Media Releases – Page 34

‘Being Diagnosed with HIV Threatens Everything Men Hold Dear’

Image: A member of Brothers for Life in Cote d’Ivoire

Written by: Stephanie Desmon

Director of Public Relations and Marketing, Johns Hopkins Center for Communication Programs

Not enough men in Cote d’Ivoire, a coastal nation with the highest HIV prevalence in West Africa, are being tested for HIV.

Getting tested is the first step to being treated, and treatment is a vital step in reducing the spread of the virus. People who are tested can almost immediately receive treatment here – for free. But Johns Hopkins Center for Communication Programs researchers and others have long known that fear is keeping men from learning their HIV status.

“The question here is: Why are men so afraid?” says Danielle Naugle, PhD, a research and evaluation officer at CCP. “Our new research has given us an answer: Being diagnosed with HIV threatens everything men hold dear. You’d be hard-pressed to find something that threatens them on so many levels. Some say they would rather die of AIDS than be tested and know they have HIV.”

Research conducted in late 2016 in Cote d’Ivoire with nearly 300 HIV-positive men, men who don’t know their status and health workers found that the masculinity of men, their sense of self, hinges on five domains: Family, social status, sexuality, work and health. And all of these can be impacted if a man is diagnosed with HIV. For example, if others learn about a man’s HIV diagnosis, he fears the serious stigma associated with the virus, including the potential loss of a job, the worry that future children could be infected, the loss of freedom to pursue multiple sexual partners – all of this without even thinking about the actual impact of being sick.

The most recent data, from 2012, found that 75 percent of men in Cote d’Ivoire had never been tested for HIV compared to 62 percent of women.

In many instances, men in Cote d’Ivoire aren’t tested until it’s the last resort, until after they are showing signs of illness. Naugle says that men are often making what can be considered “rational calculations,” that the loss of these other domains outweighs the potential upside of seeking treatment for the benefit of their health.

“If you know your status, there is the potential for other people to know and the potential that the news spreads and threatens these other aspects of your life,” Naugle says.

Said one young man in a focus group in Bouake, Cote d’Ivoire’s second-largest city: “I would not be respected like before and I could not bear that.”

“It is obvious why people hide,” said one young man from the southwestern port of San Pedro, “Because we know that it is a shameful disease, we know how it is caught.”

The antidote to this, Naugle says, is that antiretroviral treatment is available at no cost and that it can restore most people to the picture of health. HIV is no longer a death sentence and people are living longer and healthier lives. “But many men have images in their head of 30 years of fear-based messaging,” she says. “It’s hard to compete with that.”

This information collected by CCP under its former Health Communication Capacity Collaborative (HC3) project is being used to inform programming being undertaken in Cote d’Ivoire by CCP’s new USAID-funded Breakthrough ACTION project. Breakthrough ACTION is overseeing a support group called Brothers for Life that brings together at-risk men to discuss issues including HIV. The curriculum has been tweaked to address some of the team’s findings on masculinity and the threats posed to it by HIV.

Preliminary evaluations of these tweaked programs have shown that some men, learning that HIV is not the life-threatening virus it once was, are being tested after attending Brothers for Life, says Natalie Tibbels, MSPH, a senior research assistant at CCP.

“When I take the treatments, it gives me the strength to go about my business,” a man living with HIV in San Pedro told researchers. Said another from the capital Abidjan, the country’s main urban center: “With treatment, I feel normal, as if I did not have the disease.”

Naugle says she hopes the new insights she and her colleagues have made into the fear men have about testing can be used to make the process much less threatening.

“We want to be able to develop messages that can help men feel comfortable knowing and acting upon their HIV status,” she says.

HFG building capacity for mobilizing domestic resources for health

Image: Ms. Laura A. Griesmar, Deputy Chief of Mission of the U.S. Embassy in Barbados, the Eastern Caribbean and the OECS, Barbados Minister of Health Honorable John D. E. Boyce, M.P., Honorable Midori de Habich, Former Minister of Health of Peru, Julia Henn, Director, Health and HIV/AIDS Office, USAID/Eastern and Southern Caribbean, Lisa Tarantino, Principal Associate, Governance Specialist, Eastern & Southern Caribbean Region, HFG Project/Abt Associates, Dr. Marty Makinen, Health of Health, HFG Project/Results for Development and health finance officials from Ministries of Finance and Health of Barbados, Guyana, Suriname and Trinidad & Tobago AND leaders of respective National AIDS Programs, national coordinating bodies, PAHO/WHO, UNAIDS, and USAID

Recently, the Health Finance and Governance Project (HFG) organized a two-day workshop to support policymakers from Ministries of Health (MOH) and Ministries of Finance (MOF) in preparing concrete strategies for mobilizing domestic resources for health, with a specific focus on HIV programming. Representatives of Country Coordinating Mechanisms and National AIDS Coordinating Committees also participated. The workshop convened thirty-two health and finance experts from Barbados, Guyana, Suriname, Trinidad and Tobago, Peru, the United States, and various global and regional institutions in Bridgetown, Barbados.

Over the course of the workshop, MOH and MOF participants identified commons priorities and objectives related to HIV programming sustainability and heard presentations from global experts on strategies to achieve domestic resource mobilization (DRM).

