Just over a week ago, more than 2000 persons from across the English, Dutch, French and Spanish speaking Caribbean gathered in Nassau, Bahamas for the 2011 Caribbean HIV Conference. The conference is said to have been the largest scientific conference ever held in the region.

The theme for the conference was 'Strengthening Evidence To Achieve Sustainable Action'. This meant that the conference focused on identifying a viable path that can be maintained in the regional response to HIV and AIDS in the near future. The extent to which this was achieved is perhaps in question. I say this because, while there was a large number of young people --- the most I have seen at a Caribbean event, there wasn't a strong sense of representation except being in attendance. Some of us were able to present on a few panels, displayed posters of our projects and research among other things.

The Caribbean is at a crucial and challenging time in the AIDS response. Funding is depleting --- many donors are changing their focus to populations that bear a higher prevalence than the general population. Last week, the Global Fund announced the postponement of its next round of funding. Some gains have been made but there is a great risk (and probability) that these may be reversed. As UNAIDS said, 'we must courageously face up to the challenges presented by a new context and embrace wholeheartedly the opportunities to break the trajectory of the epidemic.'

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Many strides have been made over the last thirty years to control the spread of HIV. In the 1980s, HIV was a death sentence for people right across the world. People, at least those who were compassionate and empathetic not to stigmatize and scorn people living with the disease, could do nothing but sit and watch their loved ones die in agony.

Thankfully this is no longer the situation. Financial commitments made by several developed countries, political leadership by many governments and the passion and dedication of many people, there are effective methods to preventing infection and there is life saving drugs to keep people living with HIV alive. In fact, HIV and AIDS research have advanced, so much so that this year the National Institute of Health announced that antiretroviral drugs used to treat people living with HIV is also effective in preventing HIV infection.

As I pen this blog, I am forced to reflect on the first time I knowingly met someone living with HIV in 2002 at my church. I too had my fears, like many persons I knew. I was astounded that I sat in a workshop with a man, whose name I have forgotten, and couldn’t tell he was “one of them”. He looked just as healthy as the rest of us, despite being diagnosed for more than 10 years at the time. I am forever grateful to him for having disclosed his HIV status, sharing his experience and knowledge and being so patient with my hesitation to hug him after this revelation.

The AIDS response has enabled many people infected and affected by HIV to speak out about their realities - hardships, successes, you name it. It has challenged us in so many ways to care for people as people and not put a veil over our faces because of who they are or what they do. Personally, I never imagined that I would have known so many sex workers and love them so dearly. I never imagined that I would have been so comfortable with people living with HIV. I never imagined that I would have become a human rights advocate for these people. 7,000 people worldwide become infected with HIV daily. 3000 of them are young people. These 7000 people often put themselves at risk because of our prejudices. Our prejudices deny them information, access to prevention commodities such as condoms and lubricants, services and even lifesaving treatment.

The stark realities of HIV show us, in so many ways, the harmful effects of stigma and discrimination, laws, violence, etc against minorities and vulnerable people. Across the Caribbean young people, men who have sex with men (MSM) and sex workers are among the most vulnerable to HIV infection. Arguably, MSM have the strongest representation in our response. Sex workers are becoming more organized and young people continue to challenge the status quo and mainstream their issues. Sadly, despite many campaigns, people living with HIV can hardly be found and as a result, we still have to be talking with and for them.

What will happen now that the Global Fund to fight AIDS, Tuberculosis & Malaria (GFATM), which has put over 3 million people on treatment in the last ten years or so, has announced the postponement of its next round of funding? Regrettably, this has happened despite commitments made at the High Level Meeting on HIV in June 2011 by member countries of the UN to increase funding and sustain the gains made over the last 30 years. Now, the progress we have all made together may begin to reverse in the coming years because of a lack of funding. This postponement will have the most devastating impact on people living with HIV. People who are not already on treatment may have to pay, but many of them cannot afford this. Can we continue to speak for people living with HIV? Can they continue to hide in the shadows others who are coming out and fighting for their own needs?

So will the people who are most affected stand up?

