Amerindian women is the most-at-risk vulnerable HIV/AIDS group in Guyana because of the gold rush taking place in the interior, according to the National Aids Committee (NAC), which also stated that the country’s progress to getting to zero deaths is hampered by the continued practice of not recording AIDS-related deaths out of regard for the virulent stigma still surrounding the virus.
“Large numbers of itinerant miners have ready access to Amerindian communities in remote areas; young Amerindian girls are being trafficked into mining camps for sex work purposes, while doctors rarely visit communities, at most on a quarterly basis,” the NAC said in a recent release.
In the release to mark World AIDS Day, observed last Saturday, the NAC said Guyana’s performance measured by the UN theme of World AIDS Day between 2011-2015 ‘Getting to Zero: Zero new HIV infections. Zero discrimination. Zero AIDS related deaths’ to date, assuming the reliability of official statistics, is creditable. It said it welcomed the reported reduction in new infections in Guyana in 2011, although this is not recorded along with other Caribbean territories in the ‘UNAIDS World AIDS Day Report 2012: Results’. It was pointed out that reliable and regular condom availability is vital to the central message of HIV prevention.
According to the release, persons living with HIV/AIDS (PLWHA) are not all equally vulnerable. Those in regular, well-paying jobs, educated enough to know how to access help, who live in urban settings are less vulnerable.
“They benefit from the anonymity of large numbers, easier access to better equipped medical facilities as well as a relatively more enlightened attitude to HIV than pertains in rural areas,” the release said. The NAC said while all HIV positive persons still remain vulnerable, the most at-risk groups in terms of discrimination in Guyana are HIV positive Amerindians, women and people with disabilities whose access to jobs, education and HIV treatment are already reduced by virtue of discrimination on grounds of being indigenous, women or people with disabilities.
Meanwhile, according to the NAC, a second concern is the abysmal standards of midwifery prevailing even in at the Georgetown Public Hospital Corporation (GPHC) resulting in unattended births and maternal deaths.
“Expectant mothers delivering unattended by hostile personnel create an image which will deter expectant mothers from going to health facilities. This will jeopardize the good record Guyana has achieved with respect to PMTCT [Prevention of Mother to Child Transmission of HIV],” the release said.
And there is a perception that AIDS-related deaths are lessening, but without reliable statistics such impressions are hard to verify.
NAC said that for Guyana to get to zero deaths there is need for a more integrated delivery of services particularly in out-lying areas. It said PLWHA complain about the number of doctors who are unfamiliar with treatment strategies along with the practice of frequent rotation which means that any individual doctor has little opportunity to familiarize him or herself with individual patient’s treatment regimes.
“The need for locating PMTCT within a more integrated approach to maternity through to delivery would seem to be a necessary precaution, given the prevailing standards of midwifery,” NAC said.
Further, generating reliable statistics about HIV and AIDS is a function of reducing the stigma associated with the virus. And to this extent, the NAC said, persons living with HIV continue to be viewed as morally decadent forcing them to attempt to disguise, suppress, avoid and hide all of which will frustrate the possibility of achieving a clear picture of current trends and future projections of HIV.
“The inclination to condemn is prevalent at all levels of society, with families, religious leaders and health professionals often leading the charge. The fact that no HIV positive person of any social class or status in Guyana has felt confident enough to publicly acknowledge his or her status reflects both the strength of stigma surrounding HIV and the nature of the real challenge to getting to zero by 2015.”
Confronting stigma and discrimination is a social and political responsibility, which to date has been evaded largely by those best placed to give a lead to the rest of the society, it added.
“The Government of Guyana continues to resist pressure to add sexual orientation to the list of categories protected by the Constitution. Moreover, the lack of leadership is also reflected in the absence of any legal steps to foster a sense of safety among PLWHA. Without efforts in this direction, PLWHA will continue to resist coming forward early; thereby ensuring the response to HIV is rooted in accurate statistical information and integrated into the national health response,” the NAC said.
