Fellow Citizens & Residents of St. Kitts & Nevis:
“Know Your Status” is the theme chosen by the World Health Organisation (WHO) and UNAIDS in observing World AIDS Day 2018. St. Kitts and Nevis joins the rest of the global community in this key observance of World AIDS Day, which is also marking its 30th Anniversary today, Saturday, December 1, 2018. The choice of this year’s theme is certainly not accidental. Rather, it is meant to remind the world that the fight against HIV and AIDS begins with each and every individual being clearly aware of his or her HIV status via testing. Moreover, the theme also reminds us that although 75% of the persons living with HIV are aware of their status, there are still far too many persons living with HIV who are (a) unaware of their status; and (b) not receiving treatment, care or prevention services: in 2017 alone, some 9.4 million people did not know they were living with HIV.
In keeping with all prior World AIDS Day observancessince its inception in 1988, the 2018 activities are meant to achieve several objectives, such as the following:
1) To remember those persons who have lost their lives to HIV;
2) To acknowledge the progress made in response to the global epidemic; and
3) To renew the United Nations’ commitment to ending the AIDS epidemic – now with a targeted date of the year 2030.
However, in keeping with the 2018 World AIDS Daytheme of “Know Your Status”, this year’s observance has significant, additional goals which are:
➢ To break down the barriers of stigma and discrimination that prevent persons from getting an HIV test;
➢ To sensitize persons to the fact that confidential testing exists, and that there are several new ways in which testing can now be done, such as initial self-testing (which still requires further testing by a healthcare workerfor a definitive diagnosis); combining HIV testing with other multi-disease testing; and community-based testing.
Since the start of the AIDS epidemic in the early 1980smore than 35 million persons have lost their lives to the dreaded scourge. By extension, some 78 million others have become infected with HIV since the epidemic commenced. In 2017 alone, some 940,000 persons would have died from AIDS-related illnesses. As a result of these staggering statistics, it is important for every one of us to ensure that all infected persons receive life-saving treatment after confirming their status through testing. Every effort must be made to address the stigma, discrimination, abuse or social exclusion that might be experienced by the most vulnerable groups of persons who are HIV positive. It is also our collective and individual responsibility to shatter the walls of ignorance that still exists about the issue of HIV and AIDS, cognizant of the fact that such a diagnosis transcends gender, age, race, social and economic status, or one’s location on the World map.
Presently, some 36.9 million persons in the world areliving with HIV. The WHO estimates that, regrettably,only 21.7 million of them are receiving treatment i.e.just about 59% of them are linked to care and treatment. When one adds to this the stark reality that for the year 2017 alone there were 1.8 million newly infected persons, one realises the global emergency situation that we continue to live with when it comes to HIV and AIDS. The WHO has reported that of these 1.8 million persons who became infected in 2017, 47% of them are in high risk groups, meaning that they fall into the categories:
➢ Intravenous drug users;
➢ Transgender individuals
➢ Men having Sex with Men (MSM)
➢ Commercial Sex Workers (CSW) and their clients
➢ Persons who are in Prison
These categories of individuals must ensure that they engage in safer sex practices, such as abstinence, condom use, taking pre and post-exposure prophylaxis (PrEP & PEP), and avoiding the sharing of needles and syringes when taking drugs. It must also be stressed that there is no cure for HIV. However, the lives of persons who are HIV positive are greatly extended by the consistent use of antiretroviral therapy (ART).
In light of these global realities the Ministries of Health in St. Kitts and Nevis wish to stress to our people the need for each and every person to be tested for HIV, to know his or her status, and if a positive diagnosis is confirmed, that he or she be urgently linked to care,treatment and preventive services in order to stem the tide of deaths already associated with this dreaded crisis.
It is important to note our Federation’s current status as it relates to the prevalence of HIV and AIDS. Here are the latest statistics up to October 31, 2018, from the Health Information Unit within the Ministry of Health:
1) As of October 31, 2018, there were some 295 persons living with HIV in St. Kitts and Nevis. Of this number, 35 have experienced viral load suppression.
