Deeper Social Changes Needed to Contain AIDS Epidemic

The Caribbean Association for Feminist Research and Action (CAFRA) supports the Caribbean Epidemiology Centre’s (CAREC) call for young people to urge friends to abstain from sex, demand AIDS education in schools and ask their parents about HIV. Young people need much more than the facts about sex and reproduction. They need opportunities to question whether sex is the best or only way to express their feelings, to feel valued or to explore relationships. They need to know where to find information and support. They need to develop skills to make decisions, communicate them to others, deal with conflicts and stand by their decisions under pressure from other people.

Emotional pressure and physical violence are often used to force young people to have unwanted sex, especially girls. This is becoming alarmingly clear in the Caribbean where in many countries the rate of infection is fastest among the female population aged 15-24. In addition, poverty can force women into sexual situations they might otherwise avoid, whether with one man in an unsuitable relationship or with many partners who provide food, clothing and shelter - the "sugar daddy" phenomenon.

Recognition of women’s vulnerability to HIV infection has led to them being the target of many HIV/AIDS prevention programmes. A recent Panos HIV/AIDS briefing notes that while such programmes have played a major role in raising awareness of the disease, they are insufficient. In many societies the majority of women, who are usually economically dependent on their male partners, are unable to convince men to change their behaviour. The question now is whether men can be persuaded to change and whether widely held concepts of masculinity will allow men to be responsible and protective. It may be that deeper social changes are needed before the AIDS epidemic can be contained.

CAFRA also urges Caribbean people to treat all persons, regardless of their illness or lifestyle, with compassion, respect and dignity. Discrimination and inequality are significant barriers to successful HIV prevention.

There have been calls by some for draconian measures to deal with the AIDS crisis in the Caribbean, but depriving people of their rights harms everyone. Policies of isolation and compulsory testing, apart from having a high social and financial cost, make it easier to blame certain groups of people. This in turn prevents the wider public from coming to terms with the realities of HIV and the need for safer sex, as Cuba found out. People living with HIV need to be able to mix freely with others in order to reduce fear and ignorance of the disease.

In a few days time, the world will celebrate the 50^th Anniversary of the Universal Declaration of Human rights, yet the rights of people living with HIV/AIDS are threatened or violated daily in our region:

• Compulsory HIV testing and the quarantining, isolation and segregation of HIV-positive people violates the principles of liberty, security and freedom of movement.

• The lack of confidentiality or disclosure of HIV test results without consent violates the right to privacy.

• Refusal to care for or treat people with HIV violates the right to equal access to health care.

• Dismissal from or discrimination at work, and HIV testing as a precondition of employment violate the right to work and security.

As we mark Human Rights Day on December 10, let us rededicate ourselves to advancing all human rights, in full recognition of their interdependence and indivisibility. Let us find ways to help empower those whose rights are being denied. Let us confront AIDS with courage and compassion because AIDS touches us all.