Antigua and Barbuda National Faith Leaders Consultation

Friday 16 August 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP) in collaboration with the Antigua and Barbuda National AIDS Programme Secretariat (NAPS), with funding from the CARIFORUM 10th European Development Fund (EDF) Programme of Support for Wider Caribbean Cooperation, will host the Antigua and Barbuda Faith Leaders Consultation at the Heritage Quay Hotel, St John’s Antigua on Monday 19 August 2019.

This consultation is a follow-up to a series of engagements with faith leaders under the PANCAP Justice for All programme at the regional level. The consultation will facilitate the development of a national action plan for advancing faith leaders’ implementation of key elements of the Justice for All programme in Antigua and Barbuda. Participants will include 50 faith leaders representing the Antigua and Barbuda religious community.

The action plan is geared towards ending AIDS and providing psychosocial support to those infected and affected by HIV. It will also identify the lessons learned from implementing the UNAIDS Fast Track goals; establishing recommendations for improving the collaboration between the religious community and the national AIDS Programme and civil society partners, and setting priorities and timelines for achieving goals.

Speakers scheduled for the Forum include Bishop Rudolph Harris, Second Vice President, Antigua and Barbuda Evangelic Alliance Zion Church of God, Dr Carson Greene, President Seventh-day Adventist Church, South Leeward Conference, Mr Dereck Springer, Director of PANCAP, and Dr Edward Greene, PANCAP Special Advisor.

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Ministry of Public Health (Guyana) is planning to introduce Pre-exposure prophylaxis (or PrEP)

Image: Minister of Public Health, Hon. Volda Lawrence and UNAIDS Country Director for Guyana and Suriname, Dr Michael Gboun with participants of the HIV Clinical Management and Implementation of PrEP through a Public-Private Partnership Workshop

The Ministry of Public Health (Guyana) is planning to introduce Pre-exposure prophylaxis (or PrEP) as an HIV transmission countermeasure. This is a course of drugs taken pre-emptively against the spread of the disease, mainly targetted at vulnerable groups.

The target population in Guyana for HIV transmission prevention are sex workers with a 6.1% prevalence, men who have sex with men with a 4.9% HIV prevalence, and transgender people with an 8.4% prevalence. This is according to a UNAIDS survey conducted in 2016.

PrEP, or pre-exposure prophylaxis, is an HIV prevention method. People who do not have HIV can take PrEP to reduce their risk of getting HIV if they are exposed to the virus. Another countermeasure will see the government establishing a Public-Private Partnership with doctors within the private sector to whom patients will be referred for treatment.

USAID, UNAIDS and Pan American Health Organisation/World Health Organisation (PAHO/WHO) Office in Guyana along with the Ministry of Public Health hosted an HIV Clinical Management and Implementation of PrEP through a Public-Private Partnership Workshop. The three-day workshop ran from August 12 to 14, 2019.

Minister of Public Health, Hon. Volda Lawrence, who handed over certificates to participants of the workshop, noted that PrEP is a new venture of the ministry and is expected to be an effective measure in HIV prevention.

Essentially, the goal of these two new countermeasures is to ensure that full HIV prevention coverage is attained.

“Our goal is to ensure that we reach everyone everywhere. Guyana is a very small and unique country. As a result of that, it has become a stumbling block in terms of people accessing these services,” Minister Lawrence said.

She explained that due to discrimination, people are often reluctant to know their status and may spread the virus unknowingly. It is for this reason, after examining this fact with partners, the ministry thought it best to create ways in which persons can have confidence in HIV treatment and prevention services.

“The ministry stepping out in this particular venture in terms of creating another space allows persons to have their own choice of access to services. We believe it certainly will work towards the benefit of our people. It certainly will help us in terms of reaching persons and keeping persons in the system and utilising the services available.”

UNAIDS’ new Country Director for Guyana and Suriname, Dr Michael Gboun noted that moving in this direction is important since Guyana is on a road to improving access and achieving universal coverage in health care. “This partnership is important, and more so, when we are now testing a new model, PrEP, it calls for a little bit of close monitoring, closer relationships with patients,” Dr Gboun noted.

Advancing HIV Prevention and Treatment in Guyana through Advocacy

Image: Guyanese civil society participants in a practical exercise facilitated by SASOD Guyana’s Human Rights Coordinator Sarah Bovell (right) at the Caribbean Vulnerable Communities Coalition (CVC) Advocacy Planning Validation Meeting

While Guyana adopted a “Treat All” strategy in 2018, further advocacy is needed for Guyana to reach its 95-95-95 targets for HIV testing, treatment and viral suppression.  Stemming from this, organizations providing support to vulnerable groups in Guyana met during 2017 and 2018 to discuss HIV-related advocacy needs.