There are 60,737 men who have sex with men (MSM) from 26 Caribbean countries who are registered on the Adam4Adam (A4A) -- one of many social networking websites for gay, bisexual and other men who have sex with men (MSM). These users account for 14.5% of the estimated 417,520 MSM in these countries and almost all profile of users in Trinidad & Tobago (97%) and Jamaica (99%) say they are HIV negative. However, HIV prevalence in the Caribbean ranges from 1% in the Dominican Republic to 32% in Jamaica.

According to Ivan Cruickshank, Policy & Advocacy Coordinator at the Caribbean Vulnerable Communities Coalition (CVC), “the study seeks to determine how websites can provide access to hidden populations of MSM, especially those who are downlow (DL) and to use the medium to drive access to services.” CVC and Centro de Orientacion E Investigacion Integral under the “Vulnerabilised Groups” Component of the PANCAP Global Fund Project are conducting the study.

MSM are often unknown to the general population in many countries. This makes them very difficult to reach. While, the most-at-risk populations (MARPS) are becoming increasingly more important in the national response to HIV and AIDS, there are still very few services and little information being offered that is specific to the needs of LGBT people.

The survey found that among users in Trinidad & Tobago and Jamaica, more than 90% of them did not have a face photo. Both countries have laws criminalizing same-sex intimacy and varying levels of homophobia. However, in the Dominican Republic where buggery is legal, 44% of Adam4Adam users display face photos. The research hypothesize that the significantly high level of persons who do not display their photographs is as a result of fear of stigma, discrimination and violence. This is supported by the fact that the profiles of over 90% and 80% of users from Trinidad & Tobago and Jamaica respectively identify as being ‘closeted’. According to John Walters, a physician who works at COIN, this is of concern given that international research suggesting greater risk-taking behavior amongst non-gay identifying MSM.

There is tremendous value in a survey of this nature because the Internet is an emerging medium that can potentially have a powerful influence on an individual’s health. For example, research has shown that use of the Internet can play a strong role in changing the more than $1 trillion health care industry in America due to health being a primary topic on the Internet. While there is no available data on the use of the internet in this regard for Jamaica, estimates from the Harris Interactive (2001) mid 2000 survey in America revealed that eighty-six percent of adult Internet users utilized the Internet to do research on a specific disease or health care. Most of these individuals used the Internet for health related purposes at least once a month and half said access to information on the Internet has improved the way they take care of themselves (Pew Internet and American Life Project, 2000). Further, many reported that the material they gathered directly affected their decisions about getting care and treatment for their illnesses (The Pew Internet & American Life Project, 2000).

More than 2000 persons from across English, Dutch, French and Spanish speaking Caribbean gathered on Friday, November 18, 2011 for the Opening Ceremony for the 2011 Caribbean HIV Conference. This is the largest scientific ever held in the Caribbean with individuals representing a wide range of interests, perspectives, and backgrounds in forming a collaborative and sustainable response to the HIV epidemic in the region.

In a release issued by the Conference Secretariat they highlighted that:
The theme for this year’s conference, Strengthening Evidence To Achieve Sustainable Action, focuses on identifying a viable path that can be maintained in the future regional response to HIV. “In the process of identifying the theme for this Conference, we reviewed the Caribbean’s HIV experience over the last three decades or so, and identified two critical and related concepts that we felt should be central to the Conference program—sustainability and the importance of evidence in guiding the strategies that will attain this goal,” said Conference Planning Committee member Roger McLean of the University of the West Indies at St. Augustine, Trinidad and Tobago. “Sustainability is a key challenge facing the regional HIV response, and, to confront it effectively, we need to carefully evaluate what has and hasn’t worked well previously, share good practices and lessons learned, and work together in their application through more integrated approaches.”

One of the highlights of the ceremony was a performance of ‘Sometimes I Cry’ by Sheryl Lee Ralph who used the occasion to share about her first encounter with HIV and AIDS in 1981. According to Ralph, during her Broadway debut of Dream Girls, many gay men were dying from AIDS and neglected by people. She said that at the time HIV was known as “gay related disease (GRID). Today, HIV is transmitted mainly through heterosexual sex but people still refuse to accept this.

