According to an article in published in yesterday's issue of the Guyana Chronicle, the latest global update on the AIDS epidemic by UNAIDS and the World Health Organisation say 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.

One of the findings of the report revealed that among female sex workers, HIV prevalence of 3.5% has been found in the Dominican Republic, 9% in Jamaica and 31% in Guyana.

On most fronts, Guyana's confrontation with AIDS has been a success story – or rather a series of success stories. Along with the rest of the world, we may be a long way from winning the war on the spread of the disease, but the dedicated people behind the effort to control the spread of disease have won a few battles in recent years.

The victories have come mostly in the areas of treatment and care. For example, when the World Health Organisation (WHO) and UNAIDS established the 3 by 5 initiative – an international pledge to provide anti-retroviral treatment to three million people by the end of the year 2005 – Guyana set itself the relatively ambitious target of providing this treatment to the half of the 2000 people estimated to be in dire need of it.

According to the 2007-2001 Guyana National HIV/AIDS Strategy document, the final year of the "3 by 5" target saw a drastic increase in the persons initiated into the national treatment programme.

From a policy perspective, and with regards to the variety and quality of services offered, treatment and care of persons living with HIV has made some substantial gains in the past few years. For example, testing based treatment initiation moved from a syndromic model – i.e., based on the manifest syndrome of AIDS – to the much more reliable CD4 count model. Normal CD4 counts in adults range from 500 to 1,500 cells per cubic millimetre of blood. In general, the CD4 count goes down as HIV disease progresses. And then the CD4 count treatment regime was changed so that treatment began at 350 instead of the previous benchmark of 113.

The result of all this is that people living with HIV in Guyana today have a chance at a better, healthier life than they would have had some ten years ago. Yet, if better funding, better knowledge, and better practice have opened up new doorways for those persons, there remains a set of twin barriers for them to cross over to this Promised Land – stigma and discrimination. This is particularly apparent, as is reflected in the report, when it comes to the area of unsafe sex between men.

All in all, while we should rightfully be cognizant and perhaps even a little celebratory over the fact that enormous strides have been made, the journey is obviously far from over.