Get Aruba To Zero

Over two days last week, a conference at the Alhambra ballroom, welcoming medical professionals and stakeholders, discussed a forgotten topic, at least I forgot about it, the HIV virus and AIDS.

Why did I forget about it? Because we don’t die of AIDS anymore, and it is no longer perceived as a real threat the way if felt in the early 80, when it first reared its ugly head.

But we should be thinking about it, because the Caribbean is second to Africa in the number of new infected patients, for NO GOOD REASON, because we have excellent medications at our disposal, testing is easy, and patients who come into care early, can live happily ever after.

But apparently stigma surrounding HIV, shame and the fear of being excluded, slow people down, and get them to test and treatment later than needed. Research shows that more than half of people with HIV are not diagnosed until many years AFTER infection, at the average age of 40.  We should all be aware of the early symptoms of the virus and talk to our GPs, as soon as any ‘flu’ type symptoms persist, and we feel that our immune system is struggling, because the number of new HIV diagnoses in the Caribbean has not declined, on the contrary, we now have more groups at risk, undocumented immigrants who have no access to health care, older heterosexual adults, with women represented at 49%, besides members of the homosexual community, and need-sharing addicts.

This is what the press release of AIDSFonds revels about Aruba.

In Aruba, 392 people have received an HIV diagnosis. 94% of them are on treatment and 91% of them have suppressed the HIV virus.

More than half, 55%, have waited a long time to get tested for HIV. Discriminatory legislation in Aruba contributes to this: An immigrant or asylum seeker with HIV does not receive a residence or work permit, thus no AZV, and the cost of HIV testing and treatment is not reimbursed for immigrants and asylum seekers.

Most important to understand: Persons with HIV who are receiving treatment and do not have any virus in their blood, are not contagious, and may resume their life undisturbed, providing they stick to the medical regiment.

In Aruba, two-thirds of HIV diagnoses occur among men who have sex with men; almost half of the diagnosed are undocumented immigrants, yet knowledge about HIV is limited, and my pharmacist friends even report that condom sales, for self-protection, are low.

And that was the goal of the conference. To double the efforts at getting Aruba to zero, where you still have people with HIV but the viral load is so small that it is undetected. The good news is that if people are diagnosed with HIV, and they are properly treated with HIV inhibitors, the virus is successfully suppressed, and can no longer be passed on.

According to Jacqlyn de Kort HIV practitioner in Aruba, to achieve the goal of getting Aruba to Zero, everyone needs access to HIV care and treatment regardless of their legal status, thus the law must be changed to make testing and treatment available to all.

The conference reported that in In the past 4 years, anonymous data has been collected and insight obtained during a study, conducted by the hospitals on the three ABC islands, in collaboration with the University Medical Center Utrecht. The new data was presented during the conference, co-organized by Aidsfonds.

NEW TREATMENTS: HIV prevention pill PrEP

This is fantastic news. I saw PrEP advertised on CBS, the USA Television Channel, it is available here and it is super effective.

The CDC reports that PrEP (pre-exposure prophylaxis) can reduce your chance of getting HIV from sex or injection drug use. When taken as prescribed, PrEP is highly effective for preventing HIV.

Unfortunately, of the people who received an HIV diagnosis in recent years, 60% to 70% had never heard of the HIV prevention pill PrEP. There is not yet a formal infrastructure for offering PrEP on the islands. But, since 2020, there are 80 people in Aruba who use PrEP on their own initiative through the hospital, but some of them have however disappeared from sight and care.

To conclude: Breaking the taboo on HIV is important to give people living with HIV on the islands a voice and to be able to involve them more in policy regarding the care and prevention of HIV, because according to the World Health Organization 30% of new HIV infections may be found among heterosexual populations, where one partner engages with a carrier in a risk group, bringing the virus home. PrEP can eliminate that threat.

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April 04, 2023
Rona Coster