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Sharing Wisdom to Improve HIV/AIDS Treatment

Delegation from Jamaica visits Vancouver to talk progress, stigma, and 'treatment as prevention.'

By Tom Sandborn, 1 Dec 2012, TheTyee.ca

Jamaican HIV policy delegation

Team from Jamaica shares experience with The Tyee. Photo by Tom Sandborn.

What is one of Vancouver's strengths in the fight for progress in HIV/AIDS treatment? 

Civility.

That's one quality members of a delegation of Jamaican media and political figures took note of during a visit to share knowledge and understanding about the disease.

"Vancouver is so civil. And we know that civility is needed to make any progress," Dervan Malcolm, an energetic and successful radio talk show host on leading Jamaican station Power 106 FM told The Tyee. "I am impressed with what we are learning about HIV/AIDS treatment here."

Civility might be the underlying value. But a groundbreaking, made-in-B.C. program helps, too.

The delegates offered their comments days before the B.C. government announced that a pilot project called "Stop HIV/AIDS," with the aim to end HIV transmission, will go province-wide starting April 1. 

Health Minister Margaret MacDiarmid said yesterday that the government is committing $19.9 million in annual funding to new outreach programs, testing methods, more front-line staff and to cover other prevention and treatment programs, according to a Canadian Press report.

Since the project's launch in 2009, infection rates in B.C. have dropped dramatically. Julian Montaner, leader of the BC Centre for Excellence in HIV/AIDS, said the program is working towards eliminating the disease altogether in the province.

The delegates from Jamaica visited the centre earlier this week, and sat down with The Tyee to discuss impressions of Vancouver's approach to HIV/AIDS treatment and prevention, and impressions of their own country's efforts. The rate of HIV prevalence for adults in Jamaica was believed to be 1.7 per cent, or about 32,000 people, in 2009. In the same year roughly 65,000 Canadians were believed to be living with HIV/AIDS, mainly in B.C., Ontario and Quebec.

In addition to the radio host Malcolm, the delegation includes reporter Ingrid Brown of the Jamaica Observer, who covers the HIV/AIDS beat for her paper, Kathy-Ann Yetman, who hosts "Live @ 7," a daily current events program, Carol Francis of the Jamaica News Network, and Naomi Francis of the Nationwide News Network. Also visiting are two young political figures, one each from the country's ruling People's National Party and from the opposition Jamaican Labour Party. 

The struggle with stigma

Dr. Hamlet Nation, the delegate from the ruling party of Jamaica, is a physician and leading member of the party's youth organization. He too expressed admiration for the work being done in Vancouver to prevent and treat HIV infection.

B.C.'s Centre for Excellence in HIV/AIDS has pioneered efforts to "seek and treat" as many HIV positive patients as possible, as soon as possible. The result has been to make B.C. "the only province where the rate of new HIV infections is falling steadily and markedly," as reported this week by the Globe and Mail. 

Nation said he was impressed by B.C.'s success at the "treatment as prevention" tactic. The made in B.C. approach involves aggressive outreach to promote HIV testing as widely as possible, and making available highly active anti-retroviral therapy (HAART) free of charge to all who test positive. Research shows that HIV loads in the blood of patients receiving the HAART therapy are driven down so low that they are no longer in danger of passing on the virus to others -- thus, "treatment as prevention."  

"Our government is focused on prevention and access to treatment," Nation said of Jamaica's efforts. "Testing is easy to get and treatment is provided free. But stigma keeps some people from getting tested or treated." 

Stigma is an ongoing issue for lesbian, gay, bisexual and transgendered people in Jamaica, one that surfaced often and with some uneasiness in the Tyee's conversation with the group. 

Asked about a 2004 report by Human Rights Watch, "Hated to Death: Homophobia, Violence, and Jamaica's HIV/AIDS Epidemic," and a 2012 letter from the human rights group to the Jamaican prime minister urging reforms in the national treatment of gay people, the delegates indicated that bias against sexual minorities continues to be a problem in their country -- although several, including TV host Yetman, suggested it might be exaggerated by outside observers. 

Of a recent YouTube posting that showed a Jamaican mob -- and the security guards to whom he turned for protection -- beating and insulting a young man believed to be gay, several delegates pointed out that when the film went public, many Jamaicans condemned the anti-gay violence. 

Colin Virgo, the visitor representing Jamaica's opposition Labour Party, said that Jamaicans who are HIV positive will sometimes hide their situation because of anti-gay and anti-AIDS stigma. He said that younger people are less biased, but only a little. 

Virgo praised Vancouver's active encouragement of HIV testing and widely available AIDS treatment drugs -- an approach, he said, that was clearly working. 

Jean Claude Louis, the PANOS staff member accompanying the Jamaican delegation, noted that his organization's mandate was to give voices to the vulnerable and, with that in mind, to strengthen the capacities of men who have sex with men (MSM) in Jamaica to speak out about their concerns and to build the capacity of media to report sensitively on MSM issues, including from the perspectives of MSM. 

Work in progress

Eradicating homophobia in Jamaica is "a work in progress," Nation said. Virgo agreed and said a "cultural transformation" is need, which cannot be accomplished in a short time. 

Despite praise from the delegation, a spokeswoman for SFU noted that HIV/AIDS work in B.C. was also a work in progress. 

"This initiative is an important way for SFU and Vancouver to highlight and celebrate what we've done right, and to explore some areas where we're still struggling," said Shanthi Besso.

The delegates from Jamaica will be featured guests at a World AIDS Day celebration today, Dec. 1, in Vancouver. It starts at 10 a.m. at the SFU Harbour Centre, 515 West Hastings Street, Room 7000.  [Tyee]

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