These meetings resulted in an initial set of priority HIV advocacy strategies, and activities were developed to formulate an Advocacy Plan. The CVC then provided funding for advocacy activities included in the plan through the CVC/COIN Caribbean Civil Society project titled “Challenging Stigma and Discrimination to Improve Access to and Quality of HIV Services in the Caribbean.”

On July 18, 2019, Guyana’s Society Against Sexual Orientation Discrimination (SASOD Guyana) facilitated an Advocacy Planning Validation Meeting at the Guyana Marriott Hotel in Georgetown on behalf of CVC to engage key stakeholders in identifying suitable, short-term advocacy campaigns and also to revise the Advocacy Implementation Matrix for the period October 2019 to September 2022.  Fifteen persons representing 14 civil society organisations participated in the meeting.

They proposed suggestions for amending of the Implementation Matrix and selected a managing partner to coordinate the implementation of the Advocacy Plan in collaboration with the various partners. The meeting also identified two ranked priority activities.

At the meeting, challenges in reaching persons most-at-risk with testing and prevention of HIV were discussed. These include stigma and discrimination against key populations which prevent them from coming forward to be tested and treated and lack of confidentiality at treatment sites coupled with high turnover among healthcare staff due to low salaries.   These include staff who received HIV–related training resulting in clients having to rebuild trust and rapport with new healthcare staff, which takes time and can result in patient discomfort. Insufficient funding from government and the absence of Pre-Exposure Prophylaxis (PrEP) were also identified as major gaps and challenges.

Thoughtful advocacy is needed for high-quality HIV-related healthcare in Guyana in order to monitor the patient experience of health services. This scope would encompass the documentation of instances of stockouts, stigma and discrimination, breaches of confidentiality, and lack of appropriate, competent services and referrals. In addition, the Advocacy Plan recommends conducting an analysis of these situations and providing the Ministry of Public Health with clear recommendations for improvements.

The meeting also discussed the need for ongoing training of healthcare staff to prevent stigma, discrimination and judgmental attitudes. In addition, there should be enforceable measures to ensure that staff preserve the confidentiality of patient information. Further to this, there should be incentives provided to persons who access prevention and treatment services. The meeting called for government support in providing case navigators to aid retention in care and a strategy to collect data on migrant populations since there is limited data about their HIV vulnerabilities.

UNAIDS welcomes the appointment of Winnie Byanyima as its new Executive Director

GENEVA, 14 August 2019—UNAIDS warmly welcomes the appointment of Winnie Byanyima as its new Executive Director. Ms Byanyima has more than 30 years of experience in political leadership, diplomacy and humanitarian engagement.

“I am honoured to be joining UNAIDS as the Executive Director at such a critical time in the response to HIV,” said Ms Byanyima. “The end of AIDS as a public health threat by 2030 is a goal that is within the world’s reach, but I do not underestimate the scale of the challenge ahead. Working with all its partners, UNAIDS must continue to speak up for the people left behind and champion human rights as the only way to end the epidemic.”

The United Nations Secretary-General, António Guterres, appointed Ms Byanyima as the UNAIDS Executive Director and United Nations Under-Secretary-General following a comprehensive selection process that involved a search committee constituted by members of the UNAIDS Programme Coordinating Board. The UNAIDS Committee of Cosponsoring Organizations made the final recommendation on the appointment to the Secretary-General.

Ms Byanyima brings a wealth of experience and commitment in harnessing the power of governments, multilateral agencies, the private sector and civil society to end the AIDS epidemic around the world. Ms Byanyima has been the Executive Director of Oxfam International since 2013. Prior to that, she served for seven years as the Director of Gender and Development at the United Nations Development Programme.

Ms Byanyima began her career as a champion of marginalized communities and women 30 years ago as a member of parliament in the National Assembly of Uganda. In 2004, she became the Director of Women and Development at the African Union Commission, working on the Protocol on the Rights of Women in Africa, an international human rights instrument that became an important tool for reducing the disproportionate effect of HIV on the lives of women in Africa.

She holds an advanced degree in mechanical engineering (in energy conservation and the environment) from the Cranfield Institute of Technology and an undergraduate degree in aeronautical engineering from the University of Manchester.

The Secretary-General wishes to extend his appreciation and gratitude to the UNAIDS Deputy Executive Director, Management and Governance, Gunilla Carlsson, for her service as the Executive Director, a.i.

Minister Sands: It is time to increase sex education among young people

NASSAU, BAHAMAS — Following a recent Department of Public Health report that showed an uptick in sexually transmitted diseases among young persons, Minister of Health Dr Duane Sands said yesterday that while he does not want to overstep other ministries’ purview, he acknowledged it is time to increase sexual education among young people.

