February 2001

·     The Caribbean is the region hardest hit by HIV/AIDS in the world outside sub-Saharan Africa.

·     Nine out of the 12 countries with the highest HIV prevalence in the Americas are in the Caribbean basin.

·     AIDS has become a major cause of death among men and women in the 15 to 44 age group in several countries.

·     An estimated 60,000 adults and children became infected during 2000 in the Caribbean island states.

·     By end 2000 some 390,000 adults and children were estimated to be living with HIV or AIDS, compared with 360,000 at the end
of 1999. However, given the lack of consistent data from some countries and the uncertainty around such estimates, the real number could well be closer to 500 000.

·     The epidemic continues to spread in the region, devastating countries’ economies and various sectors, including education, health, agriculture, and business.

·     According to the most recent figures, over 7% of pregnant women in urban Guyana tested positive for HIV.

·     Haiti is the worst-affected nation in the Caribbean. In some areas, 13% of anonymously tested pregnant women were found to be HIV-positive. Overall, around 8% of adults in urban areas and
4% in rural areas are infected. It is estimated that 74,000 Haitian children had lost their mothers to AIDS by the end of 1999.

·     In the Bahamas the adult prevalence rate is 4%. In the Dominican Republic 1 adult in 40 is HIV-infected, while in Trinidad and Tobago the rate is 1 adult in 100.

·     In some countries the epidemic has had a slower start. In Saint Lucia, the Cayman Islands and the British Virgin Islands fewer than 1 pregnant woman in 500 tested positive for HIV in recent surveillance studies, but this is no reason for complacency.

·     Heterosexual HIV transmission in the Caribbean is driven by the deadly combination of early sexual activity and frequent partner exchange by young people. For example, in Saint Vincent and the Grenadines, a quarter of men and women in a recent national survey said they had started having sex before the age of 14, and half of both men and women were sexually active at the age of 16.

·     In Trinidad and Tobago, in a large survey of men and women in their teens and early twenties, fewer than a fifth of the sexually active respondents said they always used condoms, and two-thirds did not use condoms at all.

·     Age mixing - younger women having sex with older men - also drives the Caribbean epidemic. HIV rates are five times higher in girls than boys aged 15-19 in Trinidad and Tobago. At one surveillance centre for pregnant women in Jamaica, girls in their late teens had almost twice the prevalence rate of older women.

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