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AIDS IN THE CARIBBEAN: HOW BAD IT IS

Delegate Donna Christian-Christensen says the territory is "probably losing more people to AIDS than we lost to war," and then she explains why: "A major problem with combating the AIDS epidemic is that AIDS is born in shame, which clouds the seriousness of the disease — and people die!"
Christensen, who is a physician, was a lead speaker at the conference Feb. 24 and 25 on Heightening Awareness of HIV/AIDS in the Caribbean Region. Based on St. Thomas at the Wyndham Sugar Bay Resort, the conference also drew participants from the Bahamas, Jamaica, Barbados and Trinidad via satellite-transmitted teleconferencing to centers at those locations. More than 400 participants were present on St. Thomas, and organizers estimate some 2,000 took part throughout the region.
Among the most dramatic statistical pictures presented at the conference: The Caribbean is second only to Sub-Sahara Africa in the per capita incidence of AIDS cases. The mortality rate from AIDS infection is nine times as high in the Caribbean as it is in the United States — except for Cuba, where incidence is extremely low. And the AIDS infection is spreading fastest among young people — including pre-teens — engaging in heterosexual intercourse.
Sen. Allie-Allison Petrus, one of the opening speakers, noted that although he chairs the V.I. Legislature’s Health Committee, he is not a health professional. He urged those in the health fields to "keep bringing information to the policymakers so they may make informed decisions." He added, "Numbers are necessary to gain the attention of policymakers."
As if in answer to Petrus’ prayer, speakers who followed reeled off statistic after statistic and case study after case study. Dr. Margaret McEvoy, team leader for the joint United Nations Program on Caribbean HIV/AIDS, gave a regional perspective for the area stretching from the Bahamas to Venezuela. Dr. Cora Christian, medical director for HOVIC and founder of the Virgin Islands Health Institute, focused on AIDS in the Virgin Islands. Dr. John Jemmott of the University of Pennsylvania related research into ways to lessen the impact of AIDs.
According to McEvoy, there are 23.3 million active AIDS cases in south and central Africa, 13 million in Latin America, 5 million in south and southeastern Asia, 920,000 in North America, 520,000 in Europe and 360,000 in the Caribbean. More than one half of those stricken are under the age of 25, and one-fourth are children, she said.
In the Caribbean, at one extreme, Cuba has a per capita rate of 0.02 percent; at the other, Haiti has an urban rate of 12 percent and a rural rate of 5 percent, while the Dominican Republic has a rate of about 8 percent. The Caribbean average rate is 1.96 percent.
According to Christian, the Virgin Islands had 412 known AIDS patients as of December 31, 1999, which leads to an estimated 500-plus real patients given under reporting. The Health Department estimates some 7,000 Virgin Islanders are infected with the virus, which would give the territory a per capita rate of 7 percent.
One of McEvoy’s more dramatic slides was a bar graph of world regions and their per capita HIV/AIDS rates. Most areas barely registered, while the Caribbean was about seven times greater — and Sub-Sahara Africa’s level was some five times that of the Caribbean.
According to study findings, 42 percent of Caribbean children have had sexual intercourse before the age of 10, and some 64 percent have done so by the age of 12. If the region is considering preventive measures, these figures put the "at-risk population" in the third and fourth grades. Speaker after speaker emphasized that the only effective way to limit the spread of HIV/AIDS is a strong educational program before children have their first sexual encounter. Ironically, McEvoy said, marriage is a major risk factor. "A married woman has great difficulties requiring her husband to use condoms," he explained. "For one thing, she is afraid to imply to her husband that he may be having outside sexual partners. And if she does, she is liable to [bring on] physical abuse. As a result, she remains silent and takes her chances."
Statistics on life expectancy as a result of AIDS are chilling. The average had risen to 60 years from 40 in developing countries before the advent of AIDS. Today many of those nations are experiencing a decline in life expectancy due to AIDS, and demographers are predicting a steady decrease back to 45 years between the years 2005 and 2010.