Ralph challenged conference participants not to let denial be deeper than their grave. “We have been silent for too long and our silence will not heal us … our silence will not save us,” she said.

Bahamian Prime Minister, Hon. Hubert Alexander Ingraham delivered the key note address.

Follow me on Twitter @jaevionn for live updates.

Delsie-Ann Bailey unavoidably missed out on an important part of her teen life -- senior year. She was unable to celebrate like other teens her age. She missed her senior prom because at age seventeen she became pregnant.

When I leave College and return home to be a mother, “I stop to think how my life could have been different,” Delsie-Ann said to a group of young environmental and reproductive health activists at the One Voice Summit on October 28, 2011 in Washington DC. There were no sex education classes in her high school. Delsie-Ann like many other teens have suffered as a result of the absence of comprehensive sex education, which teaches children, adolescents and youth about abstinence, faithfulness and using condoms and other modern effective contraception.

Delsie-Ann was born in St Catherine, Jamaica. She moved to North Carolina in the United States at an early age. Many people in the developing countries would expect that sex education would be standard for American teens. Today, Delsie-Ann works part-time and attends college full-time. All this she manages while being a teen mom and she still finds time to volunteer with other teens in North Carolina to advocate for comprehensive sex education as well as train teachers how to teach sex ed to teens.

Comprehensive sex education is desperately needed to encourage adolescents to delay sexual debut, reduce sexual partners and teach young people to communicate and make safe decisions about sex.

“No one should have to go through the things I had to go through,” she said. “I advocate because I realize that not only does my work affect people now but also my daughter’s generation.”

Over $1.5b has been wasted on abstinence only until marriage programmes in the USA. Thanks in part to the work of many people, including Delsie-Ann and her colleagues; there is now a Teen Health Act so hundreds of thousands of young people in North Carolina can learn about and safeguard their sexual and reproductive health.

This is remarkable because two young people become infected with HIV every hour in the United States. The rates have stabilized over the years but it is increasing rapidly among young people, particularly among young men of colour who have sex with men, especially young black men.

There is also more good news. About 21 States and the District of Colombia mandate that schools teach sex education, 32 States teach HIV and STD education and 23 States request that abstinence be stressed.

There is growing interest in the possible health threat posed by endocrine-disrupting chemicals (EDCs), which are substances in our environment, food, and consumer products that interfere with hormone biosynthesis, metabolism, or action resulting in a deviation from normal homeostatic control or reproduction.

- Diamanti-Kandarakis, E., et al (2009)
 

Many of us get confused when we hear people talk about the environment and reproductive health. How do you include sexual reproductive health and rights in the climate change and environment fora? Without any information this appears to be very dodgy and just another strategy to push liberal sex ideologies on everyone. Furthermore, if you are as dumb about science as I am, then it gets even more confusing. However, if you care about your sexual and reproductive health then you have to care about the environment. This is because there are so many toxins (chemicals) on our clothes, hairspray, lotion, bottles and other products we use daily that can cause infertility, early puberty and birth defects.

Everyone is affected. Everyone is exposed to these endocrine disrupting chemicals (EDCs), some of us more than others. 'Endocrine disruptors are chemicals that may interfere with the body’s endocrine system and produce adverse developmental, reproductive, neurological, and immune effects in both humans and wildlife' (National Institutes of Health). For example, mechanics, hairdressers, janitors, and farm workers among several others are exposed to a significant amount of toxins on a daily basis, which are very harmful to their sexual and reproductive health. For example, mechanics are exposed to mercury, which can cause impotence. Farm workers are exposed to toxins in pesticides, which can lower sperm count. Exposure to these toxins, such as lead and mercury, is not only unsafe to you but also future generations. These toxins can alter epigenetics and in the long run make children’s DNA different from their parents.

People who cannot afford expensive products are exposed to a significant amount of Bisphenol A (BPA). BPA 'is an organic compound with two phenol functional groups. It is used to make polycarbonate plastic and epoxy resins, along with other applications'. Infertility among American women 18-25 years has doubled. Similarly, early puberty is on the rise, especially among women and girls in communities of colour. In Mossville, an African-American community in Louisiana where there are 400 households, 14 industrial facilities produces 4 million pounds of toxic chemicals annually.