“We are prepared to discuss a lot of things in this country; like who ‘ga’ win Junkanoo and other things, but when it comes down to critical issues of health and other things we get very, very quiet,” Sands told Eyewitness News Online.

The minister opined that parents have attempted to disassociate sex from young people, but said: “we need to meet our people where they are, as they are, and not pretend as if human sexuality is not real”.

According to the Department of Public Health Surveillance Unit and STI Clinic, there were 2,616 people in The Bahamas who tested positive for Syphilis at least once during between 2014 and 2018.

The report indicated that during the period, cases increased by 63 per cent, from 439 in 2014 to 714 in 2018.

It also noted that there were 816 cases of Chlamydia and 186 cases of Gonorrhea Infection in 2017.

In 2018, there were 1,004 cases of Chlamydia and 265 cases of Gonorrhea.

Sands acknowledged that while HIV and AIDS remain top priorities, there is a need to recalibrate given the trends of certain STIs.

“Not to change or diminish the efforts to reduce HIV, but to ensure that people recognize that Syphilis, Gonorrhea and other sexually transmitted infections go along with HIV and that we should not forget that they have implications as well,” he said.

In a separate interview, University of the Bahamas Dean of Students Joe Stubbs said Bahamians have to get out of the habit of pretending that young persons are not having sex.

“The leaked videos that somehow appear on social media and the conversations that are happening, and the increase in STD rates that skyrocketed recently; If these aren’t evidence that proves our young people are actively engaged in sexual relations, then I don’t know what else we need to show us that,” he said.

“So, I definitely think we need to be having more [realistic] conversations with our young people”.

“We know what you are doing and we can’t stop you from doing it, but we can put measures in places to educate you on making better and wiser decisions”.

Meanwhile, LIFE Worship Center Pastor Denczil Rolle said there is a need now, more than ever, for churches to join the conversation.

“Destruction comes when there is an absence of knowledge,” he said

“So, we have to begin the conversation. The church cannot be afraid”.

“There was a time in church wherein ministry training you were taught to not say the word sex because it creates different impulses in the minds of different persons, but now today, you have to use it.”

Sands added that his ministry will continue its efforts to educate the public, but the real education must start at home.

Two gay men exiled from Caribbean nation challenge draconian ‘buggery’ and ‘gross indecency’ laws

On 26 July 2019, two gay men filed court proceedings to challenge St Vincent and the Grenadines’ “buggery” and “gross indecency” laws, which criminalise homosexuality. Both men, who have been advised by Jeremy Johnson QC and Peter Laverack of 5 Essex Court, assert that their dignity and autonomy are stripped by these laws. They have filed claims with Affidavits stating that they have been exiled from the Caribbean nation due to the severely draconian and damaging effects of these laws.

Javin Johnson, aged 22, successfully claimed asylum in the United Kingdom in 2017 having established that he could not live as a gay man in St Vincent. Sean Macleish, aged 53, is a Vincentian resident in Chicago, Illinois. Macleish has publicly advocated to the Caribbean nation’s Prime Minister for the removal of these laws so that he may return home with his partner but to no effect.

These challenges coincide with Prince William and his family holidaying in the country on the exclusive island of Mustique, whose website states “there are no rules on Mustique”. LGBT visitors, however, would be liable to arrest and imprisonment for up to 10 years if caught being intimate. Prince William stated this month that he would be “absolutely fine” if his own children were gay.

The two claimants are unknown to each other, having separately decided that now is the time for decriminalisation. They say that these laws violate multiple and overlapping rights in the Constitution, which are there to protect all Vincentians, no matter who they are or who they love.

These court challenges come in the wake of Jason Jones’ successful challenge to Trinidad and Tobago’s anti-gay laws, a week after a similar challenge was filed in Dominica, and with other challenges already afoot in Jamaica and Barbados.

Commonwealth Caribbean nations inherited these laws during British colonial rule. Now uniquely in the Americas, these nations continue to criminalise homosexuality, placing them in an ever-decreasing minority globally.

The challenges were filed by local lawyers, Zita Barnwell and Jomo Thomas, listing English barristers Jeremy Johnson QC and Peter Laverack of 5 Essex Court, London, as the intended trial advocates. 5 Essex Court was instructed by a team at Hogan Lovells, which includes Charles Brasted, partner, Tom Smith, senior associate, and Iris Karaman, trainee solicitor.”

The two challenges are expected to be heard together in the High Court in Kingstown. The British Privy Council may have ultimate say on these colonial-era laws, as St Vincent and the Grenadines still sends its appeals to the old imperial court in London.

The Global Fund – An Open Letter to 7-Year-Olds

Calling on the World

The Global Fund is calling on the world to step up the fight against AIDS, Tuberculosis (TB) and Malaria.  After years of remarkable advances, new threats have slowed progress and enabled the diseases to gain ground.