2) Over the years 2016, 2017 and up to October 31, 2018, a total of 41 new infections occurred. This means that the Federation is averaging about 14 new infections per year.
3) Most of the new HIV infections occur among men: from 2016 to October 31, 2018, 71% of new infections were in the male population segment.
4) The number of new cases increased in 2018: about 46% of the new cases of HIV occurred in the 20-29 year old demographic i.e. six (6) new cases.
5) As of October 31, 2018, approximately 82 persons (or 28%) who are HIV positive were receiving ART.
6) Between 2016 to October 31, 2018, a total of 17 HIV-related deaths have been documented. This reflects an average of 6 deaths per year.
7) For the year 2018, a total of 1347 rapid HIV tests were done up to October 31, 2018. This is a significant drop in testing as there were 2203 rapid tests done in 2017.
As of December 1, 2017, St. Kitts and Nevis became one of the few Nations in the Caribbean basin to have attained Elimination of Mother-To-Child-Transmission(EMTCT) of HIV and Congenital Syphilis. While this is a major public health achievement, there is much work that must be aggressively done in order to maintain this enviable status and create positive life outcomes for future generations of children born to infected mothers. As such, the WHO notes that “MTCT can be nearly fully prevented if both the mother and the baby are provided with ART drugs as early as possible in pregnancy and during the period of breastfeeding.” We therefore need to hold fast to the gains we have already made.
Based on this current picture of the Federation’s HIV status, it stands to reason that much more has to be done if the Country is to realise the WHO 90-90-90 targets and be on track to attaining the global ambition of eliminating HIV by 2030. It also means that we must do everything possible to educate our people about the prevention of HIV and the imperative for testing, treatment and immediate linkages to carefollowing an HIV diagnosis. It is also important for our Country to realise a greater improvement in the viral load suppression among the number of persons who are living with HIV and are on ART. There is also much room for improvement in terms of the follow-up of persons confirmed as having HIV. This is a tall order, and cannot happen without the full cooperation of the public. In an effort to advocate for such positive behaviour changes our National AIDS Secretariat and, by extension, the Ministries of Health on both islands, have embarked upon a series of activities to mark World AIDS Day 2018. These activities include the following:
1. Media Campaign- 3rd December: Launch of newposters and promotional videos; radio talk shows
2. Press Conference & Leaders Testing- 4thDecember: Leaders leading by example- Gathering of leaders inclusive of parliamentarians, permanent secretaries, heads of departments, Faith-based Organisation (FBO) leaders, business executives and teachers. The anticipated response is that some key leaders would be receptive to participating, getting tested, and speaking to the media about their example of leadership afterhaving taken the test.
3. Work Place Testing- 5th December: Workplaces will be targeted; testing would take place on two (2) designated days.
4. Key Pop Testing- 5th & 6th December: Two evenings of specially organised key population testing.
5. General Population Testing– 7th December: Day of testing in Independence Square
The Government of St. Kitts and Nevis encourages everyone to participate in the various national HIV awareness programmes, testing opportunities, and other related activities for World AIDS Day 2018.
The Ministries of Health on both islands wish to use this occasion of World AIDS Day 2018 to salute all of our healthcare workers who continuously educate the public about HIV and AIDS, the dangers of unsafe sexual practices, the need to get tested for HIV, and the importance of accessing life-saving treatmentimmediately following a positive diagnosis. We must be reminded that HIV and AIDS do not discriminate – but people do! HIV/AIDS does not respect persons. HIV/ AIDS can happen to anyone, which makes it everybody’s business. HIV/AIDS affects all of us. However, we can only know how to respond to HIV/AIDS if we first know our status, as indicated in the 2018 theme for World AIDS Day 2018.
Fellow Citizens and Residents of St. Kitts and Nevis: Go out; get tested; and “Know Your Status”.
Thank you for listening.