HIV AIDS PREVENTION, TREATMENT DEPENDS ON YOU

In all my years as a Social Worker (more than a decade if you want to count it) I have worked with numerous HIV positive persons as well as those in whom the virus had already progressed to AIDS. I have watched them die and I have watched them live. I also designed and conducted research into the sexual behaviours and knowledge of Trinidadian youth and what I found was frightening.

As a nation, we are so scared of talking about sex with young people that we leave them ignorant and defenseless. It is dangerous to not inform children that sex is not all fun and games but involves consequences that they and society will have to take responsibility for. Many of the children I interviewed years ago are now teenagers themselves and I wonder what kind of people they grew up to be.

For children who are so connected online they are vulnerable to not just local but international sexual predators, being ignorant is not cute, but can prove fatal.

This is even more relevant taking into account certain metrics: According to Google, Trinidad and Tobago is currently number 6 worldwide in searches for internet pornography. We held the number one spot for quite a few years, reaching an embarrassing climax in August 2014. I believe we held the number one spot since 2009.

Despite all the information on AIDS and HIV available, rates of infections in the region have remained steady for the last ten years.

While mortality rates have fallen there has been a slight but consistent increase in new infections in Trinidad and Tobago.

Young women aged 20-34 have the highest rates of infections but men 20-49 also have high rates of infections. (Source UNGASS 2010 TT Country Progress report) It is clear while we have a very sexualized society, our children are left ignorant of the possibility of contracting HIV and AIDS from sexual activity until it is too late. Through hosting sex education workshops, I have come to realise when it comes to sex, Trinis, both children and adults are idiot savants. The misinformation and ignorance are frightening and our young women are most at risk. Rates of infection for women decrease rapidly after age 34, men continue to engage in risky behaviour for another 15 years.

While there are too many policy documents and programmes to mention out there the fact that the success depends on the individual. Trinidad and Tobago has not seen the level of decimation faced by the sub-Saharan region. But until we take personal responsibility for our sexual health and educate our youth so they know enough to protect themselves, our statistics aren’t going to improve.

Interestingly enough, the groups that are usually accused of being responsible for the spread of HIV and AIDS – sex workers, transgender and drug users – are the groups with the lowest rates of new infections. In fact, the groups most at risk are the heterosexual population, gay men and straight men who have sex with men and clients of sex workers (source: UNAIDS Global AIDS Update 2016) HIV and AIDS information is not just about prevention but about living well if you are infected. Although as I mentioned I have encountered a number of persons that are positive, the stigma still remains.

Unfortunately, I have witnessed it first hand, from other Social Workers and health professionals, this causes people to avoid getting tested.

When I did convince one young woman in particular to get tested and she used the public service, she was so traumatised by the experience she never did it again. She reported she was loudly berated by the nurse in the public reception area. Rather than being congratulated for taking responsibility for her sexual health and finding out her status, she faced unfounded judgement and humiliation. Maybe what we need is less policy and programmes and more compassion from public health workers.

There is a quiet revolution taking place, of people living their lives positively, in the open, daring to love, to marry and have children despite their positive status. I remember working on one case with extremely beautiful, bubbly young lady and her little girl, as well as working alongside an openly positive young man who was engaged and looking forward to getting married. Both were aware of their status and both accessed the free antiretroviral medications provided by the government. They and their partners chose to be informed and assumed responsibility for their status. They were healthy and living life to the best of their ability.

I’ve also seen those on the other end of the spectrum who remained in denial of their status and despite their symptoms refused testing and continue engaging in risky behaviour. Unfortunately, I’ve seen much more of those than the first kind, which is a pity. The bottom line is HIV and AIDS requires us to be responsible whether we are trying to prevent infection, treating the infected or living with the infection. The success you have, whichever of these you are doing, depends on you.