Three key priorities were identified as foundational to the implementation of sustainable DRM plans to achieve goals for HIV programming:

Prioritizing and allowing sufficient time for quality communication between health and finance agencies is essential to building sustainable, long-term plans. This means starting resource planning early and developing strategies to adapt to an evolving resource environment. When discussing health sector outcomes, it can be helpful to adopt a medium-term planning mindset to set realistic expectations for how investments in health will be realized. The former Minister of Health of Peru, Honorable Mrs. Midori de Habich advised participants to always have a well-developed back-up plan to quickly absorb any funding that becomes available. Proactive and timely planning were important themes that underscored many of the goals and milestones discussed.

Implementing strategies to improve shared understanding between Ministries of Health and Finance, as these two institutions don’t always speak the same “language”. A lack of common indicators, nuanced dialogue, and infrequent opportunities to cross-collaborate increases the divide between the Ministry of Health and Finance. Bringing these two institutions together—through personnel exchanges for brief secondments or by investing in personnel with backgrounds in cross-disciplinary learning, can help establish a common foundation of understanding on which to base resource planning.

Building on existing political will can allow teams to strategically position resource mobilization efforts for health to address the gaps that exist, and will arise, in HIV programming. Workshop facilitators and participants discussed the unique opportunity created by this funding transition period to bring the topic of resource mobilization for HIV to the forefront of public and political conversation. Maintaining a dialogue at high-levels while engaging with the public about issues most meaningful to them are two important tactics to driving long-term, sustainable change. Simple, key messages and the need for continuous feedback were two strategies outlined to build on, and sustain, political will.

Barbados Minister of Health, Honorable John D. E. Boyce, called upon the workshop attendees to “play an important role in creating advocacy messages that put health at the top of our governments’ agendas… continued improvements rest on the responsibility of us as stakeholders to make change happen.” He emphasized the importance of demonstrating how DRM for HIV connects to overall health system strengthening as a way to ensure that political will is cultivated and sustained. By the end of the workshop, each country team presented a thorough and ambitious action plan, incorporating one or more the tools they learned about, and made commitments to work towards implementing these actions.

SWAG succeeds with sexual health drive

Image: Ms Terianna Bisnauthh of SWAG makes a presentation to a representative of the Night Shelter, Georgetown Guyana.

As part of its community service efforts to support vulnerable women, the Society Against Sexual Orientation Discrimination: Women’s Arm Guyana (SWAG) concluded its feminine hygiene and sexual health drive by presenting 30 gift bags to the women of the Night Shelter in Georgetown, Guyana on Thursday, May 10, 2018, ahead of Mother’s Day celebrations.

SWAG representatives distributed the gift bags to both the female residents and staff at the 24-hour homeless shelter. Aimed at promoting body safety, good hygiene, and healthy lifestyles, the gift bags contained feminine hygiene products, sexual and reproductive health commodities and informational brochures.

Gift items were donated by Massy Distribution Guyana Inc., Terianna Bisnauth, Dr. Nastassia Rambarran and Her Excellency, First Lady of the Cooperative Republic of Guyana, Mrs. Sandra Granger. The sexual health commodities and brochures were provided by the National AIDS Programme Secretariat of the Ministry of Public Health.

Established in 2017, SWAG seeks to work towards the equality, safety, and protection of lesbian, bisexual and transgender women and other vulnerable women.

A conversation with Victoria Nibarger, PEPFAR Coordinator, Caribbean Regional Programme

Image: Ms. Victoria Nibarger, PEPFAR Coordinator, Caribbean Regional Programme

The PANCAP Newsletter is one of the first digital publications to interview Ms. Victoria Nibarger, the new PEPFAR Coordinator for the Caribbean Regional Programme based at the Office of the Global AIDS Coordinator and Health Diplomacy (S/GAC), U.S. Embassy Kingston, Jamaica.

Here, Ms. Nibarger discusses the new PEPFAR direction for HIV and AIDS in the Caribbean and the significant changes occuring within the programme. The following is an in-depth conversation with Ms. Nibarger and the Editor of the PANCAP Newsletter.

Editor: PEPFAR is on a new course of redefining its presence within the Region. Can you provide details on the new PEPFAR direction?

Victoria Nibarger: This is a time of transition for PEPFAR efforts in the Caribbean. At present, our PEPFAR Caribbean Regional Program covers our bilateral assistance in Barbados, Guyana, Jamaica, Suriname, and Trinidad & Tobago. To better position ourselves to address the higher HIV burden in Jamaica, we have moved our regional headquarters from Barbados to Jamaica. Over the next two and a half years, we will wind down our bilateral programs in Barbados, Trinidad & Tobago, Suriname, and Guyana. At the same time, we will continue to provide regional technical assistance from Jamaica. In terms of bilateral country programming, after fall 2020 we will focus on the HIV response in Jamaica, where there is a greater prevalence and incidence of HIV. This will help PEPFAR maximize its efforts at controlling the HIV epidemic in the region.

Editor: Can the region expect any significant changes from PEPFAR?

Victoria Nibarger: As mentioned above, our program is changing significantly. Change is never easy, and we understand that our decision-making on PEPFAR affects many others, including government partners, NGOs, multilateral organizations, and of course, the people living with HIV throughout the region. While we will not be able to provide bilateral assistance to each country in the regional program, we have started planning for regional assistance that could be offered from our new home in Jamaica. For example, I am excited about possibilities to use existing PEPFAR-supported technological platforms to support clinicians by providing continued training and in turn, help ensure people living with HIV have access to high-quality medical care.

Editor: As your tenure begins, what is your vision for PEPFAR’s contribution to achieving the International targets for ending AIDS including the 90-90-90 Targets and the Sustainable Development Goals 2030 Target?