In the United States, the AIDS mortality rate — the percentage of those diagnosed with the condition who have died as a result — was 8.6 percent in 1990. It is expected to increase to 37.1 percent by 2020. The AIDS mortality rate in the Caribbean is about 73 percent now.
Other statistics show a related drop in gross national product. Economists predict the GNP of the Caribbean nations will drop about 6 percent in the next five years because of AIDS. In Jamaica, 85 percent of hospital admissions are attributed to AIDs. The economic effect on the country is complex: The work force is depleted, absenteeism sends production down, the cost of training new workers sends costs up, the loss of skilled workers and replacement by new hires decreases productivity, all of which culminates in drastically lowered profits.
Christian noted the dearth of statistics for the U.S. Virgin Islands prior to passage of the 1998 HIV/AIDs Reporting Law. According to current statistics, "While St. Thomas has 49 percent of the territory’s population, it has 62 percent of the active AIDs cases," she said, but 70 percent of the youths infected with HIV/AIDs are on St. Croix. "Our demographics show it is teenagers who are contacting AIDs in the Virgin Islands," she said.
Jemmott described educational programs aimed at different population groups that had positive results and led to five curriculums aimed at intervention: 1991 — Be Proud, Be Responsible; 1992 — Reducing the Risk; 1994 — Get real about AIDs; 1995 — Project BART (Becoming A Responsible Teen); and 1996 — Focus on Kids. The programs were developed for ever younger target audiences as it became evident that prevention education had to take place before children had their first sexual experience. Findings of different studies were in agreement that once children begin to experience intercourse, they are not likely to return to celibacy.
All of the conference speakers concurred on what the problem and its possible solutions are. They agreed there must be different messages, training modes and education programs for those who are sexually active and for those who have yet to start, and that such programs must stress self-esteem and sexual understanding. They agreed that the target group for prevention is children who have not had intercourse. And they agreed that to deny education to youth is to condemn them to increased AIDS proliferation and death.

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Delegate Donna Christian-Christensen says the territory is "probably losing more people to AIDS than we lost to war," and then she explains why: "A major problem with combating the AIDS epidemic is that AIDS is born in shame, which clouds the seriousness of the disease -- and people die!"
Christensen, who is a physician, was a lead speaker at the conference Feb. 24 and 25 on Heightening Awareness of HIV/AIDS in the Caribbean Region. Based on St. Thomas at the Wyndham Sugar Bay Resort, the conference also drew participants from the Bahamas, Jamaica, Barbados and Trinidad via satellite-transmitted teleconferencing to centers at those locations. More than 400 participants were present on St. Thomas, and organizers estimate some 2,000 took part throughout the region.
Among the most dramatic statistical pictures presented at the conference: The Caribbean is second only to Sub-Sahara Africa in the per capita incidence of AIDS cases. The mortality rate from AIDS infection is nine times as high in the Caribbean as it is in the United States -- except for Cuba, where incidence is extremely low. And the AIDS infection is spreading fastest among young people -- including pre-teens -- engaging in heterosexual intercourse.
Sen. Allie-Allison Petrus, one of the opening speakers, noted that although he chairs the V.I. Legislature’s Health Committee, he is not a health professional. He urged those in the health fields to "keep bringing information to the policymakers so they may make informed decisions." He added, "Numbers are necessary to gain the attention of policymakers."
As if in answer to Petrus’ prayer, speakers who followed reeled off statistic after statistic and case study after case study. Dr. Margaret McEvoy, team leader for the joint United Nations Program on Caribbean HIV/AIDS, gave a regional perspective for the area stretching from the Bahamas to Venezuela. Dr. Cora Christian, medical director for HOVIC and founder of the Virgin Islands Health Institute, focused on AIDS in the Virgin Islands. Dr. John Jemmott of the University of Pennsylvania related research into ways to lessen the impact of AIDs.
