Combating AIDS in the Caribbean: a coordinated subregional approach
Narain, J.P.; White, F.M.; Kimball, A.M.; Zessler, L.; Zacarías, F.R.
Bulletin of the Pan American Health Organization 24(3): 335-340
1990
ISSN/ISBN: 0085-4638 PMID: 2224333 Document Number: 373654
This report describes AIDS in the English-speaking Caribbean and Suriname and outlines the steps being taken by the Caribbean Epidemiology Centre (CAREC) to support national AIDS Control Programmes through a subregional project. As of 31 July 1990, a total of 1702 AIDS cases had been reported to CAREC by the 19 member countries with 58% of the patients having died. Sixty two percent of adult cases in 1989 were due to heterosexual contact compared with 34% in 1986, indicating a shift in the epidemic from transmission among homo/bisexuals to heterosexuals. The male-to-female ratio has declined from 5.4:1 initially to 2.2:1 in 1989 when there were 91 AIDS cases per million inhabitants.In response to the epidemic, Caribbean countries have prepared medium-term plans (MTPs) with the assistance of WHO/PAHO/CAREC, established National AIDS Committees, started education of health staff and the public, and instituted the screening of blood donors (HIV seropositivity 0.24-0.96%). CAREC coordination and subregional support for national MTPs includes surveillance, confirmatory testing and quality control for laboratories, a Caribbean Education Information Centre, assistance with KABP surveys, preparation of manuals and promotion of effective management.[This report gives a brief introduction to AIDS in the Caribbean and a summary of CAREC's support for national AIDS Control Programmes. Within the subregion, there are interesting variations in HIV transmission such as the role of crack/cocaine in the Bahamas and migrant farmworkers in Jamaica as well as innovative strategies to combat HIV spread with limited resources. These include the integration of HIV and STD control, different counselling strategies, and the use of drama. It would be useful to document these initiatives more fully.]J.P. Figueroa.