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HIV IN LATIN AMERICA AND THE CARIBBEAN Newsletter Date UNICEF Latin America and the Caribbean Regional Office
Every hour at least 13 people in our region will be infected with HIV
The Caribbean and some parts of Central America have the second highest prevalence of HIV in the world. AIDS closely follows the fault lines of disparity and inequity.
Every hour at least 13 people in our region will be infected with HIV mostly transmitted through heterosexual sex. Although we have the basic tools to stop the pandemic, access is unequal. The key to success in this prevention agenda is reducing disparities, focusing on adolescents and promoting equity. The Caribbean and some parts of Central American are regions with the second highest prevalence of HIV in the world. Every hour at least 13 people in our region will acquire HIV. Currently, in the majority of the countries in our region, we are observing that the HIV epidemic is increasingly transmitted through heterosexual sex. Further, many countries in the region do not always have the right dosage or paediatric formulations available, which limits treatment quality and effectiveness. Prevention of mother-to-child transmission is highly effective and affordable. Yet 41% of pregnant women in Latin America and the Caribbean are not tested for HIV, as such, they are unable to know their status and prevent transmission to their babies. Situations of economic and social scarcity as well as pressure by peers and key adults can limit young people‟s choices, placing them at increased risk of HIV. Young boys and particularly girls are at a heightened risk of HIV due to the practice of intergenerational and transactional sex, which they engage in sometimes to acquire food, school books and other basic products. Young people in our region are also often subject to violence and
abuse, which increases HIV risk as well as increases the likelihood that young people will practice risky behaviours (e.g., multiple partners) over the course of their lives. Exclusion = increased vulnerability The reduction of AIDS in the region is instrumental to the achievement of other key Millennium Development Goals. AIDS closely follows the fault lines of disparity and inequity. The poor and excluded (e.g., sex workers, MSM, adolescents), and those who face stigma and discrimination and hence tend not to seek services for prevention, to know their status, etc., are more vulnerable to HIV and less likely to benefit from efforts to achieve universal access to prevention, treatment and care. Today, we have the basic tools to stop the pandemic. We have the means to prevent sexual transmission of HIV; and the access to quality antiretroviral medicines for all who need them. The access to education, condoms, health services, counselling and voluntary testing, especially for adolescents and pregnant women – the Prevention Agenda, is our greatest challenge today. The key to success in this prevention agenda is reducing disparities and promoting equity.
No. 2, 11 August 2011 CONTENT:
Schedule of events Human interest stories
Key reference documents
By 2009 in Central and South America there were 1.4 million adults and children living with HIV, 92,000 adults and children newly infected with HIV and 58,000 AIDS-related deaths among adults and children . By 2009 in the Caribbean there were 240,000 adults and children living with HIV, 17,000 adults and children newly infected with HIV and 12,000 AIDS-related deaths among adults and children . The reported number of children (0-14 years) receiving antiretroviral therapy by December 2009 in the LAC Region was 18,600 (16,300 in Latin America and 2,400 in the Caribbean). The estimated number of children needing antiretroviral therapy by 2009 in the LAC Region was 32,200. From this total, 24,100 are in Latin America and 8,100 in the Caribbean. The antiretroviral therapy coverage among children in the LAC Region by December 2009 was 58%. In Latin America it was 68% and in the Caribbean it was 29%. By 2009, there were 58,000 children under 15 living with HIV in the LAC region.
HIV in Latin America and the Caribbean
Four main goals for LAC on HIV: 1. Prevention of mother-to-child transmission (PMTCT), and the elimination of Congenital Syphilis; 2. All children in need receiving antiretroviral therapy; 3. An increase in the number of adolescents 10-18 years of age with access to correct information and relevant skills and services to reduce their HIV risk and vulnerability; 4. An increase in protection of children orphaned or made vulnerable by HIV and AIDS, including an increase in the percentage of children living with HIV who have access to comprehensive care, treatment and support.