Victoria Nibarger: I am new to the PEPFAR world, and I feel fortunate that I am joining the team at a time when globally, we have the best practices for reaching the 90-90-90 targets and achieving epidemic control. I believe we can fine-tune our approach in the Caribbean and inch closer to the goals. In Jamaica, while the majority of people know their HIV status, less than 40 percent are on antiretroviral treatment (ART) and around 20 percent are virally suppressed. In Jamaica and in the region, I envision our PEPFAR support as strategically helping the governments to bring more patients from key populations into care, retain them on treatment, and achieve viral suppression. To do so, we must continue to spread awareness of the policy shift to Treat All, so that every person who tests positive will rapidly initiate ART – ideally that same day. We must also combat stigma and discrimination, so that HIV/AIDS is treated as other ailments such as diabetes, cancer, the flu. All are health issues, not moral ones.

Editor: How does PEPFAR intend to collaborate with the region on resource mobilization in the context of declining external support?

Victoria Nibarger: Sustainability is at the heart of our transition planning. We are working with the goal of responsibly turning over PEPFAR-supported activities to host governments, civil society partners, and other donors. We have a tool called the “Sustainability Index Dashboard” that offers a sort of snapshot of a country’s sustainability landscape; this and other analysis is helping to inform our discussions. For some countries, we have funded stakeholder planning meetings, and more are scheduled. We are also trying to enhance donor coordination at a regional level, where entities such as PANCAP will continue to play key leadership roles.

Editor: How important is the role of civil society in achieving the 90-90-90 Targets?

Victoria Nibarger: Civil society is absolutely critical to achieving epidemic control in the Caribbean, and I am heartened to see so many incredible organizations working to affect positive change. The epidemic is localized in a few key populations, and these groups face serious stigma and discrimination. In my view, civil society’s role is essential on two main fronts: 1.) to help patients safely initiate treatment and stick with their regimens; and 2.) to promote policy change and government support to ensure equal rights and equal access to healthcare. Jamaica AIDS Support for Life (JASL) is doing remarkable work in Jamaica, and I understand that its model is now being replicated throughout the wider region. Simply put, PEPFAR assistance could not have the impact that it does without our civil society partners.

Editor: Do you have any further thoughts you would like to share with the Partnership?

Victoria Nibarger: It is a pleasure to once again be working in the Caribbean, this time in a regional capacity. I am grateful for the warm welcome I have received from those involved in the region’s HIV/AIDS response, and I look forward to meeting as many colleagues as possible in the coming months. I am a career U.S. diplomat, meaning I move every few years to a new country and topic of assignment; my prior assignment entailed work related to the armed conflict in eastern Ukraine, for example. To be back in the Caribbean, working on HIV/AIDS policy issues that I studied as a graduate student, is an unexpected, and most welcome, “full circle” moment for me.

PANCAP extends congratulations to Ms. Nibarger and wishes to express sincere gratitude for her insight into the new PEPFAR pivot and other essential information highlighted in this interview. The Partnership anticipates further successful collaborations with Ms. Nibarger.

Click here to read the original congratulatory message from Mr. Dereck Springer, Director, PANCAP on Ms. Nibarger’s appointment.

Speech by The Honourable Ayanna Webster-Roy, Minister of State in the Office of the Prime Minister (Gender and Child Affairs)

Good Morning,

It is a pleasure and an honour to have been invited to officially open this Pan Caribbean Partnership Against HIV and AIDS (PANCAP) led sub-regional meeting on the National Action towards the Elimination of STIs and Viral Hepatitis in the Caribbean.

The data utilised in this feature address was acquired as a collaborative effort between the Ministry of Health and the National AIDS Coordinating Committee.

As Minister of State in the Office of the Prime Minister, with responsibility for the National AIDS Coordinating Committee, I am well aware of the significance of today’s meeting.

I would like to start by thanking the Pan American Health Organization, the World Health Organisation, PANCAP and all our Technical partners for their invaluable contributions to our regional response to HIV and STIs and the support to our pioneering spirit.

The Pan American Health Organization’s EMTCT Plus framework for elimination of mother-to-child transmission of HIV, Syphilis, Hepatitis B, and Chagas highlights the point that, “one of the greatest public health success stories, globally and in particular in the Americas, has been the development and implementation of interventions to prevent mother-to-child transmission of HIV [3].

Ladies and Gentlemen, in 2015, an estimated 670,000 women aged 15 and over in Latin America and the Caribbean were living with HIV, of whom an estimated 58% were receiving antiretroviral therapy (ART) (2015 data) [4]. Medication coverage in pregnant women rose from 55% in 2010 to 88% in 2015, and the estimated mother-to-child transmission rate decreased from 15% to 8% over the same period.

New HIV infections in children (0-14 years old) declined by 55% between 2010 and 2015 (from 4,700 [Confidence interval 3,500-6,400] to 2,100 [Confidence interval 1,600-2,900]), and an estimated 28,000 new HIV infections were averted in the same period.

In Trinidad and Tobago by the end of 2016, there was an estimated 3,800 women aged 15 and over living with HIV. Of that number an estimated 92% were receiving ART [5]. Antiretroviral medicine coverage in pregnant women reached 95% in 2016 [6], this represented a significant increase from 81% in 2010 [7]. Our estimated Mother to Child Transmission rate decreased from 16.3 in 2010 [7] to 3.38 in 2016 [6].