  • Nearly 1,000 girls and young women are infected with HIV every day.
  • Tuberculosis is now the world’s leading infectious killer.
  • A child dies from Malaria every 2 minutes.

In 2019, we have a unique opportunity to take a massive step toward the Global Goal of ending these epidemics by 2030.  The Global Fund aims to raise at least US$14 billion to save 16 million more lives and prevent 234 million infections and cases.  We need your help to make this happen. Join us at this important moment as we call on the world to #StepUpTheFight.

An Open Letter to 7-Year-Olds

On Tuesday, 30 July, the Global Fund launched an Open Letter addressed to 7-year-olds around the world, the group that turns 18 in 2030.  While today’s adults are leaving the next generation with a long to-do list, we’re making a promise to 7-year-olds everywhere to do everything we can to end AIDS, TB and Malaria by 2030, so they don’t have to.

Signed by the Global Fund’s most influential supporters and partners with the aim of encouraging wide public support, the Open Letter is a global call to action in the final phase of the #StepUpTheFight campaign to commit to the shared goal to end these epidemics.

Download and sign the Open Letter to 7-year-olds here or visit https://www.stepupthefight.org/

Support the launch of the Open Letter and post a tile with one of the suggested messages to your social media channels.  To download the social media messages, click on the following link: https://digital.theglobalfund.org/CS.aspx?VP3=SearchResult&VBID=278T3ZOXVMB

Youths commit to challenging the barriers to accessing sexual and reproductive health services

Wednesday 31 July, 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, convened the Third Regional Meeting of Youth Leaders on Sexual and Reproductive Health and HIV and AIDS on 30 July 2019 in Port-of-Spain, Republic of Trinidad and Tobago.

The forum will facilitate the drafting of a roadmap with strategies for sustaining youth advocacy for the promotion of gender equality, HIV prevention, actions to end gender-based violence and access to quality sexual reproductive health (SRH) services to meet the needs of adolescents and youth regardless of disability, age, citizenship, gender identity and sexual orientation.

In opening remarks, Director of PANCAP, Dereck Springer reflected on the creation and relevance of the Caribbean Regional Youth Advocacy Framework (CRYAF) on Sexual and Reproductive Health and Rights.  “After developing the CRYAF with input from youth, we recognized that it was important to build youth leaders’ advocacy skills so that they would be better prepared to advocate at the regional and national levels”, stated the Director. “This was done during the second meeting of youth leaders, and the approach was successful as we now have a dynamic group of young people who are passionate and innovative in their approach to advocacy”.

Mr Springer stated that PANCAP has been supporting youth leaders to advocate at the regional level, which included funding for youths to engage in regional forums with Ministers of Health and Education.  PANCAP also supported youth leaders’ participation in the Joint Regional Dialogue with Faith Leaders, Parliamentarians, Civil Society Leaders and National AIDS Programme Managers.  A presentation by youth leaders advocating for access to sexual and reproductive health services was also positively received at the Meeting of the Council for Human and Social Development (COHSOD).

The PANCAP Director praised the development of action plans by the youth body.  “I was impressed that youth leaders recognized the need to adapt their advocacy approach from the regional to the national platform,” stated Mr Springer,  “I was also impressed by the reports of all the advocacy work implemented at the national level which called attention to issues concerning adolescents’ health and rights, gender equality, HIV prevention, actions to end gender-based violence and access to quality sexual reproductive health (SRH) services to meet the needs of adolescents and youth”.

He also encouraged youths to continue utilizing digital platforms, including social media, to propagate their advocacy messages.  “I am proud when I see our youths utilizing innovation to provoke responses on issues which they are passionate about,” stated the PANCAP Director, “continue to use the technology available to remain visible”.  He outlined the plethora of new knowledge which will be gained by youths during the meeting and urged participants to utilize the new skills to collaborate and heighten sexual and reproductive health advocacy across the region.

In her remarks, Ms Renatta Langlais, Member, PANCAP Steering Committee on Youth Advocacy (PSCYA) praised participants for their consistent commitment to attending PANCAP youth forums and challenged them to utilize the new skills gained within the PSCYA and CARICOM Youth Ambassadors Corps.  “We are here to share and learn from each other, we are here to meaningfully contribute to our healthy development as Caribbean youth,” stated Ms Langlais.

She highlighted that the task of achieving the three main priority areas set by the Caribbean Regional Youth Advocacy Framework in 2017 has been challenging.  These included aligning the age of access to sexual and reproductive health services to the age of sexual consent, introducing Comprehensive Sexuality Education (CSE) to all Caribbean schools and advocating for Gender Neutral Laws and policies to be passed and implemented, especially those protecting the rights of victims of gender-based violence regardless of gender, orientation, race or status.