Best practices Lessons learned... Empowerment of women living with AIDS in the Andean region [in Spanish] - Alliance A look at key aspects of the project design, execution and management: lessons learned and recommendations [Read the document] Profiles in Equity. Better practices for Women, Children and AIDS - UNICEF Programme officers from around the world share better practices in identifying and expanding HIV services for the most vulnerable. [Read the document] Good practices evaluations - UNESCO The International Bureau of Education developed three sets of criteria for the evaluation of documents on HIV and AIDS Education, to help programme planners decide what should be taught and how. [Read the documents] Passion for life [in Spanish and Portuguese] Documentary testimony of 13 people living with HIV in Latin America and the passion for life in order to dispell the myths, drive out fear and end the stigma and discrimination still attached to HIV. [Watch the videos] The Bashy Bus-Jamaica A colourful â€žbus with a differenceâ€&#x; travels to schools and communities across Jamaica to impart life-saving messages. [More information] Regional Initiative for Elimination of Mother-to-Child Transmission of HIV and Congenital Syphilis in Latin America and the Caribbean. (PAHO-UNICEF) This programme takes an approach that links prevention with improved prenatal care coverage, early detection and treatment for more than 95% of pregnant women in the region in its programme goals. [More information]
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Being an adolescent, an activist and living with HIV From the outset of the AIDS epidemic the political and community involvement of people living with HIV has played a fundamental role in regional and global processes to create and implement strategies to counter the epidemic. States have recognized the principle of Greater Involvement of People Living With or Affected By HIV/AIDS (GIPA) is essential in any ethical and effective national response to the epidemic. Adolescent involvement within public arenas is a vital element, as they are a particularly vulnerable population with their own particular demands and needs. Furthermore, adolescent participation provides a valuable opportunity for renewal in the movement of people living with HIV, which is currently in need of new activistsâ€&#x; support - a crisis situation that was debated in the 6th Central American Congress on HIV (CONCASIDA) in San JosĂŠ, Costa Rica, in 2010. The region has many positive experiences to report, including the first meeting of HIV positive adolescents in Brazil in 2005, which led to the creation of a network of HIV positive adolescents and young people. The first Latin American and Caribbean meeting for adolescents against HIV was organised in Peru in 2009, producing a proclamation that served as an advocacy document targeted on public policy decision-makers.
Issues such as the age of consent for HIV testing, discrimination in schools, paediatric medicines, sex education, access to HIV prevention and treatment, stigma, and lack of representation in civil society and decision-making circles are all pressing issues on the adolescence agenda. The complex legal requirements for meetings and travel and the lack of training are other critical points that explain why there is no network of HIV positive adolescents to work alongside the Horizontal Technical Cooperation Group (CTCH) for HIV and AIDS in Latin America and the Caribbean. Progress made on universal access has allowed many children born with HIV to stay healthy and grow into adolescents. They must all now use their voices to influence the decisions that affect their future. It is essential that advocacy and support be provided through these forums by all the stakeholders involved.
By Henry Armas HIV/AIDS Programme Officer UNICEF Latin America and the
Caribbean Regional Office
Schedule of Advocacy and Training Events: 8-11 August: IMLAS Training Workshop for Journalists. San Diego, USA. 18-21 November: The 2011 Caribbean HIV Conference: Strengthening Evidence to Achieve Sustainable Action. Nassau, Bahamas.
19-23 September: UNICEF Training Workshop for Most At-risk Adolescents. (Kingston, Jamaica. 1 December: World AIDS Day. 6-9 December: International Consultation on Bullying and Homophobic Assault in Educational Institutions. Rio de Janeiro, Brazil.
HIV in Latin America and the Caribbean
Human interest stories "I want my baby born free from HIV"-Ecuador This prevention campaign helped HIV-positive pregnant women receive appropriate treatment that prevented transmission of HIV to their children. [Read the story] Prevention of HIV/AIDS-Guatemala Highlights from a programme that reduces vertical transmission, strives to keep the mothers alive and reduce the increasing number of orphans. [Read the story] Pregnant, HIV-positive and Denying it all-Guyana In the small village of Vreed-en-hoop on the West Coast of Demerara in Guyana lives a mother and her two children. Elizabeth's story seems unbelievable, but it is true. [Read the story] Poverty, the Worst Crime of Children Orphaned by HIV/AIDS-Honduras [in Spanish] Since her daughter Xiomara died from AIDS, Doña Juan Flores has taken charge of her six grandchildren. The family survives by selling mangoes in the street. [Read the story] Boundbrook Primary School Uses Puppets for HIV/AIDS Education-Jamaica Global Movement for Children Primary schoolchildren participate in a programme that educates them about prevention as well as the impact of HIV and AIDS, encouraging them to act within their communities to support people affected by HIV. [Read the story]
