TT HIV rate up fivefold since 1992

Against the global backdrop of five million new infections and three million deaths for 2003, the number of HIV/AIDS cases in TT continues to rise and is yet to plateau. Between 1992 and 2002 there was a fivefold increase in HIV cases and four-fold increase in AIDS cases, said Principal Medical Officer (Epidemiology), Ministry of Health, Dr Ian Popplewell. At a media briefing yesterday at the United Nations Information Centre, Victoria Avenue, to present the AIDS epidemic update for this year, the doctor announced that the number of HIV cases in 2002 was 11,341 while ten years earlier there were 2,246 cases reported in this country.

AIDS cases in the same ten-year period rose from 1,156 in 1992 to 4,711 in 2002. The number of deaths have also steadily risen from six in 1983, to 172 in 1992 and 236 for 2002. The total number of deaths from 1983 to 2002 is 2,946. Dr Popplewell said the epidemic is serious and TT has not had a levelling off of cases. He was quick to point out significant under-reporting of the disease. “There are people who are high risk walking around looking healthy and are potential sources of infection. They are not reported in the system.” Dr Popplewell described the epidemic as one of “very young” people with 70 percent of cases occurring in the 20-49 age group and four percent in 15-19 age group. Children under five years account for six percent of cases.

He admitted that TT has been slow getting on board with a national response, but said this was the case globally. Dr Popplewell said other countries have had responses which were ineffective in dealing with the epidemic. He said these countries have recognised that an expanded response is required and as it is not just a Ministry of Health issue. Dr Popplewell also highlighted the impact of culture, saying sexual behaviours do not change overnight. “It will take a generation or two to change the Caribbean male’s macho image, sexual practices and teaching fidelity to one partner.” Dr Popplewell said 80 percent of mothers attending antenatal clinics accepted voluntary counselling and testing and this was used as a gauge to determine the national prevalence rate — 1.2 percent. “The Ministry’s challenge is expanding the mother-to-child prevention programme to the private sector and to deliver 30-35 percent of our antenatal mothers to have a fully national programme.”

The World Bank loan for US$20 million will be used to support this expansion and other areas of the National HIV/AIDS Strategic Plan. Dr Popplewell said major expansion is needed in the Ministry’s voluntary counselling and testing programme for the general population and especially youths. “We need to test everyone who is at risk to get an idea of what is the prevalence burden of HIV in TT.” During the question and answer session, Dr Popplewell spoke of the need for legislation that will protect the right to employment healthcare. He said there is debate whether HIV should be made a notifiable disease in order to improve surveillance. “We have avoided it because it may push the disease underground, there is already an unwillingness.”

Dr Popplewell added that to bring legislation without removing stigma and discrimination would lead to further unwillingness to be tested. Dr Popplewell said nurses in the field have expressed concern regarding informing the partners of women in the mother-to-child programme. “We have a lot of instances of HIV positive pregnant women who are, because of fear, refusing to notify their spouses about their HIV status.” He said there has to be public debate as HIV/AIDS is a public health issue. Dr Popplewell said laws are being considered to deal with people who knowingly infect others with HIV. He said laws cannot be a panacea because they cannot prevent stigma and discrimination. 

HIV doubles in TT over last 5 years

Newsday, CAREC in AIDS education project

The Caribbean Epidemiology Centre through its Special Programme on Sexually Transmitted Infections (CAREC-SPSTI) has teamed up with Newsday in a project to educate the TT public about HIV/AIDS. Last Monday, CAREC handed over thousands of an updated version of its HIV/AIDS education booklet “Frequently asked questions about HIV/AIDS” to Newsday’s Executive Chairman and Editor-in-Chief Therese Mills for distribution in this Sunday’s newspaper. The exercise is being undertaken as part of CAREC-SPSTI and Newsday’s contribution to World AIDS Day on December 1. The booklet usually sells for $2 but CAREC-SPSTI is making it available for free to Newsday readers.

Head of CAREC-SPSTI, Dr Bilali Camara, said it was his unit’s intention to have the booklet in as many homes in the country as possible, given the continued disturbing trends in the spread of HIV/AIDS in TT and the need to provide information as the first step in efforts to creating change in sexual behaviour that is required to reverse the situation. “Our surveillance of this epidemic in our region shows TT to be one of the most affected countries. And we note with concern that the incidence of HIV has doubled in this country in the last five years.” Dr Camara said CAREC-SPSTI owes it to its host country to make a special effort along with other national government and non-governmental initiatives to make a difference to the profile of the epidemic. “We are heartened and congratulate the team at Newsday for its ready response to our approach to distribute the publication.”

Dr Camara described it as another step in CAREC-SPSTI’s work with the media over the years, not only providing vital information but serving as advocates for a more supportive environment for the infected. He is also encouraged by the response to the partnership with TTPost in trying to bring attention to the debilitating impact of stigma and discrimination against People Living with HIV/AIDS. This partnership was launched last Friday at Hilton Trinidad. In the past, CAREC-SPSTI has collaborated with the National Broadcasting Network, Power 102FM with programmes sponsored by Mega Insurance Company Ltd, and with the Media Association of TT for training programmes for journalists. Newsday’s Executive Chairman expressed delight in being able to work with such a reputable establishment like CAREC-SPSTI on the project, saying she considered it a responsibility on the part of Newsday as a national newspaper to provide vital information on such an important issue as HIV/AIDS.

“We have been concerned for a long time that we should move beyond coverage of the issues relating to HIV/AIDS as news to undertaking some specific educational initiatives for the benefit of our thousands of readers, particularly the young people of our country who are the most vulnerable and who are most affected,” she said. Mills said Newsday could not possibly stand by and witness the on-going annihilation of a generation and she hoped the project would also deepen the relationship between her newspaper and specialist organisations like CAREC-SPSTI in trying to bring about a reduction in the impact and spread of HIV/AIDS. The booklet was produced by CAREC-SPSTI communication and information team and a visiting Canadian-based research student, Ian Wanyeki, who was assigned to the Centre a few years ago to assist in further development of a Caribbean AIDS telecommunication information network.