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Ensuring that communities have the power to advocate and serve is critical to ending AIDS in the Caribbean

By UNAIDS

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(PRESS RELEASE) – The theme of this year’s World AIDS Day is “Communities make the difference”.

The commemoration of World AIDS Day is an important opportunity to recognize the essential role that communities play in the AIDS response at the national and regional levels. Their leadership and advocacy ensure that the response remains relevant and grounded, keeping people at the centre and leaving no one behind.

Communities include peer educators, networks of people living with or affected by HIV, community health workers, civil society organizations and grass-roots activists.

“We highlight the role of communities at a time when reduced funding and a shrinking space for civil society are putting the sustainability of services and advocacy efforts in jeopardy,” said UNAIDS Latin America and Caribbean Regional Support Team Director, Dr. César Nuñez. “Greater mobilization of communities is urgently required. The strong advocacy role played by communities is needed more than ever to ensure that AIDS remains on the political agenda, that human rights are respected, and that decision-makers and implementers are held accountable.”

Caribbean progress

In 2018 there were 16 000 new HIV infections in the Caribbean, a 41% reduction from 2000. There were an estimated 6 700 AIDS-related deaths last year. Deaths due to AIDS have declined by 67% in the region since the turn of the century.

But HIV testing and treatment progress in the region has slowed. Of the estimated 340 000 people living with HIV in 2018, 72% knew their status. More than three-quarters (77%) of diagnosed people were on treatment. And 74% of those on treatment were virally suppressed last year. This is significantly lower than the global average for viral suppression: 86%. Viral suppression among men was lower than among women in nearly all countries in the region with available data, highlighting an acute need to improve services for men.

The slowing progress in the region is in great part due to insufficient scale-up in treatment services among people living with HIV in Haiti, the country with the largest HIV burden in the region. However, once on treatment, 86% of diagnosed Haitians are virally suppressed. Other notable successes in the region include Guyana, where 93% of people living with HIV know their status, and Barbados, which has reached 88% viral suppression among those on treatment.

One of the challenges impeding treatment initiation is late diagnosis. In 2018, five of 12 countries reporting data showed that 50% or more of newly diagnosed cases presented with advanced HIV disease.

People and communities will end AIDS

“Community organizations in the Caribbean play a critical role in ensuring that HIV prevention, testing and treatment services get to the hardest-to-reach communities including poor people, youth, gay and other men who have sex with men, transgender people, sex workers and migrants,” Dr. Nuñez said. “We also need renewed efforts to reach men and boys with services across the region.”

The work of community-led organizations is unique and powerful and can have a substantial impact on how the world fairs towards ending AIDS. UNAIDS urges all countries to fully support and enable their community-led organizations, ensure they have a seat at all decision-making tables concerning the health and well-being of their community members and remove any barriers to their active engagement in the response to HIV. Only by fully funding and fully supporting the work of community organizations will the end of AIDS become a reality.

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