December 1st is recognized worldwide as World’s AIDS day and the slogan for this year and for the following years until 2010 is “STOP AIDS. KEEP THE PROMISE”. The global theme for World’s AIDS day 2006 is accountability.

The AIDS/HIV epidemic
AIDS is one of the most destructive epidemics recorded in history and has killed more than 25 million people in the 25 years of its known existence and 15 million children have been orphaned by HIV/AIDS.

Around 40 million people are living with HIV in the world, and the Caribbean is the second most affected region of the world. In the Caribbean there are 250, 000 people living with HIV/AIDS and there are 27,000 new infections and there were 19,000 AIDS deaths this year. In Anguilla we continue to see new cases of HIV infection and despite improve access to antiretroviral treatment and care AIDS continue to claim lives of individuals.

Modes of transmission
The main modes of transmission of HIV are well known. In the Caribbean and in Anguilla, HIV transmission occurs largely through heterosexual intercourse. Sex between men is also a significant route of transmission. The work of the National AIDS committee continues. Education promoting lifestyle behavioural changes that emphasise abstinence or safe sex seems to be having limited success in Anguilla as too many individuals are still being exposed to and infected with HIV.

Challenges in the fight against HIV/AIDS
Stigma and discrimination continue to have a negative impact on the fight against HIV/AIDS. Many individuals are still afraid to be tested for HIV as a result of stigma and discrimination. Stigma also prevents individuals in Anguilla from seeking counseling and care for HIV/AIDS. Despite the many campaigns to offer free voluntary HIV testing, the number of individuals coming for HIV testing continues to be unsatisfactory in Anguilla. Innovative approaches are needed to help decrease the stigma and discrimination against HIV/AIDS in Anguilla.

World AIDS Day serves to create a greater awareness of the issues around HIV/AIDS but whether this awareness is reaching the key target groups is still not clear.

There is a need to increase the awareness of HIV/AIDS among the young people and women in Anguilla as increasing numbers of women and young people are still being infected with HIV.

We must continue to get HIV prevention messages to our children and young people and HIV and STD information must be part of the education system in a structured and integrated way.

There is room for improvement in the care of individuals living with HIV/AIDS. As regards our health system, there must be integrated HIV care with reproductive health care and other key services if we are going to greatly improve health care for HIV/AIDS.

Keeping the promise
Many individuals usually make many promises in regard HIV/AIDS. We must hold politicians and other leaders accountable for the promises they make. Many leaders have promised to make resources available to achieve the goal to halt and reverse the spread of HIV and AIDS. Have they all kept their promises? As individuals many of us in the community can do more to halt the spread of HIV/AIDS. Many individuals in Anguilla continue to engage in risky sexual behaviours which fuel the spread of HIV in our small community.

HIV/AIDS is not only a health problem.
The socio-economic effects of the AIDS pandemic can be tremendous yet many of our opinion leaders and technocrats continue to pay scant interest in this largely preventable disease. Various governmental and non-governmental groups must continue to work together if we are going to halt the spread of HIV/AIDS in Anguilla. HIV/AIDS is too big and complex a problem to be left to a small group of health professionals to deal with.

Conclusion
As we participate in activities for World AIDS Day all of us must be reminded that HIV/AIDS is largely a preventable disease but it still continues to kill many individuals each day. All of us must be part of the goal to halt and reverse the spread of HIV/AIDS here in Anguilla. Remember the slogan-“STOP AIDS. KEEP THE PROMISE’.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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