What Has Been Done?
There are 84,000 chemicals in commerce and only 200 have been tested. And only five have been regulated. Two laws exist in America to protect people from these harmful chemicals. They are the Toxic Substances Control Act (1976) and Food Drug and Cosmetic Act (1938) but these laws have not kept up with the time. Regrettably, only 11 States have restricted the use of BPA in some products. And only five states have limited cadmium in children’s jewelry. Cadmium can cause genital deformities.

On the brighter side, around thirty states have introduced legislation to mitigate the risks of these chemicals on people. Additionally, we can all do simple things that cost us little to nothing to protect ourselves. 

Here are some tips to help you protect your health
(a) Keep Plastic Cool – when plastic is heated it releases the toxins in your food; and try not to keep food in plastics; keep water bottles out of the car
(b) Leave your shoes at the door
(c) Dust, vacuum and mop frequently
(d) Look up Your Lipsticks – Check out www.cosmeticdatabase.com to see how much toxins are in your cosmetics 
(e) Clean up your cleaning supplies – www.womenandenvironment.org/greenclean 

There are also some things which you should try to avoid as much as possible
(a) Thermal receipts
(b) Fragrance
(c) BPA
(d) Teflon – when you heat Teflon it releases toxic chemical to your food
(e) Canned food – BPA is used to line canned food

The lack of access to family planning results in 75 million unintended pregnancies each year in low and middle-income countries. If funding rose to the level required to adequately address this unmet need, there would be an estimated 21 million fewer unintended pregnancies and over 8 million fewer abortions each year.

On October 31, 2011 the world’s 7 billionth person will be born. Twelve years ago, on October 12, 1999, Adnan Nevic the 6 billionth person was born in Sarajevo, Bosnia.

Population Control
There is no doubt the world is becoming more and more overcrowded and those who are living in poverty seemingly have the most children. One billion people were born in the last 12 years because there are over 215 women worldwide who have no access to modern effective contraception.

Many people are worried about population growth in some of the world’s poorest countries. Population growth can have much negative impact on health, economy and environment, to name a few. In fact, there is a direct relationship between population growth and efforts to achieve Millennium Development Goal 1 to reduce poverty and extreme hunger by half by 2015.

Women and girls must have access to all options to control the size of their families if we are to achieve such an ambitious target. Abortion and access to modern effective contraception should be a fundamental right. There is no better alternative to support (poor) people in taking responsibility for their reproductive health.

I was very shocked to learn that there was a proposal in the US to cut funding to the United Nations Population Foundation (UNFPA). Then I heard Herman Cain, a Republican Presidential candidate; say he will work towards defunding the International Plan Parenthood Foundation (IPPF). Millions of people benefit from the programmes of these organisations. Cain also said he believes abortion should be illegal in America because life begins at conception. What if Cain or one of the other Republicans who are trying to woo the votes of social conservatives were to become the 45th President of America?

US and its Impact on Global Reproductive Health Initiatives
The US Government is on of the main funders of reproductive health and family planning worldwide, but there have been several years of stagnant funding. Not surprisingly, this has had significant impact on millions of people in developing countries who depend on the support for foreign entities to empower them and increase their access to modern contraception.

The recent proposal to cut international family planning by $154 million from current funding levels for 2011 is beyond ludicrous. Luckily, the US Senate has increased that to $700 million, including $40 million for UNFPA.

What if there were many social conservatives in the US Congress? If the $154 million in cuts were enacted, we would see an estimated:
               o 9.4 million fewer women and couples receiving contraceptive services
               o almost 3 million more unintended pregnancies
               o 1.3 million more abortions (mostly unsafe)
               o 1.3 million more unplanned births
               o 7,700 more maternal deaths
               o over 35,000 more orphans

Now that funding has risen to the level required to adequately address unmet need, there will be about 21 million fewer unintended pregnancies and over 8 million fewer abortions. Cuts to international family planning and reproductive health undermine efforts to stem the tide of the HIV and AIDS pandemic. The millions of women who will lose access to services because of budget cuts will also be at greater risk of both unintended pregnancy and HIV.

