Getting to zero

Today is World AIDS Day around the world and it is being commemorated under the theme ‘Getting to Zero: Zero New HIV Infections. Zero Discrimination. Zero AIDS Related Deaths.’ At any other time, in any other year, the Ministry of Health would have been galvanized into action weeks ago. There would have been activities planned and press briefings arranged to trot out the annual statistics, which for Guyana this year would have likely shown a marked improvement, if what incumbent Minister of Health Dr Leslie Ramsammy said some time ago is to be believed. However, not only has there been no word from Minister Ramsammy on World AIDS Day, the Government of Guyana National AIDS Programme website has not been updated since October 8, following the National Week of Testing which was held from October 3-7.

However, up to yesterday, Minister Ramsammy and his ministry, like most of the rest of the country remained in a catatonic state wrought by the national and regional elections which were held on Monday (November 28) and the inability of the elections commission to produce the results up to the time this column was written yesterday. For those thus affected, it was as if their very lives had to be placed on hold until they found out whether their ballots had the impact they desired. Meantime the beat goes on; the band plays on.

Significantly, the tune being played is a slightly upbeat one. Minister Ramsammy had said on October 8 by way of a GINA press release, that there was a reduction in the HIV prevalence rate among the persons tested during National Week of Testing. He highlighted that of the 41,000 persons tested the prevalence rate “was 0.6 percent”. As a result, Guyana’s figures, using the UNAIDS formula, show a further one per cent reduction in the HIV prevalence rate, the minister had extrapolated.

“We started at a rate of 5 per cent in 2005… and prior to that in the early 1990s it was estimated that about 7 per cent of the population was infected,” the minister was quoted as saying, while arguing that the reductions show that Guyana’s strategy of awareness and protection against the transmission of the disease was effective.

Last year, while referring to a new national strategy which would come on stream in 2012, Minister Ramsammy had also boasted about Guyana’s strides in the battle against the epidemic, but noted that challenges remained. He said there should be no slackening in the fight particularly as it related to prevention strategies, calling for these to be “more robust” and for “consistency in the investment in HIV prevention.”

Stigma and discrimination remain the major challenges to Guyana ‘getting to zero’ as well as in the rest of the region (Latin America and the Caribbean). A United States Agency for International Development (USAID) HIV/AIDS health profile for the region published this year reveals that gender discrimination continues to contribute to the spread of HIV. “Traditional gender roles in many LAC countries imply that women should be submissive, allowing men to make decisions about engaging in sex. This limits women’s ability to negotiate condom use and makes them vulnerable to sexual assault. At the same time, young men are also pressured to prove their masculinity by engaging in sex at an early age, having multiple sex partners, and sometimes using physical force against women. Higher rates of new infections are increasingly being reported among young women, compared with men of the same age cohort,” the report said.

In addition, it pointed to the fact that many in this region still believe that contracting HIV is a punishment for immoral behaviour. As a result, people avoid being tested or disclosing their HIV-positive status for fear of losing family, friends, jobs, housing, or social standing. This stymies the production of accurate national data on prevalence and incidence among people living with the disease, particularly those already being discriminated against because of the sexual orientation.

It is well known that this unwarranted stigma and discrimination can contribute to the further spread of the virus as it results in members of marginalized groups being reluctant to access health services. However, apart from limited awareness and education, not much is being done here. If today, people living with HIV are to all intents and purposes ignored because of the silliness of the current season, this underscores the superficiality of the response to their plight. There is indeed a lot of work to be done here.