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Do you know your status? If you do not, as Champions for Change we urge you to do so this World AIDS Day so you can feel empowered.

Know Your Status is the theme for World AIDS Day this year. It is both a call to action and an opportunity to celebrate the achievements that have been made and recommit ourselves to continue the work towards the end of AIDS as a public health threat by 2030. The success of the regional response is evident in significant achievements for the Caribbean especially since seven of our Caribbean countries were recognized on World AIDS Day last year for eliminating the transmission of the HIV virus from Mother to an unborn child. In April 2015, Cuba became the first country in the world to achieve the target for elimination of mother-to-child transmission of HIV and Congenital Syphilis, along with 6 additional countries (Anguilla, Antigua and Barbuda, Bermuda, Cayman Islands, Montserrat, and Saint Kitts and Nevis, in 2017).

UNAIDS World AIDS Day 2018 data collected in 2017, reveals that we still have much to do and each of us needs to take action.

• Our Caribbean region still has 310, 000 people living with HIV
• The number of new infections among adults stands at 15, 000 [11 000–26 000] as reported in 2017.
• Adults aged 15 years and over, there are reports of 14,000 new infections [10 000 – 24 000]
• New infections among children (aged 0–14 years) are an estimated 1100 [710–1900] in
• AIDS-related deaths in 2017 were an estimated 10 000 [7100–17 000]
• 181,000 Caribbean people living with HIV were on treatment in 2017
• Treatment coverage for pregnant women accessing treatment is at 75% but only 58% for adults 15 years and older and just 52% for children 0-14 years and 57% overall for all people living with HIV.

This tells us that despite these efforts and in spite of the overall gains towards epidemic control, throughout the Region, prevalence continues to be higher in key populations, including women, MSM, transgender, sex workers, youth, migrants and mobile populations, incarcerated persons and people who use drugs. The legal, social and cultural barriers that drive transmission and prevent key populations from accessing comprehensive and high-quality health services are deeply rooted in Caribbean cultures and societies. As the Region is faced with rapidly declining donor support to HIV programming, interventions targeted at key populations, including through community-based organizations (CSO), are likely to be most affected, especially as national programs are challenged to find the resources needed to scale-up treatment programs in line with Treat All. At a minimum, there must be a commitment at the regional and national level to sustaining investment in prevention, treatment, communication for development, moral and values education and care programs.

It is now, therefore, a strategic imperative to work in partnership and collaboration with all stakeholders, operating as a unified, coherent and cohesive whole (without prejudice to individual/respective organizations objectives) in order to achieve the overall goal of ending AIDS as a public health threat by 2030.

Each of us must do more, and we can start by simply doing an HIV test- today or as soon as possible- which will allow us to seek treatment or continue and improve our prevention efforts. Our region needs our collective action!

This year’s World AIDS Day theme “Know your status” encourages us to be tested to know whether we are HIV negative or positive. This theme is very relevant as the world has committed to Fast Track actions towards achieving the 90-90-90 treatment targets by the year 2020. The UNAIDS 2018 Global AIDS Monitoring (GAM) report informs us that there are an estimated 310,000 adults and children living with HIV in the Caribbean, of which nearly 55,000 are unaware that they have HIV.

While many people experience anxieties when contemplating being tested, it is good to know that the majority of these will test HIV negative. What is important is those who know that they are HIV negative have an incentive to keep themselves free from HIV by adopting changes to their lives that can reduce their risk and vulnerability to HIV. The few who test positive for HIV can have immediate access to life-saving antiretroviral drugs that would enable them to enjoy a good quality life and live much longer.

The 2018 UNAIDS GAM report also helps us to understand that we still need to place 74,400 persons who are living with HIV on treatment and 103,000 are yet to achieve viral suppression, that is, having very low levels of virus in the body, even though the virus is still present.

Science and evidence show that AIDS can be defeated once we get 90 percent of people to know their HIV status, of those who are HIV positive 90 percent receive anti-retroviral drugs and are retained in care, and 90 percent of those on treatment achieve viral suppression. Once this happens, we are well on the way to achieving the end of AIDS, by 2030.