Ladies and gentlemen, the global data indicates that HIV shares a commonality with STIs and Viral Hepatitis given that these diseases are spread through pathways linked to sexual and reproductive health and changing societal behaviours.

In Trinidad and Tobago our 2016 data reveal that of the 13,482 pregnant women attending antenatal clinics, only 0.2 had a positive (reactive) syphilis serology [6]. Although our positivity rate for syphilis in pregnant women appears to be low, our surveillance of congenital syphilis needs to be strengthened.

The general positivity rate for Hepatitis B, decreased from 7.9% to 4.5% from January 2012 to June 2015 [8]. Data from one treatment and care site indicates that 3.7% of persons starting HIV antiretroviral therapy during 2017 had a co-infection with Hepatitis B [9]. Testing for Hepatitis C is expected to commence shortly.

Ladies and gentlemen, Great things come from the Caribbean. Leadership and vision are important aspects of everything we do and the Caribbean is on board as “Champions for Change” with the scaled up drive to address these illnesses. We are especially enthused at the prospect of being able to announce the elimination of mother to child transmission of HIV and Syphilis in our sub-region.

The Caribbean region was the first in the world to have a country applying for the validation of the elimination of Mother to child transmission of HIV & Syphilis in 2015 Cuba and in 2017 seven other countries received validation {- Anguilla, Antigua & Barbuda, Bermuda, Cayman Islands, Montserrat, St. Christopher & Nevis.}

Ladies and gentlemen, this is just one part of the evidence of our regional commitment to end AIDS by 2030 – an ambitious target as part of the Agenda for Sustainable Development adopted by the United Nations General Assembly.

To intensify our HIV response to “end of AIDS by 2030”, we are all aware that actions must be fast-tracked and the region’s response must be scaled up. To do so, it is paramount that we address the gaps and challenges in the STI response within the combination HIV prevention approach, as well as the viral hepatitis immunization. Here, in Trinidad and Tobago the Hepatitis B immunization was introduced in 2003.

We must as a region have access to the skills and best practice experiences that allow our wider Elimination of Mother-to-Child Transmission success and follow through on the new EMTCT Plus goals and the even wider goals to eliminate or significantly reduce the effect of other STIs.

As such we welcome this opportunity to lead the way in facing this new challenge and look forward to the expanded evaluation for the elimination of these diseases especially from mother to child.

Ladies and gentlemen, we must continue to work to make our country, region and globe a healthier, safer and happier place for all men, women and children by identifying and addressing structural, policy and programmatic barriers critical to the implementation of diagnosis, care and treatment for HIV/STI and viral hepatitis prevention, care and treatment; thus, contributing to the Sustainable Development Goals (SDG).

Cognizant of our roles and responsibilities to regional and global citizens, we are proud to be a part of these conversations and initiatives. It is broad partnerships and strong linkages with other health and development issues, like these, that must be emphasized in this response.

With the help of organizations such as yours, the Caribbean has seen enormous investments in the HIV response, large declines in HIV-related deaths and increased access to antiretroviral therapy. Our successes only attest to the commitment, resources and innovations that you have already directed at this epidemic.

We welcome the opportunity for continuous improvement and expansion to meet our clients with a range of integrated services that address their risk and support program sustainability through the effective use of resources. Though the targets are lofty, the energy is high, the commitment of the teams is evident and I am filled with hope.

Ladies and gentlemen, Today and during the course of this PANCAP forum:
1. You will be made aware of:
• global recommendations and standards,
• commitments required for the planning of a national public health response to viral hepatitis,
• policies and best practices to expand screening and treatment of STIs.

2. You will identify recommendations for addressing specific barriers to HBV and HCV testing, care and treatment. Implementation of these recommendations is hinged on improving the quality of systems for reporting of STIS and viral hepatitis data within national surveillance systems.

3. You will commit to concrete actions to address the elimination of priority STIs and viral hepatitis and identify needs and opportunities for cooperation to strengthen national responses. In short, today you will develop the framework for realizing our joint goals and outline how these goals can be achieved together- as one region, one body of people committed to the same cause, one force.

The exchange and interaction that will take place with allow for the critical review of recommendations and provide an opportunity for us to contextualize new information and incorporate evolving and new practices into our respective responses.

Please note in this time of global economic constraints, when many nations health system are being burdened by overwhelming demand, this PANAP forum will allows for the expanse of client reach and sensitize all on urgent need for the optimization of medical financial and material resources to improve overall output as well as the improved our service delivery utilizing our available workforce.

It is only through proficient management at our health institutions will we be able to create the conducive environment for development of dynamic health sector and sustain an effective country coordinating mechanism to collectively fight HIV/AIDS, STIs and Viral Hepatitis.

Therefore, I implore you, despite the obstacles and challenges that we face today, it is engagements like these and your participation that allow me to have faith in our commitment to ending the AIDS epidemic by 2030 and creating meaningful targets to mitigate STIs and Viral Hepatitis.

These are goals that I wholeheartedly believe we can achieve if we continue to place HIV/AIDS, STIs and Viral Hepatitis at the forefront of issues facing the Caribbean.

On behalf of the Office of the Prime Minister, the Minister of Health and Trinidad and Tobago, I thank you for your commitment to solving the problems at hand.

Do enjoy today’s proceedings and God bless.