For every $1 spent on international FP efforts, governments save up to $31 in health care, water, education, housing, and other costs because women who are in good health are better able to get the education and resources they need to provide for themselves and their families.

Not many of us young people in developing countries are interested in American politics, at least not until something historic happens, as was the case when Barack Obama became the 44th President. However, it is important that we understand the important role the US plays and how the decisions made on Capitol Hill in Washington DC can affect our lives.

Thanks to Janine for her contributions to this article. Congratulations to youth activists who helped in lobbying on Capitol Hill for increasing funding for international family planning and reproductive health

It is important for Christians and other people of faith to learn about their sexual and reproductive health and rights. This is especially important, given the dominant role institutions of faith, such as the Church, play in many countries (even where the Church is said to be separated from the State). After all HIV does not exclude an individual based on their socio-economic status, location or religious belief.

Last week, August 15-21, 2011, I was in Madrid, Spain with a group of other activists from several countries, including Ireland and Poland where the Catholic Church has a great deal of influence. Every four years, Catholic young people from every Diocese across the world meet for what is called “World Youth Day.” This time it was in Spain (one of the most beautiful cities I have ever visited). We were there (as a coalition) to bring the message that “Good Catholics Use Condoms” and “Condoms Save Lives” as well as thank the Pope for acknowledging that condoms are effective in preventing the spread of HIV.

It was an interesting, fun and tiring week to say the least; but it was also very instructive for my own work in Jamaica.

Do Good Catholics Use Condoms?
There were hundreds of thousands of young people clad in bright coloured shirts carrying and waving their country flags, singing and routinely shouting ‘Papa’ --the Spanish word for Pope.

I couldn’t understand what there were singing about or what they were saying and I had very little idea about what they --the pilgrims as they are called, at the World Youth Day 2011 were doing in Madrid. Much of it appeared to be a big gathering of Catholic youth in an organized chaos. Despite my ignorance or perhaps the ambiguity surrounding the events, I had one mission -- give as many people as possible a sticker and a post card. I wanted them to know they have and will not defy the “moral code” if they have use a condom. Additionally, encourage people, irrespective of age, to use a condom if they are in circumstances that they must be sexually active.

I knew the Catholic Church (or perhaps it is just the hierarchy and a few “blind” followers) does not support the use of condoms or any other form of contraceptive for that matter. Interestingly, despite their leadership in treatment and care for people living with HIV (PLHIV) their position about condom usage does not change.

Clad in my red shirt marked “condoms save lives” I stood with my friends in Puerta de Sol --the heart of the city-- in the early morning and late afternoon bringing and sharing this wonderful message to Catholic youth, the Bishops and nuns (at least those who would take our materials) and people who live in Madrid.

“How can you be Catholic and use condoms,” some would whisper as they passed us.

“Abstinence!” a few would shout.

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The Condoms4Life Campaign led by the World Youth Day 4 All Coalition is creating a buzz in Madrid, Spain that “Good Catholics Use Condoms.” Over the next five days, the Coalition will be promoting this message among Catholic young people who are at World Youth Day to raise their awareness about the need for condoms in HIV prevention efforts.

Despite the effectiveness of condoms, Pope Benedict has banned the use of condoms and all forms of contraceptives. According to Denise Ryan, a sexual and reproductive health trainer with the Irish Family Planning Association, “everyone should know of the pivotal role that condoms play in preventing the spread of HIV and AIDS.” Many people know this, but some are unable to use condoms for a variety of reasons, including religious and cultural beliefs.

In Ireland, where the Catholic Church has deep roots, public opinions do not correspond with the Vatican’s ban on condoms. 72 percent of all Irish Catholics believe the Catholic Church should support the use of condoms. There are now 6,900 people living with HIV in Ireland. A similar poll commissioned by Catholics for Choice in 2007 revealed that globally Catholics support the use of condoms because they prevent the spread of HIV.