So what is stopping us from achieving these 90-90-90 targets? The biggest challenges we face are persistent judgment and unfair treatment of people living with HIV and persons belonging to key population groups such as gay men and other men who have sex with men, transgender persons, sex workers, persons who use drugs, migrants and other mobile populations, and persons with disabilities. We judge persons who are different from us and we often times treat them differently. We do so because we do not take the time to understand.  This year’s theme must, therefore, serve as a catalyst for increased strategic advocacy using the PANCAP Regional Advocacy Strategy 2017 and national advocacy plans for increasing political will to remove the policies and legislative barriers that obstruct people from coming forward to know their HIV status. The fear is real as people are concerned that they will be treated differently if they test positive.

We must bring into the spotlight the critical need for laboratory improvements and increased coverage in our region. We need more laboratory facilities including those led by the communities themselves to know our status. We need laboratories to confirm community-led HIV screening tests.  We need laboratories and point-of-care diagnostic systems to monitor our viral loads and health care providers who are trained to provide clinical management for HIV-related illnesses.

We cannot get people tested if we do not have test kits, the right diagnostic equipment, and the right human resources. When we talk about placing 90 percent of people who are HIV positive on treatment and retaining them on treatment we must also ensure that we do not have stock-outs of key drugs. How can we be taken seriously when we encourage people to be tested and then fail to provide uninterrupted treatment? How can we fail to respond to people living with HIV when sometimes drugs are not available and people become anxious because their health care provider had stressed the importance of adherence to treatment and the impact of non-adherence on their health, including the potential for drug resistance?

If we are serious about getting people to know their status, we must move beyond the rhetoric to decisive actions to demonstrate that we understand the full implication of what it means to move someone who tests HIV positive to sustained viral suppression. We must guarantee good quality laboratory testing and laboratory services, uninterrupted treatment and monitoring within our health care system. And we must begin to tackle the reform of the justice system to enable persons who suffer discrimination to obtain redress in a timely manner. This calls for the engagement and involvement of our ministries of justice and attorneys general among others.

I call upon our governments and all who can make this happen to take the necessary actions to create an enabling environment in which people who want to know their status can come forward with the knowledge that they will not be treated differently, and that if they test positive they will be provided with the treatment, care and support they need to enjoy good quality lives and achieve viral suppression. Only then can we get them to know their status and begin the journey towards ending AIDS as a public health threat in the Caribbean.

As we mark another World AIDS Day, 30 years after the start of this epidemic, we have come a long way and are fortunate to today be standing in a better place than in prior years. But after 30 years, AIDS is still not over as yet and we have much more work to do.

Today the Caribbean Regional Network of People Living with HIV (CRN+) commemorates World AIDS Day under the theme “Know Your Status”. This theme is meant to encourage every individual who do not know their HIV status to GET TESTED NOW. Many barriers to HIV testing remain and UNAIDS estimates that more than 9.4 million people living with HIV still do not know their status. Stigma and discrimination deter people from taking an HIV test. If people don’t know their HIV status, people who are living with HIV can’t start treatment, and people who are HIV-negative can’t get the knowledge and skills they need to keep that way.

HIV has always had an enormous impact on individuals and communities. Children, mothers, and fathers are affected by each new infection. HIV knows no economic or geographic boundaries. This diverse Caribbean of ours has the second highest HIV prevalence (1.3%) in the world outside that of sub-Saharan Africa, with 310,000 persons estimated to be living with HIV.

A renewed call to the people of the Caribbean: Get tested!

We must continue to shout out and pledge that stigma and discrimination end with me. Let us commit to reinvigorating our efforts to realize a world free of AIDS and to ending the scourge of discrimination.
I urge our fellow Caribbean countries to protect the basic human rights of ALL people, especially people living with HIV, including their rights to physical and mental health and well-being, social and economic opportunities, and full participation in shaping prosperous and sustainable societies.

Even as CRN+ joins the rest of the world in remembering those we have lost by marking World AIDS Day 2018, we must also take hope in the successes we have made to date. We call upon all Caribbean people who have not yet taken an HIV test to do so today. 54,800 people living with HIV in the Caribbean do not know their status. Knowing your HIV status is very important and the experience can help to either strengthen your efforts to stay HIV-free or guide you to the treatment and care services that will allow you to live a long, healthy and productive life with HIV.

Let us Live Life Positively.

This is our 30th commemoration of World AIDS Day. Over the last three decades the global response to HIV has evolved from a place of desperation to one of hope. Today we have a formidable toolkit to prevent HIV infections and deaths.