“Change does not come easily in our Caribbean Society,” stated Ms Langlais “It is difficult to show someone a new path when they are already set in their ways. We all want a healthy society, but many allow prejudice, stereotypes and stigma to block the road to progress”.  However, she praised the progress made by the youth body in formulating goals, indicators, and challenging barriers to SRH services by adolescents and youth.  “We must face obstacles of tradition, apathy, ignorance and lack of political will, head-on.   The road we are travelling is very Caribbean, full of potholes of politics and bigotry; sometimes we fall in them, other times we manage to avoid them”.

She further praised the PANCAP Director and the Partnership for consistent commitment to building the capacity of youth leaders in advocacy and urged participants to utilize collaboration as the key to fostering change and reaching policymakers with advocacy messages.

Ms Terez Lord, CARICOM Youth Ambassador (CYA), Republic of Trinidad and Tobago in her remarks reminded participants of the significance of the CARICOM Youth Ambassador Corps (CYAC). “We, in this room, represent the hopes and the dreams that were born in 1993 when the CYAC was formed.

We hold the hopes of our Heads of Government who created this mechanism that was to be of the young people, for the young people and by the young people”.  She further highlighted that the CYAC was intended to be the catalyst to integrate and infuse the perspectives and solutions proposed by youth across the region into national, regional and international policy and practices.  She also expressed gratitude to PANCAP for supporting youths to fulfil the mandate of the CYAC by building their capacity to advocate at all levels.  She stated “as a unit, we have the strength and we have prowess – but only if we want to.  In the international community, our presence is strong, and our voices are distinct”.

The CYA urged youths to utilize their collective skills to advocate for change. She stated “If collaboration is currency, then perhaps we as CARICOM can indeed have one common currency.  We must be keen on ensuring CARICOM representation so that Heads of Government can recognize our presence, respect our intellect, accept our contributions and implement our recommendations”.

She urged youths to utilize the forum to create innovative, inclusive and impactful recommendations.  “CARICOM Youth Ambassadors are a dynamic group of young people who are always prepared to disrupt old ways, mount a challenge to the status quo and contribute meaningfully and constructively to the sustainable development of our region,” stated Ms Lord.

Keynote speaker, Shaquille Knowles, Chairperson, Caribbean Regional Youth Council (CRYC) praised PANCAP for providing a space for young people to discuss issues affecting youth including universal health and SRH.  He expressed his anticipation for the specific outcomes from the meeting which include the development of practical solutions capable of increasing youth’s access to quality health services, and a commitment to stand up against issues that have prevented adolescents’ access to quality universal health and SRH services.

He expressed his passion for advocating for SRH for adolescents and outlined the challenges affecting adolescents’ access to quality health services which included the inability to afford health services and the stigma associated with receiving health services to treat specific illnesses.   “Unfortunately, as the world continues to revolve without adequately addressing these key challenges within our critical demographic – more adolescents continue to grapple with the challenges with access to services that ‘healthy’ individuals take for granted,” stated the CRYC Chair.

He recounted an experience in which a family member died as a result of inadequate access to preventative health care services.  “This loss of life could have been prevented with adequate resources to properly educate persons on the preventative measures to avoid being infected with HIV and measures to reduce the stigma of HIV within our communities and homes,” stated Mr Knowles.

“I have witnessed continued efforts to reduce the prevalence rate of the HIV and other STIs in the Caribbean thanks to efforts from PANCAP, Ministries of Health and advocates,” stated the CRYC Chair,  “However, we must remain steadfast in transforming the lives of the world’s most critical population by continuing the work to reduce the detrimental effects of a lack of access to universal health services”.

He concluded by challenging participants to use innovation to advocate for adolescents’ access to SRH and to use their platforms to keep health for young people at the top of every policymaker’s agenda.

-ENDS –

What is PANCAP?

PANCAP is a Caribbean regional partnership of governments, regional civil society organisations, regional institutions and organisations, bilateral and multilateral agencies and contributing donor partners which was established on 14 February 2001. PANCAP provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, coordinates the response through the Caribbean Regional Strategic Framework on HIV and AIDS to maximise efficient use of resources and increase impact, mobilises resources and build capacity of partners.

What are the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 Targets?

