Regional HIV/AIDS control in the Caribbean
Title: Regional HIV/AIDS control in the Caribbean
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Countries: PANCAP Member States, specifically the Dominican Republic, Haiti, Guyana, Antigua and Barbuda, Suriname, Trinidad and Tobago, Sint Maarten
Leading executing agency: Caribbean Community Secretariat (CARICOM); Pan Caribbean Partnership against HIV/AIDS (PANCAP)
Overall term: 2009 to 2015
Although the Caribbean ranks just behind sub-Saharan Africa among the regions with the highest prevalence of HIV (1 per cent), the number of new infections in the region has decreased by about half over the past 10 years. This has allowed for the Caribbean to boast the sharpest rate of decline in new HIV infections in the world.
Apart from this success, the region has a poor record in terms of the rights and access to HIV services available to the highest risk groups. Stigmatisation along with discrimination and criminalisation of sex workers, sexual minorities and people infected with HIV are part of a bitter everyday reality. The prevalence of HIV among these groups is far above average, as data compiled by the Pan-Caribbean Partnership Against HIV/AIDS (PANCAP) from 2012 shows: the infection rate for men who have sex with other men (MSM) in Guyana is 19 per cent, while sex workers in the Dominican Republic suffer from a rate of 4 per cent. Migrants must also often be considered to be a highly vulnerable group, either because they belong to one of the previously mentioned groups and/or additionally face specific challenges when utilising health services – such as linguistic and cultural barriers, fear of deportation, lack of information, and many others.
The conditions related to accessing HIV prevention, treatment and counselling services for migrants has been improved across a number of Caribbean countries.
This project seeks to improve the legal and political parameters regionally as well as within individual partner countries; this includes a range of measures such as reforming laws against discrimination. At regional level, the project supports the partner organisation PANCAP (Pan Caribbean Partnership against HIV and AIDS) in advancing existing initiatives aimed at creating a model anti-discrimination law and implementing it at the national level across the Caribbean. Financing mechanisms are being developed both nationally and regionally, and the resulting extras revenues will be used to strengthen existing health systems. The main goal is to improve the health system as a whole so that the available services will also benefit migrants.
There are two additional service areas that focus on implementation. These centre on inclusionary measures targeted at migrants and the qualitative improvement of HIV services within the partner countries. These measures will help overcome language barriers and facilitate intercultural sensitivity.
Results achieved so far
This regional project currently provides crucial information about access to HIV services for migrants in the Caribbean – such as expanding the scope of national HIV surveys in Guyana. In cooperation with the project partner at top political levels, the issue of HIV and migration has been incorporated into the agenda at the regional, binational and national levels, thereby feeding it into the general debate. This has led to various achievements, including discussion by the CARICOM Ministers of Health regarding a tourist tax for funding an inclusive health system.
Targeted training courses at health centres are being carried out together with the responsible ministries. Their aim is to create more migrant-friendly and gender-sensitive HIV services while simultaneously counteracting stigmatisation and discrimination. In places such as Sint Maarten, HIV tests and counselling measures in certain hotspots were accompanied by informational campaigns that have led to a significant increase in the demand for these services, especially by migrants. In the context of trans-national cooperation between Haiti and the Dominican Republic, advisory services related to improving health services for migrants has markedly gained in importance.