JAMAICA AIDS Support for Life (JASL) regional programme manager for Kingston, Christina Gordon, says the introduction of injectable HIV treatments is one way Jamaica could fight issues with adherence to medication among the vulnerable community.

Gordon noted that currently the Ministry of Health and Wellness provides free antiretroviral (ARV) medications to persons living with HIV in the form of a pill that is taken once a day. However, she said the process of taking a pill every day can become daunting for members of the vulnerable group who face different barriers, resulting in adherence issues.

“People have real things that happen to them, real-life adversities [such as the] death of a loved one, substance misuse, disclosure issues, issues around gender-based violence, and so on. As a result, these things can be barriers to adhering to a pill every single day,” reasoned Gordon.

“I would have worked on the ground and I would have seen where people literally have physical barriers with swallowing the pill, and sometimes it is mental. Some people, once they see the pill, there is this psychological barrier where they can’t swallow it, and maybe an injection would achieve the suppression faster than the pill. When you look at the men, for example, some men just don’t like to take pills, so I think if there are other options you would definitely have more adherence,” she told the Jamaica Observer at a recent Monday Exchange.

According to UNAIDS, 30.7 million people globally were accessing antiretroviral therapy at the end of December 2023, up from 7.7 million in 2010, but still short of the 34 million target for 2025.

Gordon shared that injectable HIV treatments are currently being used in the United States as an effective treatment option for persons living with HIV.

According to the Centre for Disease Control and Prevention in the United States, injectable HIV treatments are given by a health-care provider and are administered once a month or once every other month, depending on the treatment plan.

Gordon stated that the injection is more costly than the pill. However, she urged the Government to explore the option, if they can afford it, to remove the daunting process of persons living with HIV taking medication daily.

She clarified that the injection would not replace the pill but give individuals the option to choose.

“Some people will prefer the tablets over the injection because of their fear of needles, but you have some persons who would prefer a needle over taking pills every day. It could help with adherence,” she insisted.

The JASL regional programme manager said that in the absence of alternatives JASL has created programmes to help members of the vulnerable community overcome barriers through psychosocial and adherence counselling as well as support groups.

She noted that Jamaica has come a far way in terms of medication, but stressed that she does not think strides have been made in terms of other options.

Jamaica’s National Strategic Policy 90-90-90 HIV treatment cascade goals seek to have 90 per cent of people know their HIV status, 90 per cent of people with HIV on antiretroviral therapy, and 90 per cent of people on antiretroviral therapy have suppressed viral load by 2025, and 95-95-95 by 2030. However, the country is far from reaching its goal.

The Planning Institute of Jamaica (PIOJ) Economic and Social Survey for 2023 reported that 91 per cent of persons with HIV were aware of their status, 53 per cent of persons with HIV who knew their status were retained on HIV treatment, and 79 per cent of persons with HIV who were on treatment were reported as being virally suppressed.

The medical director at JASL, Dr Jennifer Tomlinson, stressed the importance of adherence and urged members of the vulnerable population to take their medication.

“Once clients are adherent to their medication, the medication is extremely effective and what that means is the amount of virus that they carry in the blood goes down to a level that is undetectable. If it is undetectable, it means that the person living with HIV is not able to transmit the virus to another person,” Dr Tomlinson told the Observer.

She said that while Jamaica does not provide injectable HIV treatments, the ARV medication provided in pill format by the health ministry is very effective.

Dr Tomlinson also stressed the need to address barriers affecting members of the vulnerable community that create issues with adherence.

“We have to identify all the barriers they have, whether it is that they are afraid to let their partner see the medication, whether it is that they don’t believe in taking tablets every day, or whether it is that they don’t have bus fare to come to the clinic to fill their prescription,” she said.

The Ministry of Health continues the fight to treat and prevent the spread of HIV across Jamaica.

According to the PIOJ survey for 2023, ministries, departments, and agencies, members of civil society organisations, and individuals from the network of persons living with HIV collaborated to identify the barriers and issues of inequality that exist and effectively address them.

“The initiative led to the launch of the HIV Champions for Change Campaign to increase awareness about stigma and discrimination, human rights, and the responsibility that exists among individuals, families, and communities,” stated the report.

World AIDS Day is recognised annually on December 1. The theme for this year is ‘Take the Rights Path: My Health, My Right!’ which emphasises how important human rights are to reaching the 2030 AIDS eradication target.

Individuals who want to know their HIV status, receive treatment or support can contact JASL offices islandwide for further information.