  • By 2020, 90% of all people living with HIV will know their HIV status.
  • By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
  • By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

Contact:

Timothy Austin

Communications Specialist

PANCAP Coordinating Unit

CARICOM Secretariat

Turkeyen, Greater Georgetown, Guyana

Email:      taustin.consultant@caricom.org

Tel: (592) 222-0001-75, Ext. 3409  | Visit www.PANCAP.org

Editor’s Notes:

Overview of PANCAP Youth Initiatives

The Caribbean Regional Strategic Framework (CRSF) 2014-2018 articulates the vision and collective priorities of Caribbean states through their membership in the Pan Caribbean Partnership against HIV and AIDS (PANCAP). The CRSF recognises that resources must be strategically allocated to target the epidemic at regional, country, community and individual levels. Doing so effectively will require establishing and sustaining an enabling environment (Strategic Priority Area 1) by addressing social and cultural drivers of the epidemic and by removing barriers to access sexual and reproductive health information, education and services. In particular, more conscious efforts to address human sexuality are needed in order to equip young people with the regional public goods including knowledge and tools they need for healthy development.

As of 2014, there were 280 000 [210 000–340 000] people living with HIV, 8800 [5700–13 000] AIDS-related deaths among adults, and 44% [33%-54%] of adults living with HIV accessing HIV treatment in the Caribbean. Young people, especially among key populations, in Caribbean are disproportionately at risk of HIV infection, and they face greater barriers to accessing prevention services. According to the Pan American Health Organization (PAHO), HIV prevalence among young people is 0.07% and 0.05% in females and males in the non-Hispanic Caribbean and 0.2% and 0.3% in the Hispanic Caribbean both respectively. In Jamaica, where the data are available, higher estimated HIV prevalence has been reported among gay, men that have sex with men (14%) and transgender adolescent girls (27%).  While the regional response has realised some progress with a 43% reduction among adults and a 90% reduction in children acquiring HIV, gaps and challenges remain.  HIV prevalence remains high among Key Populations (KPs) such as Sex Workers (SW), Men who have Sex with Men (MSM), and young people.  At the same time, challenges regarding stigma and discrimination, violations of human rights and gender-based violence continue to hinder access to services for young people in general.

To work more systematically with young people belonging to KPs who are more difficult to reach, PANCAP/Global Fund grant programme proposed to collaborate with CVC/COIN to link at-risk youth with the CYAP. The CYAP provides a unique platform for leadership development and collaboration that can strengthen the participation of a more diverse and better-informed youth constituency in CARICOM decision-making. This will serve a mutually beneficial purpose of strengthening the relevance and impact of the Youth Ambassadors as well as providing access to high-level CARICOM fora for KP youth, allowing for collaborative approaches to high-level advocacy that better links the issues and priorities of CARICOM to those of young people. This initiative supports the inclusion and participation of some Key Population groups (i.e. PLHIV, MSM, SW and youth) in the regional response addressing the critical gaps given the overwhelming evidence of the main drivers of HIV transmission in these groups.

The First Meeting of Youth Leaders held in April 2017 allowed for in-depth discussion of sexual health issues affecting young people, identified what are barriers to their access to sexual health services, as well as identify what knowledge and tools are required to protect themselves from HIV. The meeting provided input required to develop a regional advocacy framework on key sexual health issues affecting youth and to inform subsequent training to strengthen advocacy skills of regional youth leaders. This has strengthened the inclusion of youth leaders in the regional and national responses to work towards a more coherent and holistic approach to issues affecting youth from key populations and young people living with HIV: the dissonance between the age of sexual initiation (before age 15), prevailing legislation on the age of consent (16 years), and the age for independent access to health care (18 years) with the exception of Jamaica in which age for independent access for health care is 16, the implementation of Comprehensive Sexuality Education in all schools in the Caribbean and Gender-neutral laws that protect victims of sexual exploitation.

The formalization of a Steering Committee on Youth Advocacy and follow up meetings are an innovative approach to mobilise regional youth leaders to actively engage in high-level advocacy and policy dialogues by linking the CYAP with PLHIV youth leaders and other sexual and reproductive health youth activities/leaders.

The Second Meeting of Youth Leaders held in May 2018, provided the opportunity for an in-depth discussion on the achievements and challenges confronted by youth leaders in addressing the three priority areas identified in the Caribbean Regional Youth Advocacy Framework (CRYAF) to set in motion practical advocacy tools and techniques that can be adapted per country context. The meeting served to identify regional and international mechanisms that can be used as best practice models for the achievement of priority objectives, provide the opportunity to exercise advocacy techniques with parliamentarian(s), CSO representation and CYAs through a panel discussion addressed sexual and reproductive health issues and concerns identified by youth leaders. The meeting enabled the adaptation of standardized data collecting and reporting tool used by youth leaders in their respective countries. This informed PANCAP of opportunities to support an innovative approach to mobilize regional youth leaders to actively engage in high-level advocacy, as well as further develop advocacy tools and materials to review and address policies, practices and laws that affect young people’s vulnerabilities to HIV.