5. UNAIDS. (2017). Trinidad and Tobago 2017 HIV Estimates 1990 – 2017. UNAIDS

6. Ministry of Health. (2017). Global AIDS Monitoring Report 2017 – Health Sector Indicators Subnational 2016 Data. HIV and AIDS Coordinating Unit, Ministry of Health: Trinidad and Tobago (unpublished)

7. Office of the Prime Minister. (2012). Global AIDS Response Progress Trinidad and Tobago Country Progress Report January 2010- December 2011. Trinidad and Tobago: Office of the Prime Minister.

8. Ministry of Health. (2017). Trinidad Pubic Health Laboratory – Hepatitis B Testing Data. (Unpublished).

9. Ministry of Health. (2018). Global AIDS Monitoring Report 2018 – Health Sector Indicators Subnational 2017 Data. HIV and AIDS Coordinating Unit, Ministry of Health: Trinidad and Tobago (unpublished).

Stakeholders to address gaps and challenges in the STI response

PAHO, in partnership with PANCAP, CARPHA, UNAIDS and the U.S. Centers for Disease Control and Prevention (CDC), hosted the National action towards the elimination of STIs and Viral Hepatitis in the Caribbean: A sub-regional meeting in Port-of-Spain, Republic of Trinidad and Tobago from 21–23 May 2018.

The aim of the meeting was to stimulate National Action to address gaps and challenges in the STI response as part of HIV combination prevention and expand viral hepatitis response beyond immunization in the Caribbean.

Present were the Honourable Ayanna Webster-Roy, Minister of State in the Office of the Prime Minister, holding the portfolios of Gender and Child Affairs, Ecclesiastical Affairs and Central Administration Services, Tobago, Mr. Dereck Springer, Director of PANCAP, Dr. Virginia Asin-Oostburg, Director of Surveillance, Disease Prevention and Control at the Caribbean Public Health Agency (CARPHA), Dr. Massimo Ghidinelli, Director, PAHO, Unit for HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections, Dr. Edwin Vicente C. Bolastig, PAHO/WHO Representative, ad interim, Trinidad and Tobago.

The STI component focused on syphilis, gonorrhea, and HPV especially among pregnant women and their sexual partners, adolescents and key populations at increased risk for STIs/HIV. The Viral Hepatitis component focused on increasing the public health response, including access to HBV and HCV testing and treatment, and integration of hepatitis action within the general health system.

Youths Challenged to Advocate for Changes to Dissonance between the Age of Consent for Sex and the Age for Independent Access to Health Care at Opening of Second Regional Youth Meeting

Friday, 18 May 2018 (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, commenced the Second Regional Meeting of Youth Leaders on Sexual and Reproductive Health and HIV and AIDS on 18 May 2018 in Port-of-Spain, Republic of Trinidad and Tobago.

In his opening remarks, Director of PANCAP, Mr. Dereck Springer, lauded the PANCAP Youth Steering Committee for developing and executing the agenda and methodology for the Second Youth Meeting. “This is clear indication of your growth since the First Meeting of Youth”, stated the Director, “I wish to commend the entire Youth Network for taking definitive steps in advocating for the priority areas identified at the previous meeting”.

The priority areas included (1) the dissonance between the age of sexual consent (16 years), and the age for independent access to health care (18 years), (2) the implementation of Comprehensive Sexuality Education in all schools in the Caribbean and (3) Gender inclusive laws that protect victims of sexual exploitation.

The PANCAP Director highlighted the additional progress since the first meeting, which included the establishment of the PANCAP Youth Advocacy Steering Committee and a specialized training workshop held in January 2018 designed to equip participants with skills to develop an advocacy strategy. He shared his expectations that the meeting would reach agreements on innovative and practical actions for advancing the key priority areas identified in the Caribbean Regional Youth Advocacy Framework (CRYAF) on Sexual and Reproductive Health and Rights, as well as on key issues for advocacy within their respective countries. He urged the youth advocates to collaborate with the PANCAP Coordinating Unit, other stakeholders and each other to implement those actions. Mr. Springer indicated that PANCAP would facilitate their participation in high-level fora.

The Chair, PANCAP Youth Advocacy Steering Committee, Mr. Kevin Mendez stated that he has experienced significant positive change in his life since as a gay man, he is able to openly share his story and experience in the Caribbean, which has legislation that “impede on the rights of LGBT persons”. The Chair thanked PANCAP for creating a safe space for youth to have discourse and create a plan of action for regional advocacy.

He further stated that the meeting would focus on creating effective methods to advocate for the aforementioned key issues, which he believes, have a direct impact on the quality of life of young people, especially young key populations: young gay men, Men who have sex with men (MSM), and Transgender-persons, who have the highest HIV prevalence in the region.

Mr. Mendez further explained that in “the last year, with the support of PANCAP and the Youth Advocacy Steering Committee, we have received the mentorship to improve our advocacy skills to address our priority areas in our country context”.

He challenged participants to actively participate in discussions, invited them to be open and comfortable to share their challenges and opportunities in advocating for change. He also explained that the forum will be important for formalizing initiatives and effective communication among the youth network.

“One country cannot move ahead of another. Our issues, our needs are the same and you are all brilliant and passionate key players from whom we can learn and share a wealth of knowledge”, stated Mr Mendez, “we are one young Caribbean family and as such we have the responsibility to work together at the country level and as a region”.

In addition, he reminded participants that in 2017 there was a 1% increase of HIV infections among young men. “This HIV epidemic is killing our youth, our friends and families and our society”, implored Mr. Mendez, “we have been told we are the future but with HIV and HIV-related discrimination, our tomorrow in not certain. This is our time to take action, work together, stay informed and be real!”

