More education among youth about HIV/AIDS
Jamaica has made good progress over the years towards ending the AIDS epidemic in our country. At present, 81 per cent of the estimated 1.8 per cent of people 15-49 years, or 29,260 people living with HIV, know their status. Most of the gains in reducing HIV prevalence have been in the general population, among sex workers (from over 14 per cent in the 1990s to 2.9 per cent at the end of 2014), and Mother-to-Child-Transmission (MTCT), which is less than two per cent.
The stellar work of many individuals, ministries, organisations and government agencies such as Jamaica AIDS Support for Life, Ministry of Health, J-FLAG, and ministries of Health and Education cannot go unnoticed in this regard.
However, notwithstanding these gains, reducing HIV prevalence among gay, bisexual and other men who have sex with men (MSM) remains a big challenge. But this is perhaps not a mammoth task when compared to the desperate need to begin to reach and provide more services to adolescents and youth who do not typically feature much in constructive discussions about the national HIV and AIDS response. Young people account for one in every three new infections worldwide. HIV prevalence among the general population of adolescent girls and boys is 0.4 per cent and 0.5 per cent, respectively; 14 per cent for men who have sex with men who are between 15 and 19 years and 27 per cent among adolescents 15-19 years who identify as transgender. In addition, HIV prevalence among young girls and boys 20-24 years is one per cent and 1.4 per cent, respectively.
There is clearly a lot of work that has to be done to halt and reverse the spread of HIV among our young people. Evidence shows that the main proximal factors driving the epidemic in Jamaica are insufficient condom use, high HIV rate among MSM, multiple sex partnerships, and unawareness of HIV status. The underlying factors driving the epidemic continue to be poverty, stigma and discrimination, gender inequity and gender roles and substance use.
At the end of 2012, low-risk heterosexual sex accounted for 15 per cent of all new infections, MSM - 30 per cent; casual heterosexual sex - 23 per cent; female partners of MSM - seven per cent and the partners of those who engage in casual heterosexual sex. The data for HIV prevalence among MSM show that adverse life events such as being raped, low literacy or jailed can impact quite drastically on HIV prevalence.
Globally, stakeholders within the HIV and AIDS response are working assiduously to achieve the '90-90-90' targets to ensure: 1) 90 per cent of all people living with HIV will know their HIV status; 2) 90 per cent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 3) 90 per cent of all people receiving antiretroviral therapy will have viral suppression by year 2020. There is no doubt that we will achieve target one; however, it is clear that there is a great deal of work to be done to increase the percentage of people living with HIV on antiretroviral treatment from 38 per cent at the end of 2015 to 90 in the next five years. Similarly, more needs to be done by government and non-government actors to achieve viral suppression, which is currently 49 per cent.
Earlier this week, December 1, World AIDS Day was observed. Locally, we used the occasion to recommit ourselves and organisations to the mammoth/daunting tasks we have to do to reduce new infections, reduce stigma and discrimination, put and keep people on treatment, and reduce AIDS-related deaths.
We must, therefore, never forget that people living with and affected by HIV depend on us to:
1. Address the barriers that cause young people and key populations not to access or take up prevention and treatment services.
2. Enhance the training health-care workers/professionals get before and during service to ensure they are capacitated to provide psychosocial support to key populations.
3. Reduce stigma and discrimination in our health facilities, whether perpetrated by clients/patients or health-care workers.
4. Improve orientation training programmers at our health facilities so health-care workers are knowledgeable about the protocols and policies governing their work, human rights and other important aspects of their work.
5. Train health-care workers around effective communication.
6. Find innovative ways to encourage/
support adherence to antiretroviral treatment.
7. Remedy the link with laws and policies and their impact on vulnerability to HIV.
Let us never lose sight of the ambitious but achievable targets we have set for ourselves. We have done well over the years but much more is left to be done to end the AIDS epidemic in our country.