THE 2007 global update on the AIDS epidemic by UNAIDS and the World Health Organisation says the primary mode of HIV transmission in the Caribbean is sexual intercourse, with unprotected sex between sex workers and clients a significant factor in the transmission of the virus.

Among female sex workers, HIV prevalence of 3.5% has been found in the Dominican Republic, 9% in Jamaica and 31% in Guyana.

The number of adults living with HIV in the Caribbean is estimated at 1.0%, with the prevalence rate highest in the Dominican Republic and Haiti, which together account for nearly three quarters of the 230, 000 people living with HIV in the Caribbean , including the 17, 000 who were newly infected in 2007.

An estimated 11,000 people in the Caribbean died of AIDS this year, and AIDS remains one of the leading causes of death among persons aged 25 to 44 years.

Unsafe injecting drug use is responsible for a minority of HIV infections, and contributes significantly to the spread of HIV only in Bermuda and Puerto Rico.

Unsafe sex between men is a significant factor in this region but is largely hidden because of associated stigma.Little research has been conducted in the Caribbean among men who have sex with men, but the available data suggest that about 12% of reported HIV infections are the result of unsafe sex between men.

Haiti still accounts for the largest HIV burden in the Caribbean. Among pregnant women attending antenatal clinics, HIV prevalence declined from 5.9% in 1996 to 3.1% in 2004.

According to UNAIDS, new data show global HIV prevalence—the percentage of people living with HIV—has levelled off and that the number of new infections has fallen, in part as a result of the impact of HIV programmes. However, in 2007, 33.2 million people were estimated to be living with HIV, 2.5 million people became newly infected and 2.1 million people died of AIDS.

The International AIDS Society (IAS) said the new global HIV estimates, underscore the continued severity of the HIV pandemic.

IAS stated that the new estimates which show a reduction from the 2006 estimate of 39.5 million reflect the better use of monitoring tools, new surveys and more sophisticated modelling of the epidemic.

The Society noted that HIV/AIDS is the subject of some of the most sophisticated measures of any disease tracked globally.

A number of critics have accused the UNAIDS and WHO of distorting figures in the past to push for increased funding to fight AIDS, but IAS said “this seems an unnecessary and petty position.”

“The fact is the evolution of HIV prevention, treatment, and care over the past quarter century is one of the great successes of medical science.

Committed and sustained research efforts, combined with an increasing political and social mobilization, have provided the evidence on which approaches to programming are based.

These same scientific efforts are now resulting in new prevention technologies and drugs, and new strategies to manage and deliver both. They are also allowing us to see a clearer picture of the epidemic,” IAS stated.