During remarks, Mr. André Browne, Dean, CARICOM Youth Ambassadors Programme (CYAP), stated that the CYAP can function as a key resource for reaching youth and gathering youth voices at a decision-making level for all matters regarding CARICOM.

He highlighted that PANCAP has understood the need for Caribbean Youth Ambassadors (CYAs) to have opportunities to get together to share experiences, plan activities and receive the training they need to ensure their efforts are effective in their communities.

Mr. Browne explained that PANCAP has been a key support for the programme, bringing together CYAs with other youth to discuss ending AIDS since 2017. He revealed that for most of the CYAs present at the inaugural meeting, it was the first time they were able to meet in person. “Deans before me have effusively sang the praises of PANCAP and rightly so, the PANCAP leadership’s dedication to youth involvement is remarkable and must be applauded” stated the CYAP Dean, “from carving out a space for us in the form of these youth meetings to ensuring we have a voice at high-level decision making meetings such as the PANCAP Regional Coordinating Mechanism (RCM) and Executive Board, and building our capacity through the recently concluded Local Capacity Initiative (LCI), even allowing us the use of their online platform for meetings”.

He informed the meeting that his goal is to renew the charge to the youth participating in the meeting, particularly the CYAs. Mr. Browne stated “the meeting comes at a time when 15 to 24-year-olds account for one-third of new HIV infections in the Caribbean, and at a time when almost half (46.2%) of Caribbean young people ages 15 – 24 did not have adequate knowledge about HIV, and at a time when two of five (38.6%) young people ages 15 – 24 did not use a condom the last time they had sex. It is time we act”.

He challenged participants to utilize the forum to formalize an actionable plan based on the CRYAF particularly on Comprehensive Sexuality Education, access to care for youth and creation of gender inclusive laws. He emphasized that the forum is another positive step to achieving the 2030 goal of zero AIDS among adolescents and the 90-90-90 Targets.

In her keynote address, Youth Advocate, Ms. Terry-Ann Roy, Alliance for Justice and Diversity, advocated for the removal of laws, which discriminate against sexual, gender minorities, and prevent them from accessing proper health care and information through fear of stigma and discrimination.

“We have to join forces in all areas of our activism because these issues intersect with each other”, stated Ms. Roy “when LGBT persons are discriminated within the law, this affects how they navigate the health-care system and how they access the necessary information to prevent contracting HIV as well as treatment if they need it. These laws do not only affect gay people but also those who are also listed as key populations in PANCAP’s own initiatives to end HIV and AIDS”.

She explained that these persons include sex workers, Trans women, People living with HIV (PLHIV), MSM, young women, girls and neglected persons who do not have access to these services. She stated, “we must recognize how these issues interconnect and work together, unite to combat these discriminatory laws and demand better policies and modified legislation. This is why we are here today and this why we will continue to return to get the necessary information to arm ourselves and approach these policymakers and parliamentarians with our demands. I stress on demands because we are entitled to these rights. It is written in all our constitutions. The right to freedom of expression, liberty, equality before the law, family life and dignity. Simply echoing that some laws are not enforced do not grant us the dignity we deserve”.

The opening ceremony was chaired by Ms. Alexus D’Marco, Vice Chair of the PANCAP Youth Steering Committee.

The meeting comes approximately one year after the First Meeting of Youth Leaders and two years ahead of the 2020 deadline for reaching the 90-90-90 Targets. It is expected to culminate with the development of advocacy supporting tools and materials for youths to advocate at the highest-level for the end of AIDS by 2030.

– 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 and 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 recognizes 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 realized 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 to 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 will provide the opportunity for 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. This meeting will serve 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 addressing sexual and reproductive health issues and concerns identified by youth leaders. The meeting will enable the adaptation of a standardized data collecting and reporting tool used by youth leaders in their respective countries. This will better inform 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:

PANCAP Youth web page: https://pancap.org/what-we-do/youth/
Caribbean Regional Strategic Framework on HIV and AIDS: https://pancap.org/who-we-are/caribbean-regional-strategic-framework/
Caribbean Regional Youth Advocacy Framework on Sexual & Reproductive Health and Rights: https://pancap.org/pc/pcc/media/pancap_document/Final_Caribbean-Regional-Youth-Advocacy-Framework-on-SRHR.pdf

Challenges Implementing Caribbean Regional Youth Advocacy Framework (CRYAF) for Discussion at Second Meeting of Youth Leaders: Sexual and Reproductive Health And HIV and AIDS

Friday, 11 May, 2018 (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 host the Second Meeting of Youth Leaders on Sexual and Reproductive Health and HIV and AIDS on 18 -19 May 2018 in Port-of-Spain, Republic of Trinidad and Tobago.

The meeting comes approximately one year after the First Meeting of Youth Leaders and two years ahead of the 2020 deadline for reaching the 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.
The overarching aim of the meeting is to foster increased understanding of the challenges and opportunities of youth leaders in order to develop advocacy supporting tools and materials for youths to advocate at the highest-level for the end of AIDS by 2030.

Over 40 participants are scheduled to attend consisting of CARICOM Youth Ambassadors (CYAs), youth leaders from Key Populations, select parliamentarians and representatives of the Caribbean Family Planning Affiliation (CFPA) and the Caribbean Vulnerable Communities Coalition (CVC-COIN). Over 15 Caribbean territories will be represented.

