
Even while condom use has increased significantly, Dr. Gebre says thousands of people are still engaging in unprotected sex with non-regular sexual partners.
“Overall, condom use is still high. However, there is a pocket of the population, almost 20 per cent to 25 per cent of both men and women, who are not using condom with a non-regular sexual partner. That translates into hundreds of thousands of adult men and women who are putting themselves at risk.women more than men,” he adds.
The rate of new HIV infection in women in the age group 20-24 is increasing steadily more than men in the same age group, according to statistics from the National HIV/STD Prevention and Control Programme. The statistics further indicate that the number of newly reported AIDS cases in adolescent girls in the age group 15-24 years was three times higher than boys of the same age group.
From January to June this year, there were 31 adolescent girls and boys reported with AIDS. Researchers claim that poverty, ignorance, early sexual experiences with older men and embarrassment to seek advice on protection are responsible for the increase among adolescent females.
For the first half of 2004, there were 40 children under the age of 10 years reported with AIDS, compared to 22 children in the previous year. However, there were fewer Paediatric AIDS deaths, as 18 children died of AIDS compared to 29 in the previous year. This is also attributable to the improvement in care and treatment for HIV infected children and a decrease in mother to child transmission of HIV.
For the coming year, Dr. Gebre is hopeful about the number of projects slated to come on stream to deal with HIV/AIDS. One such project will look at educational campaigns aimed at changing the behaviour of high-risk persons, namely young men and women, people living in depressed areas, commercial sex workers and homosexuals.
During 2005, persons living with HIV/AIDS can also expect to have increased access to treatment.
Through the implementation of a national policy, the high level of discrimination and stigma will be dealt with through a human rights approach. There is also expected to be a scaling up of prevention programmes through the latest project dubbed, Priority Location Aids Control Efforts (PLACE).
Dr. Gebre, in explaining how this will work, tells JIS News that surveys have been done to identify the locations where people are most likely to meet new sex partners. Once these places are located, he says this will provide the opportunity for interventions through different approaches.
Currently, the Ministry of Health collaborates with several other ministries in dealing with the HIV/AIDS epidemic. These include the Ministries of Education, Labour, Security, Tourism and Local Government.
Other funding agencies such as the German Technical Co-operation (GTZ), Canadian International Development Agency (CIDA), United Nations Global Programme on AIDS, the Pan American Health Organisation/World Health Organization (PAHO/WHO), Caribbean Epidemiology Centre (CAREC), United Nations Population Fund (UNFPA) and the United Nations Educational Scientific and Cultural Organisation (UNESCO), have played significant roles in the development and implementation of prevention programmes.