Babies of mothers living with HIV can be born HIV free. HIV positive people can be treated so that the level of virus in their blood is undetectable and they are no longer infectious. HIV negative people can take medicines to prevent contracting the virus. All this was unimaginable during the 1980s. In short, we now have the tools to end the AIDS epidemic.  Yet the pace of progress is not matching global ambition.

This year’s World AIDS Day theme points to a simple action that ordinary people can take to bring us closer to that goal: know your status.

HIV testing is a critical strategy for both prevention and treatment. For people who test negative there is the occasion to assess their risks and devise a strategy to stay HIV free. For those who test positive there is an opportunity to start treatment, stay healthy and thrive.

An estimated 77% of people living with HIV in Latin America and 73% of people living with HIV in the Caribbean knew their status in 2017. This means that roughly one of every four HIV positive people in our region are not aware. Knowledge is power. Knowing your status means you can take steps to protect yourself and others. People’s ignorance of their HIV status undoubtedly contributed to the 100,000 new infections in Latin America and 15,000 new infections in the Caribbean last year.

In 2017 29% of newly diagnosed cases in Latin America and almost quarter of new diagnoses in the Caribbean were among people at an advanced stage of infection. This is a particular risk factor for men who are less likely to go to the clinic or visit a doctor unless they are gravely ill. It is in everybody’s interest to build a culture in which regular HIV testing is expected and supported. This makes early diagnosis, effective treatment and prevention possible.

Just as there have been innovations in treatment, there have also been innovations in testing. Throughout our region there is free access to rapid HIV testing. It takes just minutes to learn your status.

HIV self-tests are becoming more widely available. Brazil has led the way in terms of regulating this industry and ensuring that people have the information and resources they need to follow-up following a home test.

Community organizations are using peer outreach to test the most marginalized and vulnerable populations. We encourage governments to do more to support these organizations in reaching the people who find it difficult to access public healthcare services.

Service providers are increasingly using a method called index testing which involves offering tests to the sexual partners, children and other household members of people who have been diagnosed.

Governments, healthcare systems, civil society and development partners are all playing their parts. You can play your part by getting tested.

This year marks the 30th anniversary of the first World AIDS Day. Thirty years of activism and solidarity under the banner of World AIDS Day. Thirty years of campaigning for universal access to life-saving services to treat and prevent HIV. But after 30 years, AIDS is still not over. We have miles to go.

World AIDS Day is a day to remember the millions of people who have lost their lives to AIDS-related illnesses, many of whom died because they couldn’t access HIV services, because of stigma, because of discrimination and because of criminalization of key populations.

On this World AIDS Day, UNAIDS is campaigning for people to know their HIV status and their viral load. In 2017, 9.4 million people were simply unaware that they are living with a potentially deadly, but treatable, disease. If people don’t know their HIV status, people who are living with HIV can’t start treatment, and people who are HIV-negative can’t get the knowledge and skills they need to keep that way. If people don’t know their HIV status, they can’t protect themselves, their families, their partners. If people living with HIV don’t know their viral load, they won’t be sure that the treatment is effective, protecting their health and stopping HIV transmission.

Live life positively. Know your HIV status.

Thirty years after the first World AIDS Day, the response to HIV stands at a crossroads.  Which way we turn may define the course of the epidemic — whether we will end AIDS by 2030 or whether future generations will carry on bearing the burden of this devastating disease.

More than 77 million people have become infected with HIV and more than 35 million have died of an AIDS-related illness.  Huge progress has been made in diagnosis and treatment, and prevention efforts have avoided millions of new infections.

Yet the pace of progress is not matching global ambition.  New HIV infections are not falling rapidly enough.  Some regions are lagging behind and financial resources are insufficient.  Stigma and discrimination are still holding people back, especially key populations — including gay men and other men who have sex with men, sex workers, transgenders, people who inject drugs, prisoners and migrants and young women and adolescent girls.  Moreover, one in four people living with HIV do not know that they have the virus, impeding them from making informed decisions on prevention, treatment and other care and support services.

There is still time to scale up testing for HIV; to enable more people to access treatment; to increase resources needed to prevent new infections; and to end the stigma.  At this critical juncture, we need to take the right turn now.