HIV in Curacao
Situation on Curaçao.
An estimated 1,000 people live with HIV on Curaçao. We regularly see new infections; every new patient is 1 too many. A substantial proportion of those who know they have HIV are being treated. Thanks to the HIV inhibitors, they have the same life expectancy as people without HIV. In addition, people who are successfully treated cannot transmit the virus. It is currently difficult to estimate how many people in Curaçao do not know that they carry the virus. We do know that there is a great taboo on the subject, and that a group of patients has difficulty coming to the hospital for treatment.
To get a better picture of the situation on Curaçao, the HIV Monitoring Foundation (SHM) since 2005 data from some 1246 HIV-infected people. This has resulted in a unique database that provides a clear picture of HIV care and the challenges this Caribbean island faces. What is worrying is that of the 990 people in 2019, 307 people are now untraceable. They have not died and have not moved abroad, they may have disappeared out of care due to social problems (financial), shame or sometimes also due to problems with residence permits. So these are patients who can get sick and infect other people. Solutions must be found to enable these people to be treated again.
Too late for care.
Unfortunately, many of the patients arrive late for care. This is due to stigma, a lack of information, low-threshold testing, fear and shame. As a result, several people in Curaçao still die each year from the effects of AIDS, while this is prevented with timely discovery and treatment.
Background:
The number of new patients per year has been stable at around 50 in recent years, so about 1 per week. What is worrying is that the new patients often come when they are very ill and have low immune cells. Due to a lack of accessible testing, partly due to shame, patients are much too late. Complaints (which can even lead to death) can be prevented if you start treatment earlier. Often patients have been HIV positive for years before they discover this themselves and start treatment. In those years they can also have infected many others.
HIV inhibitors are readily available here, but people often do not dare to go to the pharmacy for fear of being recognized. For fear of a stigma, the Curaçaoan prefers to stay at home. The ignorance and shame to discuss things is great. People are afraid of reactions from the environment, while these are often not so bad after explanation. People also think that HIV is a death sentence, while with good treatment (usually only 1 pill a day!) not so. Patients in care have a high rate of treatment success.
HIV prevention.
Prevention is of course always better than cure!
On November 2, 2020, Curaçao and the Netherlands signed the mutual arrangement for the implementation of the National Package Curaçao. Significant investments are being made in the economy, healthcare and education. A good time to tackle social problems with a number of great projects. With a large-scale public campaign and a number of other projects, the Plons Foundation wants to contribute to reducing the HIV virus in Curaçao.
HIV without you even knowing it.
The greatest risk that the epidemic in Curaçao will spread comes from people who do not know that they have HIV. If you do not know that you have HIV, the chance that you will transmit HIV is greater. People who do know that they have HIV generally have safer sex. In addition, you have more virus in your blood just after you are infected. In people with HIV who are successfully treated with HIV inhibitors, the virus is no longer detectable in the body. That means they do not transmit the virus. Even with sex without a condom. (With sex without a condom you still run the risk of other STDs.) This is called N=N: Not measurable = Not transferable. The goal is therefore to actively test on Curaçao.
Discrimination.
Unfortunately, people with HIV in Curaçao still have to deal with negative reactions. A large part of the people with HIV in Curaçao has (had) to deal with discrimination in the family or circle of friends, in the nightlife, in the work environment, and in contacts with financial service providers or by their sex partners. This includes accusations, avoidance, extraordinary hygiene measures, indifference and exclusion. This causes stress and other health problems for many people with HIV. Moreover, discrimination has a negative effect on the fight against AIDS. This makes it less easy to talk about HIV, while this is actually necessary for good prevention. It is also important to pay more attention to processing the diagnosis, (self)stigma, social skills, preventing stress and understanding the rights of people with HIV.