HIV/AIDS in Jamaica

Last updated

HIV/AIDS in Jamaica has a 1.5 percent prevalence of the adult population estimated to be HIV-positive and no significant change over the last five years and therefore Jamaica appears to have stabilized its HIV/AIDS epidemic.

Contents

Prevalence

Recent data from high-risk groups suggest that at least 9 percent of commercial sex workers and 20 to 30 percent of men who have sex with men (MSM) are estimated to be HIV-positive. Men and women aged 20 to 39 account for 54 percent of reported AIDS cases in Jamaica. First detected in 1982, HIV is present in all of Jamaica’s parishes, but Kingston, St. Andrew, and St. James – the three most urbanized parishes – have the majority of cases, but St James being the highest overall. UNAIDS estimates that 25,000 people in Jamaica are HIV-infected. [1]

The primary contributors to the epidemic are sociocultural, behavioral, and economic factors that result in risky behaviors such as multiple sex partners, older men having sex with younger women, and early sexual debut. A 2004 Behavioral Surveillance Survey demonstrated that 89 percent of males and 78 percent of females aged 15 to 24 had sex with a nonmarital or noncohabitating partner in the preceding 12 months (2006). Fifty-six percent of males and 16 percent of females had multiple sex partners in the preceding 12 months. Among patients attending sexually transmitted infection (STI) clinics in Kingston, St. Andrew, and St. James, HIV infection rates reached 5 percent. In the general population, overall AIDS case rates among men continue to exceed the rates among women. However, surveillance data, as presented by Dr. Peter Figueroa of Jamaica’s Ministry of Health (MOH) at the U.S. Government-sponsored sixth annual Caribbean U.S. Chiefs of Mission Conference on HIV/AIDS held in Jamaica in October 2007, indicate that adolescent females (10 to 19 years old) are 2.7 times more likely to be infected than same-age males. Young women are particularly at risk because they find it difficult to negotiate whether and when to have sex and how to protect themselves from pregnancy and disease. For example, the “sugar daddy” phenomenon, in which young women and girls exchange sex with older men for material or financial gain, is common. In addition, gender inequality, high levels of unemployment, persistent poverty, rising crime and violence, population mobility, and the growing commercial sex trade – including sex tourism – compound the country’s vulnerability to the HIV/AIDS epidemic. [1]

Although Jamaica has a well-established national surveillance system, collecting accurate data about at-risk groups is challenging. Despite some progress in reducing stigma and discrimination (S&D), homosexual behavior continues to be illegal in Jamaica, and many MSM hide their sexual orientation and behavior, impeding accurate health surveys. Recent program estimates indicate that 20 to 30 percent of MSM are HIV-positive. Jamaica also has a large number of mobile sex workers, both Jamaican and from outside Jamaica, who are difficult to monitor. HIV infection rates among sex workers are much higher than they are in the general population. A 2006 study of female sex workers, reported by UNAIDS, showed an HIV prevalence of 9 percent in this group. However, according to Jamaica’s 2006 UNGASS report, an earlier study found a 20 percent prevalence rate among sex workers in the tourist areas of Montego Bay. The actual prevalence of HIV may be higher in these groups as data collection remains difficult and is limited by sampling methods. Sex workers who were older, less educated, and used crack cocaine were more likely to be HIV-infected. According to UNICEF/Jamaica, in 2003, there were 5,125 children in Jamaica who had lost one or both parents to HIV/AIDS, and thousands more were estimated to have been made vulnerable by the disease. Poverty and neglect have led to a growing number of street and working children. There were 5,143 children in institutional care in 2003, including those in foster care. [1]

Controlling new tuberculosis (TB) infections in Jamaica remains a challenge; the incidence rate is 3 per 100,000 people. However, according to the World Health Organization (WHO), the prevalence of HIV among Jamaican TB patients is 26 percent. This figure is similar to other developing countries. However, Jamaica has a higher mortality rate among those who are co-infected, so prompt diagnosis of HIV infection and early institution of active antiretroviral treatment (ART) are imperative. [1]

