Common Themes and Challenges throughout the Caribbean and Central America

November 18, 2008


It is clear that HIV/AIDS stigma and discrimination impedes all facets of HIV/AIDS prevention, education, awareness, direct care, psycho-social support, and treatment of PLWHA throughout the Caribbean and Central America.


PLWHA in this region universally agree there needs to be laws and policies initiated, enacted, widely publicized and communicated clearly to the public, and enforced that protect women and girls against sexual violence, gender discrimination of all kinds, domestic violence, protection for homosexuals and other at-risk groups (sex workers, prisoners, uniformed personnel, at-risk youth, etc.), confidentiality, and protect PLWHA in the workplace, housing and within the health care systems from discrimination. 


Other consistent challenges throughout the region included the following:


  • Lack of regular communication that ensures consistent information exchange, HIV/AIDS treatment/policy updates, and skills-sharing among AIDS Service Organizations (ASO) and NGOs (peer ASO/NGO in the region)
  • Low literacy levels
  • Limited computer/technical skills
  • Limited free and easily accessible condom distribution
  • Limited media/Public Relations/Marketing experience or skills among ASO and NGO
  • Little to no fundraising skills among key project staff of ASO/NGO
  • National networks are at different stages of development; which poses challenges for project implementation and management
  • Most ASO/NGO offices do not allow the space, comfort and privacy for confidentiality in regards to HIV/AIDS counseling and/or testing
  • Current HIV/AIDS research, treatment and global policy information such as the SMART study results, introduction of the new triple-therapy (“Atripla”) ARVT (one dose a day) , and the development of an algae-based micro-biocide (currently being used in Brazil) have not been funneled from “northern-based” ASO to ASO and NGO in the region
  • Limited or no mental health services available for PLWHA in this region
  • Absence of legislation (or enforcement) to protect PLWHA
  • Ignorance and discrimination within the health care systems, and most other sectors (from education to business/private)
  • Socio-economic issues and constraints such as high unemployment, poverty, drug and alcohol abuse, poverty-driven prostitution, illegal and legal immigration among the region, early sexual initiation, some obstacles from various churches, and USAID mandated ABC strategies endorsed by national AIDS responses.
  • (Perceived) Apathy from some of the PLWHA members themselves
  • Confidentiality issues among HIV Support Groups themselves; no grievance policies and regulations designed, implemented and enforced
  • Low self-esteem of PLWHA
  • HIV Drug adherence issues; many PLWHA disinterested in taking ARVT at all or afraid to be identified as “HIV+” by local pharmacist
  • Inconsistent access to drugs and few treatment options for ARVT-related side effects such as neuropathy, lypodystrophy (metabolic and body changes), urinary tract infections, etc. and Opportunistic Infections (OIs.)   PLWHA un-informed of other ARVT combinations and drugs being used in other countries—how can PLWHA do treatment advocacy if they do not know or understand all the drug options that are currently available on the world market?
  • ASO and NGO in the region are currently dependant upon large multi-national grants and this is not sustainable; therefore, a need for alternative funding strategies/skills/projects ranging from income generation projects to private, local and corporate support to capital campaigns and gifts-in-kind needed; local business/community support needed
  • Inadequate medical services such as laboratory services, few have the opportunity/funds/means to obtain a viral load (most PLWHA did not know what a viral load is), poor delivery, no grievance policies, and lack of confidentiality
  • Lack of donor/funding support for administrative and operations costs
  • Few or limited hospice or palliative care services for PLWHA
  • Difficulty in directly observing ARVT treatment (adherence issues)
  • Few or limited services for AIDS-related orphans (and vulnerable children)
  • Competition (instead of collaboration) among peer ASO and NGO in the region
  • Very little discussion about HIV education, awareness and prevention strategies for the youth

One Response to “Common Themes and Challenges throughout the Caribbean and Central America”

  1. Kathy Lehay Says:

    I’m just getting a chance to look at your new blog. Love it! Also ashamed to say that I brushed up my LFA skills with one of your older posts 🙂 – Kathy.

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