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How to end AIDS

Submitted by unaidsadmin on Fri, 2017-03-31 07:48 - 0 Comments

A Zero Discrimination and Transgender Day of Visibility message for Latin America and the Caribbean

By Dr. César Núñez, UNAIDS Latin America and Caribbean Regional Support Team Director

No one in Latin America and the Caribbean should have AIDS. New HIV infections may continue, hopefully with far lower frequency. But in 2017 there is no good reason that an individual living with HIV anywhere from Rio de Janiero to Port au Prince should develop AIDS or die as a result.

We now have the ability to not only keep people alive and healthy but also to dramatically reduce the likelihood that they will infect others. To achieve this we must do three things. First, ensure that those who are living with HIV know it. That means getting lots more people tested. Second, we must get those who have tested positive on antiretroviral treatment early. One by one, countries in this region are moving away from waiting until HIV infection progresses and are instead offering treatment right away. Third, we must ensure that this treatment succeeds in lowering the level of the virus in people’s blood. They’ll still be HIV positive but they won’t be ill or infectious.

We have the tools to do all these things. HIV testing, treatment and care are available today at a scale that was unimaginable just 15 years ago. So why, then, are only 54% of adults living with HIV in the region accessing treatment?  Why were there an estimated 50,000 AIDS-related deaths across Latin America and the Caribbean in 2015? This isn’t 1985. People aren’t dying for lack of medicines. For the most part they’re dying because of fear, shame and prejudice.

Unfortunately much of the concerns and anxiety surrounding HIV are centred around healthcare spaces. Worry about gossip or being treated badly prevents people from walking into free healthcare centres where they can learn their HIV status in minutes. UNAIDS conducted  public opinion surveys in six Caribbean countries and found that the biggest obstacle to people getting tested is their concern about stigma and discrimination if news of a positive diagnosis gets out.

Fear about the way workers at clinics would treat them gets in the way of people accessing the effective medical care and monitoring available throughout the region. A regional analysis of stigma and discrimination in Latin America found that between 7% and 40% of people living with HIV avoid going to a health centre or hospital when they need it, for fear of discrimination. And studies done in four Caribbean countries by the Health Policy Project and University of the West Indies revealed that at least one in five healthcare staff had observed a co-worker who was unwilling to care for a patient living with HIV.

For many communities—among them young people, transgender people, sex workers and men who have sex with men—the otherwise simple act of getting medical care can be fraught. Will they have to contend with an unsettling look or a comment? Might they be denied service? Can they be assured their affairs will be treated confidentially?

Late detection of new HIV cases and difficulty keeping people living with HIV on treatment are linked to the stigma and discrimination that continue in healthcare settings. This month the world commemorated Zero Discrimination Day while this week we mark the International Transgender Day of Visibility. UNAIDS encourages those who work in, and are responsible for, healthcare systems to do the research, training and monitoring necessary to ensure that their services are truly stigma-free.

We also encourage governments to support civil society organizations in providing services to the most hard-to-reach groups. Keep in mind that in our region transgender people are particularly vulnerable. According to  the Latin American and Caribbean Network of Transgender People (REDLACTRANS), HIV/AIDS and lack of access to health services are among the top five causes of death for the transgender community in this region.   

We have four years left to scale up efforts and services in order to end AIDS as a public health threat by 2030. The target won’t be reached with just pills and lab equipment. Our attitudes, actions and words play a key role in determining whether from communities to clinics and homes to hospitals, all people feel safe and supported.


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About the Author

unaidsadmin's picture

The UNAIDS team offers the Caribbean the broad expertise of cosponsors and other UN organisations in areas such as program development and management, women and child health, education, legal networking, community care initiatives and resource mobilisation. The goal is an expanded response to HIV in the region with the world’s second highest HIV prevalence.