National Response

The Government of Jamaica has aggressively addressed the HIV/AIDS epidemic since 1988, when it established the National HIV/Sexually Transmitted Disease Prevention and Control Program and the National AIDS Committee (NAC), a nongovernmental organization (NGO). The Program, working under the MOH, facilitates governmental cooperation with the private sector and NGOs in the fight against HIV/AIDS. NAC, which has more than 100 member organizations, coordinates the national response to the epidemic. [1]

During the past two decades, Jamaica has taken several steps to combat HIV/AIDS. More recent efforts include joining the Pan Caribbean Partnership Against HIV/AIDS upon its formation in 2001 and continuing to serve as an active member; developing an HIV/AIDS prevention and control project; implementing two national strategic plans on HIV/AIDS and STIs, the most recent of which ended in 2006, and launching a new plan in 2007; providing ART for persons with advanced HIV and HIV-infected mothers since 2004; adopting a national HIV/AIDS policy in 2005; and establishing a private sector-led business coalition on HIV in 2006. [1]

The government recently began implementing its third National Strategic Plan on HIV/AIDS/STIs, covering 2007 to 2011. The Plan focuses on achieving universal access to prevention, treatment, and care and support. Currently, only 56 percent of HIV-infected people who need treatment receive ART, according to a WHO/UNAIDS/UNICEF report. In July 2007, the World Bank announced that it would work with Jamaica to design a second HIV/AIDS prevention and control project to be implemented after the current project closes in May 2008. [1]

In 2004, Jamaica’s MOH received a third-round grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria to strengthen multisectoral national activities to prevent and address the HIV/AIDS epidemic. This has been done through scaling up efforts to: [1]

Jamaica has applied to the Global Fund for a 2007 $44.2 million grant to consolidate existing gains while scaling up efforts to provide universal access to HIV treatment, care, and prevention, with special emphasis on vulnerable populations. Jamaica had already received $16.4 million from the Global Fund during round three for HIV/AIDS treatment, prevention, and policy efforts. [1]

See also

Related Research Articles

The Caribbean is the second-most affected region in the world in terms of HIV prevalence rates. Based on 2009 data, about 1.0 percent of the adult population is living with the disease, which is higher than any other region except Sub-Saharan Africa. Several factors influence this epidemic, including poverty, gender, sex tourism, and stigma. HIV incidence in the Caribbean declined 49% between 2001 and 2012. Different countries have employed a variety of responses to the disease, with a range of challenges and successes.

Since the first HIV/AIDS case in the Lao People's Democratic Republic (PDR) was identified in 1990, the number of infections has continued to grow. In 2005, UNAIDS estimated that 3,700 people in Lao PDR were living with HIV.

Kenya has a severe, generalized HIV epidemic, but in recent years, the country has experienced a notable decline in HIV prevalence, attributed in part to significant behavioral change and increased access to ARV. Adult HIV prevalence is estimated to have fallen from 10 percent in the late 1990s to about 4.8 percent in 2017. Women face considerably higher risk of HIV infection than men but have longer life expectancies than men when on ART. The 7th edition of AIDS in Kenya reports an HIV prevalence rate of eight percent in adult women and four percent in adult men. Populations in Kenya that are especially at risk include injecting drug users and people in prostitution, whose prevalence rates are estimated at 53 percent and 27 percent, respectively. Men who have sex with men (MSM) are also at risk at a prevalence of 18.2%. Other groups also include discordant couples however successful ARV-treatment will prevent transmission. Other groups at risk are prison communities, uniformed forces, and truck drivers.

Although Senegal is a relatively underdeveloped country, HIV prevalence in the general population is low at around 0.08 per 1000 people, under 1% of the population. This relatively low prevalence rate is aided by the fact that few people are infected every year– in 2016, 1100 new cases were reported vs 48,000 new cases in Brazil. Senegal's death due to HIV rate, particularly when compared it to its HIV prevalence rate, is relatively high with 1600 deaths in 2016. Almost two times as many women were infected with HIV as men in 2016, and while almost three times as many women were receiving antiretroviral therapy (ARV) as men, only 52% of HIV positive people in Senegal received ARV treatment in 2016.

