New HIV cases in Ja plunge

Jamaica is reporting a decline in new HIV cases, but experts are cautioning the public to hold off on the celebrations, as there is still more work to be done.

According to the 2017 annual HIV/AIDS Epidemiological Report, there were 1,197 new HIV infections, a 41 per cent decline from 2016. There was also a 10 per cent decrease in AIDS deaths from 2016.

Males accounted for the higher proportion of new HIV infections. The parishes of Kingston and St Andrew had the majority of new HIV infections, while Manchester recorded the fewest number of cases.

Executive director of Jamaica AIDS Support for Life, Kandasi Levermore, in an interview with The Sunday Gleaner, said her organisation would have to now scale up strategies to canvass the population to gauge the behaviour change required to minimise risk factors.

“It’s good news, but it is not good enough news for us to be jumping and screaming and thinking that HIV is now leaving. It is a step in the right direction, and before we can even scream, we would have to see this consecutively over at least a good five to 10 years for us to feel like we are getting a handle on the epidemic,” said Levermore.

HIV is primarily transmitted through sexual intercourse. The report showed that the cohort aged 20 to 39 had the highest number of people currently living with HIV/AIDS among all age groups and both sexes.

This is of particular concern for development experts because that age cohort is one of the most important drivers of economic production and for forming new families.

“The age of consent is 16, so usually you don’t pick up the cases earlier because of that limitation in terms of when can persons be tested versus when persons are actually becoming sexually active, and so you will notice that when you get to the 20-29 cohort, we see almost like a shoot to the sky in terms of the cases being identified, because that is when persons are taking responsibility for their own sexual health and are seeking care and treatment,” said Levermore. “So even if they contracted the virus very young, it is difficult for us to know.”

The report further showed that more males are diagnosed with HIV/AIDS and have higher mortality. Levermore attributed the higher mortality rate among men to a more cavalier approach to healthcare than women, who are generally more proactive.

“We need to do more work with men in terms of getting them to the services or getting the services to them, making spaces more accessible and friendly,” she said.

Director of health promotion and prevention at the National Family Planning Board, Andrea Campbell, agrees with Levermore on moderating the optimism.

“We have scaled up our testing with our key and vulnerable population. Also, since the introduction of our test and start programme last year, more persons are going on medication, which is free of cost, and persons can get it once they are confirmed positive.

“But we still don’t want persons to get too comfortable because becoming virally suppressed is not so easy. We have a culture of starting our medication and as we start feeling a little better, we stop, so getting virally suppressed means that you have to be taking your medication on time, every time,” said Campbell.

Not disclosing status

Another reason not to get excited is that persons are not disclosing their status due to stigma and discrimination, Campbell also pointed out that persons have become complacent with testing and, therefore, you might not have so many persons testing and that might have contributed to a decrease in the numbers.

“A lot of times we go into the community to do testing and men especially would say ‘me good because my babymother just have baby’, but if she went to the clinic and got a positive result, would she have been comfortable to come home and tell him? So she can go and get her test knowing that she’s positive and she don’t have to tell him, and just continue carry on, so we really have a challenge with that and we know that that is caused by stigma and discrimination,” said Campbell.

While agreeing that Jamaica has made progress on HIV diagnosis and treatment, UNAIDS country director for Jamaica, Manoela Manova, said the country must do far more to increase the number of people who are linked to care, retained in care, and remain on antiretroviral therapy.

“While the country has done a good job at HIV testing, new strategies are needed to reach the one in four Jamaicans living with HIV who are not aware of their status.

“Many people only get tested after becoming ill and symptomatic. The Ministry of Health HIV Epidemiology Report noted that almost seven per cent of diagnoses in 2017 (82 persons) were at the stage of death. The goal is early diagnosis so people can access treatment to keep them alive and reduce the risk of infecting others,” said Manova.

 

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There are 34,000 (Spectrum, UNAIDS, 2017) persons living with HIV in Jamaica, of whom 22 per cent are unaware of their status.

 

• There were 1,197 new HIV infections in 2017.

 

• Kingston and St Andrew had the majority of new HIV infections and Manchester the least number of new HIV infections in 2017.

 

• Overall, males accounted for the higher proportion of new HIV infections in 2017 (males: 621, females: 576)

 

• In 2017, new HIV cases diagnosed declined by 41% from 2016.

 

• There were approximately 8% fewer late diagnoses (advanced HIV, AIDS, and AIDS deaths) than the previous year (2016)

 

• In 2017, there was a 10% decrease in AIDS deaths from 2016.

 

• The majority of deaths among PLHIV occurred between the ages 40 years and 49 years for males and 30 years and 39 years for females in 2017.