Helpful links:

Caribbean Youths to create roadmap to advocate for Sexual Reproductive Health Services for adolescents and youth

Image: Kevin Mendez, Chair, PANCAP Youth Advocacy Steering Committee

Thursday 25 July, 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, will convene the Third Regional Meeting of Youth Leaders: Sexual and Reproductive Health and HIV and AIDS on 30 July – 2 August 2019 in Port-of-Spain, Republic of Trinidad and Tobago.

The meeting comes approximately one year after the Second Meeting of Youth Leaders and 18 months ahead of the 2020 deadline for reaching the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 Targets—90% of people living with HIV diagnosed, 90% of diagnosed people on treatment and 90% of those on treatment virally suppressed.

Regional youth leaders will be involved in drafting a roadmap with strategies for sustaining youth advocacy for the promotion of gender equality, HIV prevention, actions to end gender-based violence and access to quality sexual reproductive health (SRH) services to meet the needs of adolescents and youth regardless of disability, age, citizenship, gender identity and sexual orientation.

According to Kevin Mendez, Chair, PANCAP Youth Advocacy Steering Committee, the forum will also facilitate sharing of success stories, and lessons learnt from regional youth leaders calling attention to issues concerning adolescents’ health and rights. “Youth leaders will combine their experiences and knowledge to identify innovative ways to address gaps in the achievement of the priority areas of the Caribbean Regional Youth Advocacy Framework on Sexual and Reproductive Health and Rights,” stated the Chair, “our goal is to strengthen the Caribbean regional HIV response and create a roadmap with strategies for sustaining youth advocacy”.

In excess of 40 participants will attend, consisting of CARICOM Youth Ambassadors (CYAs), youth leaders from Key Populations, representatives of the Caribbean Family Planning Affiliation (CFPA), Pan American Health Organization (PAHO)/ World Health Organization (WHO), Caribbean Vulnerable Communities Coalition (CVC), CariFLAGS, Caribbean Right Here, Right Now (CRHRN), and the Youth Coalition for Sexual and Reproductive Health and Rights. Over 15 Caribbean territories will be represented.

What is PANCAP?

PANCAP is a Caribbean regional partnership of governments, regional civil society organisations, regional institutions and organisations, bilateral and multilateral agencies and contributing donor partners which was established on 14 February 2001. PANCAP provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, coordinates the response through the Caribbean Regional Strategic Framework on HIV and AIDS to maximise efficient use of resources and increase impact, mobilises resources and build capacity of partners.

What are the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 Targets?

  • By 2020, 90% of all people living with HIV will know their HIV status.
  • By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
  • By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

Contact:

Timothy Austin

Communications Specialist

PANCAP Coordinating Unit

CARICOM Secretariat

Turkeyen, Greater Georgetown, Guyana

Email:      taustin.consultant@caricom.org

Tel: (592) 222-0001-75, Ext. 3409  | Visit www.PANCAP.org

Editor’s Notes:

Overview of PANCAP Youth Initiatives

The Caribbean Regional Strategic Framework (CRSF) 2014-2018 articulates the vision and collective priorities of Caribbean states through their membership in the Pan Caribbean Partnership against HIV and AIDS (PANCAP). The CRSF recognises that resources must be strategically allocated to target the epidemic at regional, country, community and individual levels. Doing so effectively will require establishing and sustaining an enabling environment (Strategic Priority Area 1) by addressing social and cultural drivers of the epidemic and by removing barriers to access sexual and reproductive health information, education and services. In particular, more conscious efforts to address human sexuality are needed in order to equip young people with the regional public goods including knowledge and tools they need for healthy development.

As of 2014, there were 280 000 [210 000–340 000] people living with HIV, 8800 [5700–13 000] AIDS-related deaths among adults, and 44% [33%-54%] of adults living with HIV accessing HIV treatment in the Caribbean. Young people, especially among key populations, in Caribbean are disproportionately at risk of HIV infection, and they face greater barriers to accessing prevention services. According to the Pan American Health Organization (PAHO), HIV prevalence among young people is 0.07% and 0.05% in females and males in the non-Hispanic Caribbean and 0.2% and 0.3% in the Hispanic Caribbean both respectively. In Jamaica, where the data are available, higher estimated HIV prevalence has been reported among gay, men that have sex with men (14%) and transgender adolescent girls (27%).  While the regional response has realised some progress with a 43% reduction among adults and a 90% reduction in children acquiring HIV, gaps and challenges remain.  HIV prevalence remains high among Key Populations (KPs) such as Sex Workers (SW), Men who have Sex with Men (MSM), and young people.  At the same time, challenges regarding stigma and discrimination, violations of human rights and gender-based violence continue to hinder access to services for young people in general.

