Every 25 seconds someone in the world is infected with HIV.

According to the World Health Organization (WHO), approximately 42.3 million people have died from HIV since the beginning of the epidemic. Regrettably, many people continue to behave as if HIV no longer exists. In fact, sexual education is not prioritised in the education system. As a result, many have turned to alternative sources in order to obtain information regarding their sexual health.

The WHO defines sexual health as “a state of physical, emotional, mental, and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence. For sexual health to be attained and maintained, the sexual rights of all individuals must be respected, protected, and fulfilled”.

World AIDS Day is observed on December 1 annually. The theme this year is ‘Take the Rights Path: My Health, My Right’. It is an opportunity for every community and individual to honour the more than 32 million people who have died worldwide from AIDS-related illnesses. It is a day for voices to unite by sharing experiences, remembering those lost, and standing together in the fight against HIV.

World AIDS Day remains as relevant today as it has always been, reminding people and governments that HIV has not gone away. There is still a critical need for increased funding for the AIDS response, to increase awareness of the impact of HIV on people’s lives, to end stigma and discrimination, and to improve the quality of life of people living with HIV.

The day sheds light on global health, in solidarity with people around the world who are affected by HIV and gives voice to the shared experiences of the affected, remembering those lost, and standing strong in the fight against HIV. The observance is also used as a day to highlight new and effective programmes and policies across different sectors concerning HIV/AIDS.

Take The Rights Path

The United Nations (UN) is adamant that the world can end AIDS if everyone’s rights are protected. With human rights at the centre, with communities in the lead, I believe the world can end AIDS as a public health threat by 2030. The substantial progress that has been made in the HIV response is directly linked to progress in protecting human rights. In turn, the progress made through HIV response has galvanised broader progress in realising the right to health and strengthening health systems.

But gaps in the realisation of human rights for all are keeping the world from getting on the path that ends AIDS and are hurting public health, and now a surge in attacks on rights is threatening to undermine the progress that has been made.

Ending AIDS requires that we reach and engage everyone who is living with, at risk for, or affected by HIV, especially including people who have been most excluded and marginalised.

The upholding of everyone’s human rights is an essential underpinning of an effective HIV response. This World AIDS Day was a call to action to protect everyone’s health by protecting everyone’s rights. Leaders need to take the rights path.

Latin America and the Caribbean

In Jamaica it is estimated that 32,000 people are living with HIV and as many as 50 per cent are unaware of their status. The most urbanised parishes have the highest cumulative number of reported HIV cases: Kingston & St Andrew 1,570.1 cases per 100,000 people and St James, 2094.

According to the Pan American Health Organization (PAHO), the Caribbean has the highest rate of reported AIDS cases in the Americas. The HIV epidemic in the region disproportionally affects certain sub-populations, including gay men and other men who have sex with men (MSM), transgender women, and female sex workers. In 2021, there were an estimated 3.8 million people with HIV in the Americas, of which 2.5 million live in Latin America and the Caribbean.

PAHO declares that approximately 1.7 million people living with HIV were receiving antiretroviral treatment (ART) in Latin America and 240,000 in the Caribbean at the end of 2023.

Additionally, UNAIDS reported that nearly 90 per cent of new infections in the Caribbean in 2017 occurred in four countries: Cuba, Dominican Republic, Haiti, and Jamaica. With between 350,000 and 590,000 Caribbean people living with HIV/AIDS, the region has an adult HIV prevalence rate between 1.9 per cent and 3.1 per cent, second only to Africa (7.5 per cent and 8.5 per cent). As a whole, the Caribbean is facing a generalised epidemic. The most recent national estimates showed HIV prevalence among pregnant women reaching or exceeding 2 per cent in eight countries: the Bahamas, Belize, the Dominican Republic, Haiti, St Lucia, Suriname, and Trinidad and Tobago. The Caribbean had a reduction of 28 per cent from 2010 to 2021, down from an estimated 19,000 new cases to 14,000 per year. Jamaica ranks sixth on the global statistics regarding sexually transmitted diseases rate per 100,000 population at 29,600.

Gender and HIV/AIDS

All the research which have been done have concluded that HIV disproportionately affects women and girls because of their unequal cultural, social, and economic status in society. Women are less likely to negotiate condom use and safe sex practices in their relationships.

According to Avert, a UK-based internationally focused charity, women constitute more than half of all people living with HIV and AIDS-related illnesses, remaining the leading cause of death for women aged between 15 and 49. Young women (aged 15-24), and adolescent girls (aged 10-19) in particular, account for a disproportionate number of new HIV infections. In 2017, 7,000 adolescent girls and young women became HIV-positive. This is a far higher rate than new infections among young men, with young women twice as likely to acquire HIV as their male peers.

Avert added that in sub-Saharan Africa, despite making up just 10 per cent of the population, one out of every five new HIV infections happen among adolescent girls and young women. In the worse-affected countries, 80 per cent of new HIV infections among adolescents are among girls, who are up to eight times more likely to be living with HIV than adolescent boys.

The United Nations Children’s Fund (UNICEF) declares the main drivers of the HIV epidemic are influenced by a wide range of gender inequalities. According to UNICEF, early and forced marriage, gender-based violence; unequal access to information, including sexual health knowledge; and a lack of negotiating power and economic autonomy are among the factors that place women and adolescent girls at increased risk of HIV infection as well as circumscribe their responses to being infected. At the same time, masculine norms that promote promiscuity and substance abuse increase the risk of infection among men and boys.

Medical Advancements

The medical community continues to make great strides since the first known cases of AIDS were reported in 1981. However, in 2023 an estimated 39.9 million people were living with HIV globally and an estimated 630, 000 people died from HIV-related causes in the same year.

Interestingly, a drug currently being used to treat HIV has also been found to dramatically reduce the risk of infection, significantly more than the primary option available for pre-exposure prophylaxis or PrEP. In a Phase 3 clinical trial, 99.9 per cent of participants who took a twice-a-year injection of lenacapavir for HIV prevention did not acquire an infection, according to data from drug maker Gilead Sciences. The issue of affordability, especially for developing countries, will be critical in terms of access to this drug for the many who live outside the USA and Europe.

World AIDS Day serves as an important reminder that global community must remain steadfast in their commitment to prevent new HIV infections and provide essential services to all people living with HIV globally. The day also serves as a powerful reminder that we must become more sexually responsible in order to safeguard ourselves from HIV.

Unfortunately, discriminatory laws, policies, and practices still are prevalent and continue to punish and stigmatise vulnerable people. The international community, therefore, needs to redouble its efforts in order to achieve the United Nations Sustainable Development Goals, especially goal number three that addresses good health and well-being.

Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and/or gender issues. Send comments to the Jamaica Observer or waykam@yahoo.com.