The ban on contraceptives does not only affect Catholics, as non-Catholics who use their institutions, such as schools and health centres, are unable to access such services.

Richael O’Hagan, a member of the International Youth Leadership Council at Advocates for Youth and student at Georgetown University, the oldest Catholic university in the United States. Georgetown observes the Vatican’s ban on condoms and other forms of contraception. She shared her experience with the members of her Coalition and the media this morning:

The University does not distribute condoms or other forms of contraception at its Student Health Center, nor does it distribute the morning-after pill at its hospital - even for rape victims. When one of my friends went to the Student Health Center with concerns that she was pregnant, they recommended that she go to a clinic several miles away to obtain a birth control prescription because they were not permitted to write a prescription for her themselves. Furthermore, all staff member are prohibited from distributing condoms to students. Students can only distribute condoms in the “free speech” zone of campus.

It’s not like students at Georgetown have no need for condoms. By the time they graduate from college, about 70 percent of people are sexually active. 98 percent of sexually active Catholic women use birth control not approved by the church. The ban on condoms just doesn’t reflect the reality of students’ lives. Yet, this policy is present at many of the other 240 Catholic universities in the United States, putting thousands of students at risk who expect to be cared for by their college in addition to receiving a good education. Those universities who deny their students access to the right to protect themselves from HIV and unintended pregnancy fail to respect their student body as a group of intelligent adults who can make their own decisions.

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Do you know if god has reserved a special place for persons who are opposed to the use of condoms and other forms of contraceptives? Perhaps there is also one especially for those who persecute homosexuals in Jamaica or women in Pakistan who are thought to have “dishonoured” their family.

Let us pause for a moment to think about these people:

The woman in the Philippines who must give birth to another child that she will be unable to feed. If not, she must practice natural family planning and risk being beaten by her husband for refusing to have her vagina penetrated by his penis another time. She is also unable to protect herself from HIV and other sexually transmitted infections.

The young people who use drugs to escape and cope with all the problems they have in their life. They find solace with a bunch of street youth who use drugs. In many instances, they share needles to inject drugs. Many of them become HIV positive, yet the most acceptable solution to harm reduction are more laws to criminalize them and lock them away in a jail cell -- thinking this will solve their problems.

The young gay man in a homophobic country like Jamaica or Uganda that is unable express his identity freely. He was never given the appropriate information and services he needed to safeguard his health at school or his community clinic.

The lesbian in Zimbawe who is routinely raped by men as a way to cleanse her sexually, show her how being with a man feels like, which should ultimately make her heterosexual.

The young Catholic woman, born HIV positive, married to the man she loves but is told by her Bishop not to have sex, since condoms “kills babies”. What about protecting her husband from becoming HIV positive too.

The young HIV positive person who is the subject of much discrimination and harassment -- refused entry to an educational institution or a country they wanted to visit.

The young girl who in India was deemed to have dishonoured her family and must pay the cost. She was raped by a group of men (perhaps without condoms) as a punishment for what she has done.

I do not know what god you serve, but I doubt any would sanction these violations. There are many other stories. Maybe those of us who fight for the rights of oppressed people missed an important lesson at church, mosque, or wherever it is we congregate.

It is alarming to hear people speak of these human rights struggles. Many of us, even myself a human rights activist, do not know the half of what many people are subjected to. Much of our knowledge is based on what we have read in a report or seen on a documentary, yet we find it so unbearable. Imagine the people live in these circumstances. I can only imagine what the people who bear these sufferings everyday experience. In some countries where these human rights discrimination occur, they are often supported by the state and faith-based organisations.

There is too much intolerance, hate and violence -- much of which is motivated by prejudice and ignorance. How can we as Christians, Muslims, Hindus, Rastafarians, or whatever our faith, be comfortable and even glorify others when they promote or perpetually discriminate against others? This is unjust. I don’t know much about religion, especially outside of my own region, but from my understanding they all agree on one thing: there is a god and he/she teaches us to love each other.

It is time we all do something about this. I encourage you to change our world to make it a better place. No one should be subjected to such harsh circumstances, especially when we can do something about it.