To work more systematically with young people belonging to KPs who are more difficult to reach, PANCAP/Global Fund grant programme proposed to collaborate with CVC/COIN to link at-risk youth with the CYAP. The CYAP provides a unique platform for leadership development and collaboration that can strengthen the participation of a more diverse and better-informed youth constituency in CARICOM decision-making. This will serve a mutually beneficial purpose of strengthening the relevance and impact of the Youth Ambassadors as well as providing access to high-level CARICOM fora for KP youth, allowing for collaborative approaches to high-level advocacy that better links the issues and priorities of CARICOM to those of young people. This initiative supports the inclusion and participation of some Key Population groups (i.e. PLHIV, MSM, SW and youth) in the regional response addressing the critical gaps given the overwhelming evidence of the main drivers of HIV transmission in these groups.

The First Meeting of Youth Leaders held in April 2017 allowed for in-depth discussion of sexual health issues affecting young people, identified what are barriers to their access to sexual health services, as well as identify what knowledge and tools are required to protect themselves from HIV. The meeting provided input required to develop a regional advocacy framework on key sexual health issues affecting youth and to inform subsequent training to strengthen advocacy skills of regional youth leaders. This has strengthened the inclusion of youth leaders in the regional and national responses to work towards a more coherent and holistic approach to issues affecting youth from key populations and young people living with HIV: the dissonance between the age of sexual initiation (before age 15), prevailing legislation on the age of consent (16 years), and the age for independent access to health care (18 years) with the exception of Jamaica in which age for independent access for health care is 16, the implementation of Comprehensive Sexuality Education in all schools in the Caribbean and Gender-neutral laws that protect victims of sexual exploitation.

The formalization of a Steering Committee on Youth Advocacy and follow up meetings are an innovative approach to mobilise regional youth leaders to actively engage in high-level advocacy and policy dialogues by linking the CYAP with PLHIV youth leaders and other sexual and reproductive health youth activities/leaders.

The Second Meeting of Youth Leaders held in May 2018, provided the opportunity for an in-depth discussion on the achievements and challenges confronted by youth leaders in addressing the three priority areas identified in the Caribbean Regional Youth Advocacy Framework (CRYAF) to set in motion practical advocacy tools and techniques that can be adapted per country context. The meeting served to identify regional and international mechanisms that can be used as best practice models for the achievement of priority objectives, provide the opportunity to exercise advocacy techniques with parliamentarian(s), CSO representation and CYAs through a panel discussion addressed sexual and reproductive health issues and concerns identified by youth leaders. The meeting enabled the adaptation of standardized data collecting and reporting tool used by youth leaders in their respective countries. This informed PANCAP of opportunities to support an innovative approach to mobilize regional youth leaders to actively engage in high-level advocacy, as well as further develop advocacy tools and materials to review and address policies, practices and laws that affect young people’s vulnerabilities to HIV.

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WHO recommends Dolutegravir as preferred HIV treatment option in all populations

Based on new evidence assessing benefits and risks, the WHO recommends the use of the HIV drug dolutegravir (DTG) as the preferred first-line and second-line treatment for all populations, including pregnant women and those of childbearing potential.

Initial studies had highlighted a possible link between DTG and neural tube defects (birth defects of the brain and spinal cord that cause conditions such as spina bifida) in infants born to women using the drug at the time of conception. This potential safety concern was reported in May 2018 from a study in Botswana that found 4 cases of neural tube defects out of 426 women who became pregnant while taking DTG. Based on these preliminary findings, many countries advised pregnant women and women of childbearing potential to take efavirenz (EFV) instead.

New data from two large clinical trials comparing the efficacy and safety of DTG and EFV in Africa have now expanded the evidence base. The risks of neural tube defects are significantly lower than what the initial studies may have suggested.

The guidelines group also considered mathematical models of the benefits and harms associated with the two drugs; the values and preferences of people living with HIV, as well as factors related to the implementation of HIV programmes in different countries, and cost.

DTG is a drug that is more effective, easier to take and has fewer side effects than alternative drugs that are currently used. DTG also has a high genetic barrier to developing drug resistance, which is important given the rising trend of resistance to EFV and nevirapine-based regimens. In 2019, 12 out of 18 countries surveyed by WHO reported pre-treatment drug resistance levels exceeding the recommended threshold of 10%.

All of the above findings informed the decision to update the 2019 guidelines.

In 2019, 82 low- and middle-income countries reported to be transitioning to DTG-based HIV treatment regimens. The new updated recommendations aim to help more countries improve their HIV policies.

As for any medications, informed choice is important. Every treatment decision needs to be based on an informed discussion with the health provider weighing the benefits and potential risks.

WHO also stresses the importance of providing information and options to help women make an informed choice. To this end WHO has convened an advisory group of women living with HIV from diverse backgrounds to advise on policy issues related to their health, including sexual and reproductive health. WHO highlights the need to continually monitor the risk of neural tube defects associated with DTG.