A whitewashed grave topped by a grey tombstone serves as the final resting place of a once-beloved George Town man, who recently died following a short bout with an aggressive form of stage four cancer. At the time of his death, he was also positive for AIDS.
He lived well into his 70s and his family only learned of his AIDS diagnosis on his deathbed.
“When the doctor told my sister and I that our father was positive for AIDS and he had it for the past 25 years, I felt as if my legs gave out from under me, I was in utter disbelief,” said the man’s son, who requested his identity not be revealed.
He added, “All I could remember thinking was I failed him as a son, and a human being, because I never created an environment for him to feel comfortable enough to speak to me about it.”
However, the family of the man says he lived a long and fulfilling life despite having been diagnosed with HIV in the 1990s.
During the time in which the patient lived with the disease, Cayman has made incremental advances towards curbing stigmas and increasing the willingness of people to get tested and to access health care.
“But there is still a long way to go,” said Noel Cayasso-Smith, the president of the Cayman AIDS Foundation.
For the past 16 years, Cayasso-Smith has fighting to overcome a persistent misunderstanding which spreads from generation to generation, infecting them with misinformation which serves as the basis of the stigmas.
“We have several programmes, lectures, information sessions, and even reading material that we consistently make available, but the same way you can take the horse to the well but can’t make it drink, well, you can’t force people to come and get the information,” said Cayasso-Smith, who believes the lack of community engagement is a crucial reason why the virus continues to spread.
Cayman’s HIV records go back to 1985, and since then, 188 people have been diagnosed with HIV; of that, 83 have developed AIDS. The latest data shows that between January 2020 and December 2022, 18 new cases of HIV were recorded.
However, the true number of cases remains unknown as HIV/AIDS testing is not mandatory. Therefore, the disease may go undetected until the patient becomes gravely ill.
Declining HIV infections
According to the United Nations Population Fund, between 350,000 and 590,000 people are thought to be living with HIV/AIDS in the Caribbean, the highest within North, South and Central America, and second only to sub-Saharan Africa.
Between 2010 and 2022, the number of new HIV infections in the Caribbean was reduced by 15% and widening coverage of HIV treatment saw numbers of AIDS-related deaths decrease by 53%, according to UNAIDS, the organisation committed to ending AIDS.
The reduction is largely thanks to public-education campaigns and enhanced access to medication and condoms to prevent transmission.
But much like Cayman, the effectiveness of the programmes depend on the level of community participation, and if AIDS is to be eradicated by 2030 Dr. Richard Amenyah, of UNAIDS, says the community must get involved.
“The Caribbean has a long way to go and creating an environment that encourages meaningful community participation is vital for effective public health interventions to close these gaps in prevention and treatment for the region to get closer to ending AIDS by 2030,” he said.
Cayman’s fight to stem the disease
In Cayman, there is a wealth of information about HIV/AIDS which is freely available to the public; however, a casual onlooker could understandably think Cayman’s response to addressing HIV/AIDS is built on isolated ‘health-silos’ all operating in their own bubble, while trying to stem the spread of the disease.
But behind the scenes, nothing could be further from the truth. Leading the charge is the Health Services Authority which keeps confidential records of both public and private AIDS patients.
Positive tests from public and private clinics are collated and each positive patient is assessed on their socio-economic standing to determine their ability to cover medical expenses for their appropriate level of treatment.
“If you are Caymanian, and you test positive for HIV/AIDS, then you automatically qualify to get your medication for free and this has been the case for decades,” Cayasso-Smith told the Compass.
But if you are not Caymanian, then you must demonstrate that you are capable of purchasing your own medication, in addition to having a valid private insurance policy.
Outside the scope of actual medical intervention, organisations such as the Cayman Islands Red Cross have delivered awareness sessions in 2023 on HIV/AIDS and sexually transmitted infections to more than 150 people between the ages of 15 and 21. And the Red Cross, the Cayman AIDS Foundation and the HSA all provide monthly free HIV testing.
“The collaboration between the Ministry of Health & Wellness and the Cayman Islands Red Cross stands as a beacon of hope in empowering our youth to make informed choices about their sexual and reproductive health,” said Health Minister Sabrina Turner, in a press release. “Together, we are dedicated to not only raising awareness about HIV & AIDS but also dismantling the barriers of stigma and discrimination that are detrimental to our nation.”
Dispelling today’s myths could save tomorrow’s generation
The theme for this year’s World AIDS Day, which annually falls on 1 Dec., is ‘Let communities lead’. Cayasso-Smith believes the youth of Cayman need the greatest level of support.
“We need to seriously rethink the sexual education lessons in our schools,” he said. “I’m not talking about the sexually explicit material, but children should know the warning signs, such as smells, bodily discharges,… of infections.”
He added, “A lot of people may be in denial about their children’s sexual activity, but they should create a safe space where their children can speak to them and learn about the ways to protect themselves.”
To learn more about HIV/AIDS, visit the CAF website.
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