The meeting is organized by the PANCAP Youth Advocacy Steering Committee with support from the PANCAP Coordinating Unit. According to Mr Kevin Mendez, Chair, PANCAP Youth Advocacy Steering Committee, the meeting will provide youth leaders with the opportunity for 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) on Sexual and Reproductive Health and Rights with the aim of developing practical advocacy tools and techniques that can be adapted in each Caribbean territory.

Through the CRYAF, PANCAP’s intended objective is to further the remit of the Caribbean Regional Strategic Framework (CRSF) on HIV and AIDS under Strategic Priority Areas (1): An Enabling Environment and (3) Prevention as well as to support the PANCAP Justice for All Roadmap.
The Chair further explained that the forum will serve 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 parliamentarians, Civil Society Organisation representatives and Caribbean Youth Ambassadors (CYAs) through a panel discussion addressing sexual and reproductive health issues and concerns identified by youth leaders.

He highlighted that the meeting will enable the adaptation of a standardized data collecting and reporting tool used by youth leaders in their respective countries. This will better inform PANCAP of opportunities to support innovative approaches to mobilize regional youth leaders to 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.

“The intention is to provide a forum for in-depth discussion on achievements and challenges of youth leaders advocating for the implementation of the CRYAF on Sexual and Reproductive Health and Rights priority objectives in their respective countries,” stated Mr. Mendez.

Further, youth leaders will be engaged in identifying and analyzing regional and international mechanisms for use as best practice models addressing barriers that impede access to sexual health services by youth.

The forum will also provide an opportunity for practical high-level advocacy involving parliamentarians, Civil Society Organization and CYAP representatives.

– ENDS –

What is PANCAP?

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

Faith Leaders Consultation held in Belize

Image: Dr. Edward Greene former UN Secretary-General Special Envoy for HIV in the Caribbean now PANCAP Special Advisor (center),

with participants of the Faith Leaders Consultation (Belize)

Thursday, 10 May, 2018 (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, collaborated with National HIV/AIDS Commission to convene National Faith Leaders consultation in Belize on 10 May 2018 in Belize City, Belize. The consultation is funded by the CARIFORUM 10^th European Development Fund Programme of Support for Wider Caribbean.

The aim of the consultation is to establish main goals for an inter-religious faith leaders network in Belize with emphasis on contributing towards the end of AIDS. This meeting follows a series of regional meetings involving faith leaders.

In welcoming participants Hon. Laura Longsworth, OBE, Speaker of the House of Representatives and Chair of the National HIV/AIDS Commission, acknowledged the assistance and support of Faith Leaders and other partners that have helped to sustain the efforts to end the AIDS epidemic; Mrs. Longsworth observed that faith leaders are key to the response because they believe in the intrinsic value of human beings and noted that faith leaders promote access to services with love and humanity.

In his opening statement Chair of the meeting, Bishop Roosevelt Papouloute noted that as human beings, faith leaders are challenged by the development in families and society. He lauded PANCAP for its leadership in advancing the Justice for All Programme and for recognizing the importance of the Faith leadership in accelerating the response to end AIDS by 2020.

Bishop Michael Perreira, Senior Pastor of the Eccles Assemblies of God Church Guyana in delivering the keynote address acknowledged the value of networking with other stakeholders to achieve the purpose of God in ending AIDS by 2030. He applauded PANCAP for providing a platform for engagement. He contended that “as a leader in the Christian community our task is not only to prepare people for heaven but provide them with a model for living a life here and now”. He urged that the Church should not be oblivious of the human condition and must not fail to protect social justice for everyone. “If the church cannot resolve to fight AIDS it is neglecting their duty; Religious organizations need to do more and be more consistent in spreading the words and work together to end AIDS”.

Bishop Perreira concluded his address by encouraging faith leaders to:

Love people without necessarily approving what they do;
Inform their views/concepts of persons of a different sexual orientation. He stated, “this is necessary because members of key populations are not inclined to take us (faith leaders) seriously, as they are convinced that we are not genuinely concerned about them”.
Preach and practice Christian Godly principles: love and respect all human beings whom God loves, just as they are our own.
Partner with other stakeholders giving loving, empathetic Godly support.
Find common ground as stated in the Regional Faith Leaders Forum Declaration of February 2017.

Director of PANCAP Dereck Springer provided the background to the national consultation in the context of the PANCAP Justice for All Programme and Roadmap. He reminded the consultation of the underlining principles of the JFA Roadmap: Enhancing family life and focusing on those in need; Increasing access to treatment and affordable medicines: PANCAP playing an important role in reducing the price of medicines; Reducing gender inequality including violence against women, girls, and adolescents; Promoting sexual and reproductive health and rights including age-appropriate sexual education; and Implementing legislative reform for modifying AIDS-related stigma and discrimination.

Dr. Francis Morey, Deputy Director of Health, Ministry of Health, Belize provided a status report on the HIV epidemic in Belize and the current response. He highlighted the challenges to achieving viral suppression among people living with HIV.

First Lady of Belize and Chair of the Spouses of Caribbean Leaders Action Network (SCLAN) Mrs. Kim Simplis Barrow identified the major issues addressed by the ‘Every Caribbean Women Every Caribbean Child’ (CARIWAC) initiative. In defining the role that faith leaders can play Mrs. Barrow noted that health and well-being could be advanced by increased collaboration between SCLAN and Faith Leaders. She called attention to the adolescent population that is being overlooked, noting that a considerable number of girls are giving birth under the age of 15 years, thereby perpetuating the cycle of poverty. She also called for engagement of men and boys in reducing inequality of women and girls.