HIV/AIDS in Eswatini was first reported in 1986 but has since reached epidemic proportions. As of 2016, Eswatini had the highest prevalence of HIV among adults aged 15 to 49 in the world (27.2%).

With less than 0.1 percent of the population estimated to be HIV-positive, Bangladesh is a low HIV-prevalence country.

<span class="mw-page-title-main">HIV/AIDS in Nepal</span>

The first HIV/AIDS cases in Nepal were reported in 1988. The HIV epidemic is largely attributed to sexual transmissions and account for more than 85% of the total new HIV infections. Coinciding with the outbreak of civil unrest, there was a drastic increase in the new cases in 1996. The infection rate of HIV/AIDS in Nepal among the adult population is estimated to be below the 1 percent threshold which is considered "generalized and severe". However, the prevalence rate masks a concentrated epidemic among at-risk populations such as female sex workers (FSWs), male sex workers (MSWs), injecting drug users (IDUs), men who have sex with men (MSM), Transgender Groups (TG), migrants and Male Labor Migrants (MLMs) as well as their spouses. Socio-Cultural taboos and stigmas that pose an issue for open discussion concerning sex education and sex habits to practice has manifest crucial role in spread of HIV/AIDS in Nepal. With this, factors such as poverty, illiteracy, political instability combined with gender inequality make the tasks challenging.

HIV/AIDS infection in the Philippines might be low but growing fast. The Philippines has one of the lowest rates of infection, yet has one of the fastest growing number of cases worldwide. The Philippines is one of seven countries with growth in number of cases of over 25%, from 2001 to 2009.

Since HIV/AIDS was first reported in Thailand in 1984, 1,115,415 adults had been infected as of 2008, with 585,830 having died since 1984. 532,522 Thais were living with HIV/AIDS in 2008. In 2009 the adult prevalence of HIV was 1.3%. As of 2016, Thailand had the highest prevalence of HIV in Southeast Asia at 1.1 percent, the 40th highest prevalence of 109 nations.

HIV/AIDS in Bolivia has a less than 1 percent prevalence of Bolivia's adult population estimated to be HIV-positive and therefore the country has one of the lowest HIV prevalence rates in the Latin America and Caribbean region.

Cases of HIV/AIDS in Peru are considered to have reached the level of a concentrated epidemic. According to a population-based survey conducted in Peru’s 24 largest cities in 2002, adult HIV prevalence was estimated to be less than 1 percent. The survey demonstrated that cases are unevenly distributed in the country, affecting mostly young people between the ages of 25 and 34. As of July 2010, the cumulative reported number of persons infected with HIV was 41,638, and there were 26,566 cases of AIDS, according to the Ministry of Health (MOH), and the male/female ratio for AIDS diagnoses in 2009 was 3.02 to 1. The Joint United Nations Program on HIV/AIDS (UNAIDS) estimates 76,000 Peruvians are HIV-positive, meaning that many people at risk do not know their status. There were 3,300 deaths due to AIDS in Peru in 2007, down from 5,600 deaths in 2005.

The Dominican Republic has a 0.7 percent prevalence rate of HIV/AIDS, among the lowest percentage-wise in the Caribbean region. However, it has the second most cases in the Caribbean region in total, with an estimated 46,000 HIV/AIDS-positive Dominicans as of 2013.

HIV/AIDS in El Salvador has a less than 1 percent prevalence of the adult population reported to be HIV-positive, El Salvador and therefore there is a low-HIV-prevalence country, but the virus remains a significant threat in high-risk communities, such as commercial sex workers (CSWs) and men who have sex with men (MSM).