Keren’s Story-Honduras A young activist and editor sets an example for children living with HIV. [Read the story] Enrique Speaks of his Experience at the XVIII International Conference on AIDS-Mexico [in Spanish] With more than 13 years of experience, this young man is a community leader and communicator committed to the rights of children and adolescents in his home country of Nicaragua. [Read the story] Massiel Changes his Outlook on HIV and AIDSDominican Republic [in Spanish] The Programme for the Prevention of HIV and AIDS in Adolescence changes student opinions on HIV and AIDS and encourages them to share what they have learned of their community and help other people. [Read the story] Fighting for a Shared Future-Dominican Republic [in Spanish] Highlights from the children and adolescents work for a shared future programme in Dajabón, Dominican Republic and Wanament, Haiti. [Read the story] Un día a la vez (One day at a time)-BBC Mundo [in Spanish] Six people from six countries in the Americas, each a different age, profession and history, united by a common disease: HIV and AIDS, share their observations of daily life with the disease through their private diaries. [Read the stories]
Key reference documents Getting to Zero-UNAIDS Strategy for 2011-2015 The strategy aims to advance global progress in achieving country set targets for universal access to HIV prevention, treatment, care and support and the achievement of the MDG goals by 2015. [Read the document] Consolidated Regional Analysis of the UNGASS Reports presented by 17 countries of Latin America in 2010 - UNAIDS, June 2011 [in Spanish] First regional analysis with strategic information on the progress and achievements made and the challenges facing countries. [Read the document] United Nations Declarations and Goals [Read the documents]
Report on the Global AIDS Epidemic 2010 For the first time the report includes trend data on incidence from more than 60 countries. [Read the document] Children and AIDS. Fifth Stocktaking Report 2010 (UNICEF, UNAIDS, WHO, UNFPA and UNESCO) This report examines current data, trends and progress made - pointing out disparities in access, coverage and outcomes - and calling for concrete actions to benefit children, women and families. [Read the document] Global Commitments on Children and HIV / AIDS UNICEF focuses on making a difference in the lives of children affected by AIDS. [Read the document]
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Resources 1. Links of interest International Community of Women Living with HIV/AIDS (ICW) Latina : The only international network led and made up of HIV-positive women. [Web site] Latin America Media AIDS Initiative (IMLAS) - A Latin American coalition of radio and television companies created to strengthen and increase the effectiveness of the media contribution to communication the fight against AIDS. [Web site] International HIV/AIDS Alliance (the Alliance) is a global partnership of 37 nationally-based linking organisations, including an international secretariat, working to support community action on AIDS in developing countries. [Web site] Pan Caribbean Partnership against HIV and AIDS (PANCAP) is the regional umbrella organisation that brings together national HIV programmes with international and regional organisations involved in the fight against AIDS in the Caribbean. [Web site] [Knowledge Center] AIDSspace is an online community for connecting people, sharing knowledge and providing services for the 34 million people living with HIV and the millions engaged in the AIDS response. [Web site]
Latin America and the Caribbean Horizontal Technichal Working Group on HIV/AIDS Is a network of national AIDS programmes, community networks who adhere to a common group of principles, commitments, guidelines and action strategies. [Web site momentarily not available] Communication Initiative-CILA, Where communication and media are central to social and economic development. [Web site] The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to dramatically increase resources to fight three of the world's most devastating diseases, and to direct those resources to areas of greatest need. [Web site] UNAIDS Leveraging the AIDS response, UNAIDS Works to build political action and to promote the rights of all people for better results for global helath and development.[Web site] Youth Coalition is an international organization of young people (aged 15-29 years) committed to promoting adolescent and youth sexual and reproductive rights at the national, regional and international levels. [Web site] [The Watchdog Bulletin]
HIV in Latin America and the Caribbean
2. Videos Shakira-UNICEF Campaign “Unite for Children, Unite Against AIDS” Shakira speaks of the devastating effects of HIV and AIDS on children‟s education. [Watch video] Sexto Sentido (Sixth Sense) Run by the Nicaraguan NGO Puntos de Encuentro, Sexto Sentido is a drama serial that tells the life experiences of a group of adolescents and young people with various experiences and perspectives on the world. [Watch videos] [More about Puntos de encuentro] Audiovisual resources on HIV and AIDS-The Communication Initiative, together with UNICEF-LAC and IMLAS has compiled and edited regional videos to provide support those working in HIV and AIDS treatment and prevention. [Watch videos] Myths and Realities of HIV and AIDS-Nicaragua [in Spanish] News report on HIV and AIDS, broadcast on the television programme “Abre tus ojos” (Open your eyes) produced and presented by adolescents and transmitted on Nicaraguan television. [Watch video] Campaign Against Mother to Child Transmission of HIV and AIDS-Ecuador [in Spanish] A video that aims to encourage pregnant women to be tested for HIV in order to give birth to healthy children. [Spot 1] [Spot 2] Youth Leaders for the Prevention of Teenage Pregnancy and HIV-Honduras [in Spanish] This video highlights a project that provides young people with critical knowledge on issues, such as the prevention of HIV and unwanted pregnancy, allowing them to provide guidance to their peers. [Watch video]
