HIV AIDS: a predator in paradise: today the Caribbean has the highest prevalence of HIV/AIDS outside of Sub-Saharan Africa. Some Caribbean scholars are taking steps to educate the academy and national leaders about curbing the spread of the disease

Black Issues in Higher Education, Jan 30, 2003 by B. Denise Hawkins

A $2.7 million grant from the European Union supports the work of UWI HARP on the university's three campuses and a satellite facility. With the exception of the Mona campus in Jamaica where Bain is based, there is no paid staff. UWI HARP is still in its infancy and is taking small steps to create awareness about itself and the disease on and of the campuses. The initiative is set to launch a modest multimedia marketing campaign aimed at university students that will deliver "soft messages" such as "are you at risk for HIV/AIDS?"

`THE DISEASE WILL COME TO THE CARIBBEAN'

In the early 1980s, Bain was not unlike many physicians and clinicians that were as intrigued as they were frightened by the modern-day plague that was emerging in the United States. Before long, Bain was preparing for a predator in paradise--AIDS--that he and other clinicians knew very little about.

It was June 1981, Bain recalls, when he and some of his colleagues, including the chief of the small epidemiology unit at the Ministry of Health, reviewed the first AIDS report issued from the Centers for the Disease Control and Prevention and concluded--"the disease will come to Jamaica and we must begin to plan for it." A year later in November 1982, AIDS did come to Jamaica as predicted. A Florida hospital diagnosed the first case of the disease seen in a Jamaican national, who later returned home to the island nation.

In the early years of AIDS, the work of many researchers and clinicians working on AIDS was considered "low tech." They could describe the early cases of the disease and track its reckless path through the island nations, gaining an understanding of who was most at risk for contracting HIV infection and why. They also were the only ones who saw the face of AIDS.

Strict confidentiality policies governing healthcare kept AIDS patients concealed from the general public. "For the most part, the public was only told the cumulative count of cases," Bain says. "Because they weren't allowed to see persons with the disease there was a tendency to deny that the disease existed."

A strong stigma around AIDS also prevented those living with the disease from telling their families or community. In fact, Bain says, "several patients told friends and sometimes family members alternative diagnoses in an effort to hide the reality that they had AIDS."

The Caribbean got a late start on its response to AIDS. And now, just as some critical new programs and approaches are being introduced in Jamaica and across the island nations--counseling and screening of pregnant women for HIV/AIDS; administering anti-retroviral drugs to expectant mothers with HIV/AIDS to reduce mother-to-child transmission of the disease--educators and clinicians already are pondering a long-term fight against AIDS that could span the next 50 years.

But some say it is now or never for an AIDS response in the Caribbean. The Caribbean has no choice but to plan and act immediately to curb the further spread of the disease, says Prime Minister Owen Arthur of Barbados.