According to the Global Fund, Honduras is the Central American country most adversely affected by the HIV/AIDS epidemic. As of 1998, Honduras had the highest prevalence of HIV out of all seven Central American countries according to a study published by the office of the Honduran Secretary of Public Health. As of that same year, Hondurans made up only 17% of the Central American population, yet Honduras contained 50% of the initial AIDS cases in Central America and 60% of all Central American cases in 2001. In more recent years, new HIV infections have decreased by 29% since 2010 while AIDS-related deaths have increased by 11% since then. HIV/AIDS heavily affects the young, active, working population in Honduras, and HIV/AIDS deaths account for 10% of the overall national mortality rate. As of 2008, AIDS was the leading cause of death among Honduran women of childbearing age and the second-leading cause of hospitalization among both men and women. Sexually transmitted infections are common, and condom use in risky sexual encounters is sporadic and variable. HIV remains a mainly heterosexual epidemic in Honduras, as 90% of emerging infections are attributed to heterosexual transmission. It is estimated that the prevalence of HIV among Honduran adults is 1.5%.

In 2016, the prevalence rate of HIV/AIDS in adults aged 15–49 was 0.3%, relatively low for a developing country. This low prevalence has been maintained, as in 2006, the HIV prevalence in Mexico was estimated at around 0.3% as well. The infected population is remains mainly concentrated among high risk populations, men who have sex with other men, intravenous drug users, and commercial sex workers. This low national prevalence is not reflected in the high-risk populations. The prison population in Mexico, faces a fairly similar low rate of around 0.7%. Among the population of prisoners, around 2% are known to be infected with HIV. Sex workers, male and female, face an HIV prevalence of around 7%. Identifying gay men and men who have sex with other men have a prevalence of 17.4%. The highest risk-factor group is identifying transgender people; about 17.4% of this population is known to be infected with HIV. Around 90% of new infections occur by sex-related methods of transmission.. Of these known infected populations, around 60% of living infected people are known to be on anti-retroviral therapy (ART).

With only 0.2 percent of the adult population estimated to be HIV-positive, Nicaragua has one of the lowest HIV prevalence rates in Central America. HIV was first detected in Nicaragua in 1987, after concentrated epidemics had been reported in other Central American nations. The onset of the epidemic was likely delayed by Nicaragua’s 10-year civil war and the U.S.-led economic blockade, both of which left the country isolated for several years. Relative control over commercial sex work, low infection rates among injecting drug users, and a ban on the commercial sale of blood also slowed HIV transmission. However, the country is at risk of a broader epidemic because of social conditions such as multiple sex partners, gender inequality, and widespread poverty. Many people are unaware of their HIV status and could unwittingly spread the disease. UNAIDS estimates Nicaragua has 7,300 HIV-positive people, nearly half of whom were identified over the past three years.

With less than 1 percent of the population estimated to be HIV-positive, Egypt is a low-HIV-prevalence country. However, between the years 2006 and 2011, HIV prevalence rates in Egypt increased tenfold. Until 2011, the average number of new cases of HIV in Egypt was 400 per year. But, in 2012 and 2013 it increased to about 600 new cases and in 2014 it reached 880 new cases per year. According to UNAIDS 2016 statistics, there are about 11,000 people currently living with HIV in Egypt. The Ministry of Health and Population reported in 2020 over 13000 Egyptians are living with HIV/AIDS. However, unsafe behaviors among most-at-risk populations and limited condom usage among the general population place Egypt at risk of a broader epidemic.

Since reports of emergence and spread of the human immunodeficiency virus (HIV) in the United States between the 1970s and 1980s, the HIV/AIDS epidemic has frequently been linked to gay, bisexual, and other men who have sex with men (MSM) by epidemiologists and medical professionals. It was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. The first official report on the virus was published by the Center for Disease Control (CDC) on June 5, 1981 and detailed the cases of five young gay men who were hospitalized with serious infections. A month later, The New York Times reported that 41 homosexuals had been diagnosed with Kaposi's sarcoma, and eight had died less than 24 months after the diagnosis was made.

References

  1. 1 2 3 4 5 6 7 8 9 10 "Health Profile: Jamaica" Archived 2008-09-13 at the Wayback Machine . United States Agency for International Development (June 2008). Accessed September 7, 2008. PD-icon.svg This article incorporates text from this source, which is in the public domain .
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.