Faith leaders who attended the regional faith leaders’ dialogues reflected on the experiences that helped them to dispel their apprehensions, the role of the science in achieving the end of AIDS, barriers to access to health services and the need to foster continued transformation of the mind.

Following deliberations in small groups, faith leaders identified the following challenges impacting faith leaders’ response including differences between religious principles and practices; creating refuge for those in need; lack of religious organizations’ input into the development of the sexual education curriculum; unified education and counselling; preparation for respectful dialogue when court rulings contradict religious doctrines; lack of concrete information; how to creatively utilize social media.

Participants provided several proposals for addressing the challenges identified. These included education of the congregation; liaising with key stakeholders including National AIDS Programmes (NAP); establishing a structured approach such as hubs; identifying and sharing best practices from other Faith-based Organizations (FBOs) and Civil Society Organizations (CSOs); ensuring that faith leaders are relevant by utilizing social media; create spaces of refuge and places of acceptance; provide prevention services; sensitizing faith leaders about confidentiality; accept people where they are; uplift the community; encourage people to know their status and in the case of couples share their results and offer positive alternatively ways of living.

Faith leaders also recommended the promotion of the following programmes and policies within individual religious groups and national inter-religious networks: structured approach that is focused on helping people; development and implementation of youth education programmes utilizing creative methodologies such as edutainment and utilizing the mobile app developed by the National AIDS Commission (NAC), Belize to access information.

Faith leaders agreed on the need for an inter-religious organization that brings together the various groupings around the HIV response and will meet shortly to formalize the process for moving forward. The Director of PANCAP pledged the Coordinating Unit’s support to the national network as it evolves.

-ENDS –

What is PANCAP?

10th European Development Fund (EDF) Programme of Support for Wider Caribbean Cooperation

Under the 10th (EDF) Programme of Support for Wider Caribbean Cooperation, PANCAP will strengthen coordination on human rights issues in keeping with the Justice For all Roadmap through the HIV and AIDS Thematic Task Force in CARIFORUM.

CARIFORUM

CARIFORUM refers to the Grouping of Caribbean States which are signatories of the Georgetown Agreement establishing the African, Caribbean and Pacific Group of States (ACP). The ACP grouping is composed of 79 African, Caribbean and Pacific states.

CARIFORUM is the recipient of and manages the implementation of Caribbean Regional Indicative Programmes financed by the EDF and Caribbean regional programmes financed by individual Member States of the European Union. It also provides technical assistance to agencies/institutions implementing projects under these programmes.

European Union

The Member States of the European Union have decided to link together their know-how, resources and destinies. Together, they have built a zone of stability, democracy and sustainable development whilst maintaining cultural diversity, tolerance and individual freedoms. The European Union is committed to sharing its achievements and its values with countries and peoples beyond its borders’.

Background to the PANCAP Justice for All (JFA) Roadmap

The PANCAP Justice For All (JFA) Programme was established in September 2013 as a regional response to the UN High-Level Political Declaration (June 2011) designed to reduce AIDS-related stigma and discrimination. The objectives of the JFA Roadmap are:

Enhancing family life and focusing on those in need
Increasing access to treatment and affordable medicines
Reducing gender inequality including violence against women, girls and adolescents
Promoting prevention with special reference to sexual and reproductive health and rights including age-appropriate sexual education
Implementing legislative reforms for modifying AIDS-related stigma and discrimination

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

Belize National Faith Leaders Consultation

Thursday, 3 May 2018 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), with funding from the CARIFORUM 10th European Development Fund (EDF) Programme of Support for Wider Caribbean Cooperation, will host the Belize National Faith Leaders Consultation in Belize on the 10th May 2018.

This Consultation is a follow-up to a series of engagements with faith leaders including Belize under the PANCAP Justice for All programme. This consultation will facilitate the development of an action plan for advancing faith leaders’ implementation of key elements of the Justice for All programme. Participants will include 40 Faith Leaders representing national faith leaders’ network across Belize.

The action plan will include the establishment of the main goals for an inter-religious faith leaders network in Belize with emphasis on contributing toward the end of AIDS; identification of the lessons learned for ending AIDS from faith leaders’ engagements with people living with HIV and with other groups such as parliamentarians, youth leaders, civil society and members of the church communities; challenges for developing a viable Faith Leaders Network and proposals for overcoming them; specific recommendations to achieve the goals of the inter-religious/faith leaders network; and priorities and timelines for achieving the goals of the Network.

In an invited comment, Coordinator of the consultation, Bishop Roosvelt Papouloute, (Belize Council of Churches) said that this consultation will be an opportunity for leaders from the different Christians denominations and other religious communities to come together to strengthen the response to HIV and AIDS, to raise awareness and educate the wider population about issues relating to HIV and AIDS. He encourages all those who have been invited to make every effort to attend.

– ENDS –

What is PANCAP?

– CARIFORUM

– European Union

Background to the PANCAP Justice for All (JFA) Roadmap

The PANCAP Justice For All (JFA) Programme was established in September 2013 as a regional response to the UN High Level Political Declaration (June 2011) designed to reduce AIDS related stigma and discrimination. The objectives of the JFA Roadmap are:

 Enhancing family life and focusing on those in need
 Increasing access to treatment and affordable medicines
 Reducing gender inequality including violence against women, girls and adolescents
 Promoting prevention with special reference to sexual and reproductive health and rights including age appropriate sexual education
 Implementing legislative reforms for modifying AIDS-related stigma and discrimination