Regional and international HIV experts have been tasked with developing strategies to engage the Caribbean on the “treatment as prevention” approach to HIV care which will put the region on track to end the AIDS epidemic.
The challenge came during the opening ceremony of the Caribbean Cytometry & Analytical Society’s (CCAS) expert summit, “From Care to Cure – Shifting the HIV Paradigm”. The summit is being held at the Almond Beach Resort in Speightstown, Barbados from August 27th to 31st.
“We know we are on the brink of being able to eliminate the AIDS epidemic,” said Professor Clive Landis, CCAS Chairperson. “However, there is a gap between what we, the HIV experts know, and what the public knows. The public is still terrified of this disease and sees it as a death sentence. We have to challenge misconceptions and the fear that is driving stigmatizing attitudes of people living with HIV.”
“Treatment as prevention” is an approach to HIV treatment which forms the basis of a global commitment to end the AIDS epidemic by 2030 as part of the Sustainable Development Goals.
It is hinged on the finding that diagnosing and treating people early and lowering the level of the virus in their blood to undetectable levels (viral suppression) virtually eliminates the risk that they will transmit HIV to other people.
HIV treatment best practice now calls for people to start treatment immediately after being diagnosed, regardless of how far the illness has progressed. Treating people living with HIV fully so that they achieve viral suppression not only keeps them healthy, but dramatically reduces their infectiousness.
UNAIDS Director for Latin America and the Caribbean, Dr. César Núñez, noted that through the 2016 Political Declaration on ending AIDS, United Nations members states have agreed to adopt a Fast-Track strategy that involves increasing prevention, testing and treatment services while working to eliminate stigma and discrimination.
Central to this goal are the 90-90-90 treatment targets—90% of people living with HIV knowing their status, 90% of diagnosed people on treatment and 90% of people on treatment with an undetectable viral load. However, countries’ ability to achieve these targets will depend on the success of their work with partners including civil society to remove barriers to ensure that no one is left behind.
“People continue to get diagnosed late or die due to AIDS-related causes when testing and treatment services are available. Our reality is that the potential impact of game-changing scientific advances is being undermined by ignorance, fear, shame, prejudice and exclusion,” Dr. Núñez said.
Dr. Núñez called for partnerships to conduct more research on Caribbean HIV epidemics including epidemiological surveillance, sero-prevalence and key population studies. This, he said, would help countries better respond to the unique characteristics of their epidemics.
He further called for strategies to address the specific vulnerabilities of young people, men, women, migrants, men who have sex with men, sex workers, transgender people, people who use drugs, prisoners and homeless people.
The opening ceremony’s distinguished Speaker, Dr. Deanna Kerrigan of the Johns Hopkins Bloomberg School of Public Health, shared the findings of a study involving female sex workers living with HIV in the Dominican Republic.
Kerrigan noted that stigma and discrimination, violence and substance abuse negatively impacted the sex workers’ treatment outcomes. However, these challenges could be addressed through a multifaceted approach that combined psycho-social support, activities that encouraged solidarity and supportive government policies.
Over the next four days the “Care to Cure” summit will explore other strategies to maximize the impact of HIV treatment, particularly among key populations.
“Fear and stigma rule hearts and minds, blocking people form learning their status and blocking them from getting and staying on treatment. If we recast the public health message and give people clear information, attitudes can turn around,” said Professor Landis.
The Caribbean Cytometry & Analytical Society (CCAS) is a registered HIV Charity comprised of volunteers from the University of the West Indies, the Barbados Ministry of Health and the private sector.
The mandate of the CCAS is to train and educate healthcare providers for improved diagnosis, monitoring and treatment of HIV and AIDS in the Caribbean region by removing technical and social barriers to care.
CCAS’s annual HIV/AIDS regional workshop rotates through the region and has trained more than 1250 HIV/AIDS specialists from over 20 countries.