Live Up! Love, Protect, Respect - Caribbean Broadcast Media Partnership on HIV and AIDS Seeks to inspire and motivate the local population, especially young people, to stop the spread of HIV and to reduce the stigma and discrimination against people living with the disease. [Watch video] Voices from the Field - Integrating the AIDS response with broader health and development agendas Video shown during panel 5 of the UN High Level meeting panel: Integrating the AIDS response with broader health and development agendas. [Watch video] XPress Brasil, México, Jamaica Xpress is a special program developed by UNICEF with the support of MTV, that covers issues relevant to young people, such as sexuality, homophobia, gender roles and HIV and AIDS. [Watch video] Childhood AIDS ends the lives and hopes of children - UNICEF [in Spanish] Provides data on the impact of HIV and AIDS on the lives of children. Many are orphaned by parents with the disease, or acquire HIV because their mothers did not receive appropriate treatment to prevent MTCT. [Watch video] Between two of Us This video is part of a campaign by the National Cricket Boards and UNICEF National Committees participating in the ICC Cricket World Cup 2011 aim to help AIDS prevention. [Watch video]
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3. Publications: Opportunity in Crisis: Preventing HIV from Early Adolescence to Young Adulthood - UNICEF, 2011 The report outlines key steps towards building a continuum of HIV prevention that can help keep children HIV-free as they develop into young adults. [Read the document] Obstacles and Challenges in the Prevention of Vertical Transmission of HIV and Syphilis in Uruguay 2008-2010 [in Spanish] Latin America and the Caribbean Regional Initiative for the Integration of Prenatal Care with the Testing and Treatment of HIV and Syphilis. [Read the document] Y ni siquiera lloré (And I didn’t even cry) CW Latina, 2007 [in Spanish] This Project addresses issues, such as the fear of discrimination, relationships with parents or memories of parents who have died and motivation for taking action. [Read the document] Strengthening Health and Family Life Education in the Region: The Implementation, Monitoring, and Evaluation of HFLE in Four CARICOM Countries - UNICEF Barbados, 2009 This evaluation documents the implementation and impact of the initial roll-out of the revised HFLE Curriculum for students of secondary schools in selected Caribbean countries. [Read the document] Don’t let HIV Stop us Dreaming! [in Spanish] Terre des Hommes Foundation, UNICEF, Mesa de Niñez, Adolescencia y VIH/Sida, Red Sida Perú, 2009 Document from the First Latin American and Caribbean Meeting of Adolescents affectd by HIV, held in Lima, Peru in 2009. [Read the document]
Empowerment of women living with HIV in Bolivia Advocacy rooted in everyday realities -Alliance, 2008 A formula as simple as it is complex: Empower to Influence. [Read the document] Regional Initiative for Elimination of Mother-toChild Transmission of HIV and Congenital Syphilis in LAC. Conceptual Document - PAHOUNICEF, 2009 Studies the feasibility of eliminating both diseases as public health problems, establishes basic standards for the strategy and explores aspects relating to the implementation of elimination plans. [Read the document] Clinical guidelines for the Elimination of Motherto-Child Transmission of HIV and Congenital Syphilis in LAC - PAHO-UNICEF 2010 Provides guidelines on interventions to eliminate mother to child transmission of HIV and congenital syphilis in Latin America and the Caribbean. [Read the document] Childhood and HIV/AIDS in Latin America and the Caribbean ECLAC-UNICEF 2007 Number 7 of the Challenges series that reports on mother-to-child transmission of HIV in LAC, and reports on how children are accessing life-saving treatment in the region. [Read the document] Watchdog Bulletin Written by Youth Coalition members, peer activists, and partner organizations, and entirely youthauthored, highlight youth participation, services or increased funding for youth programs. [Read the bulletins]
unite for children This is a joint initiative of HIV/AIDS and Communication Units, coordinated by Gladys Hauck, Document Information Assistant, email@example.com For more information on HIV: Mark Connolly, HIV/AIDS Regional Adviser, firstname.lastname@example.org Amy Weissman, Adolescent HIV/AIDS Specialist, email@example.com Ralph Midy, HIV/AIDS Specialist, firstname.lastname@example.org Henry Armas, HIV/AIDS Programme Officer, email@example.com For more information on Communication: Tamar Hahn, Communication Specialist, firstname.lastname@example.org
UNICEF Latin America and the Caribbean Regional Office Av. Alberto Oriol Tejada, Building No. 102, Ciudad del Saber Panama, Republic of Panama Telephone: + 507 301 7400 www.unicef.org/lac