According to McEvoy, there are 23.3 million active AIDS cases in south and central Africa, 13 million in Latin America, 5 million in south and southeastern Asia, 920,000 in North America, 520,000 in Europe and 360,000 in the Caribbean. More than one half of those stricken are under the age of 25, and one-fourth are children, she said.
In the Caribbean, at one extreme, Cuba has a per capita rate of 0.02 percent; at the other, Haiti has an urban rate of 12 percent and a rural rate of 5 percent, while the Dominican Republic has a rate of about 8 percent. The Caribbean average rate is 1.96 percent.
According to Christian, the Virgin Islands had 412 known AIDS patients as of December 31, 1999, which leads to an estimated 500-plus real patients given under reporting. The Health Department estimates some 7,000 Virgin Islanders are infected with the virus, which would give the territory a per capita rate of 7 percent.
One of McEvoy’s more dramatic slides was a bar graph of world regions and their per capita HIV/AIDS rates. Most areas barely registered, while the Caribbean was about seven times greater -- and Sub-Sahara Africa’s level was some five times that of the Caribbean.
According to study findings, 42 percent of Caribbean children have had sexual intercourse before the age of 10, and some 64 percent have done so by the age of 12. If the region is considering preventive measures, these figures put the "at-risk population" in the third and fourth grades. Speaker after speaker emphasized that the only effective way to limit the spread of HIV/AIDS is a strong educational program before children have their first sexual encounter. Ironically, McEvoy said, marriage is a major risk factor. "A married woman has great difficulties requiring her husband to use condoms," he explained. "For one thing, she is afraid to imply to her husband that he may be having outside sexual partners. And if she does, she is liable to [bring on] physical abuse. As a result, she remains silent and takes her chances."
Statistics on life expectancy as a result of AIDS are chilling. The average had risen to 60 years from 40 in developing countries before the advent of AIDS. Today many of those nations are experiencing a decline in life expectancy due to AIDS, and demographers are predicting a steady decrease back to 45 years between the years 2005 and 2010.
In the United States, the AIDS mortality rate -- the percentage of those diagnosed with the condition who have died as a result -- was 8.6 percent in 1990. It is expected to increase to 37.1 percent by 2020. The AIDS mortality rate in the Caribbean is about 73 percent now.
Other statistics show a related drop in gross national product. Economists predict the GNP of the Caribbean nations will drop about 6 percent in the next five years because of AIDS. In Jamaica, 85 percent of hospital admissions are attributed to AIDs. The economic effect on the country is complex: The work force is depleted, absenteeism sends production down, the cost of training new workers sends costs up, the loss of skilled workers and replacement by new hires decreases productivity, all of which culminates in drastically lowered profits.
Christian noted the dearth of statistics for the U.S. Virgin Islands prior to passage of the 1998 HIV/AIDs Reporting Law. According to current statistics, "While St. Thomas has 49 percent of the territory’s population, it has 62 percent of the active AIDs cases," she said, but 70 percent of the youths infected with HIV/AIDs are on St. Croix. "Our demographics show it is teenagers who are contacting AIDs in the Virgin Islands," she said.
Jemmott described educational programs aimed at different population groups that had positive results and led to five curriculums aimed at intervention: 1991 -- Be Proud, Be Responsible; 1992 -- Reducing the Risk; 1994 -- Get real about AIDs; 1995 -- Project BART (Becoming A Responsible Teen); and 1996 -- Focus on Kids. The programs were developed for ever younger target audiences as it became evident that prevention education had to take place before children had their first sexual experience. Findings of different studies were in agreement that once children begin to experience intercourse, they are not likely to return to celibacy.
All of the conference speakers concurred on what the problem and its possible solutions are. They agreed there must be different messages, training modes and education programs for those who are sexually active and for those who have yet to start, and that such programs must stress self-esteem and sexual understanding. They agreed that the target group for prevention is children who have not had intercourse. And they agreed that to deny education to youth is to condemn them to increased AIDS proliferation and death.