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This is an abstract of a paper prepared and presented by the Afro-Latin@ Project at the recent CSA conference in Salvador da Bahia was supported by a grant from the HIV/AIDS Global Initiative at the Ford Foundation.
Introduction:
The 2% HIV prevalence rate among adults 15-49 in the circum-Caribbean region is considered to be second only to AIDS-ravaged sub-Saharan Africa, where the prevalence of HIV among adults ages 15-49 is reported to be 8.0% 1,2. New trends specify a shift: half of all new cases now found in young women 15-19 and heterosexual sex is their mode of transmission which has implications for their children both living and yet unborn.3 Contributing to new trend: Afro-descendant populations such as the Garifuna (slave descendants who live primarily in Honduras, Guatemala and Belize) have some of the highest HIV/AIDS (8% to 14% in Honduras) rates in Latin America.4 well which exceed the 2% prevalence rate assigned to the region by UNAIDS.5
Afro-Latin@ populations and Trans-nationalism (circum-Caribbean<->United States)
The circum-Caribbean region includes all of the island states and nations within and surrounding the Caribbean Sea. Initial pilot work will be done in: Honduras and Panama and the Dominican Republic with focus on Afro-descendant populations. A major challenge is the absence of consensus about socio-political identity. Race for example is a politically charged issue in some countries contributing to a dearth of data disaggregated by race. Also, regional poverty presents economic stressors while rampant HIV/AIDS related stigma, forces some people to forego seeking treatment/services. The more powerful challenges will come from socially prescribed gender roles, one of which is the economically driven, historical practice of relationships between very young girls and much older men.
A unique characteristic of the HIV/AIDS epidemic among Afro-Latin@ population has to do with the practice of circular migration and living on two home fronts: the country of origin and the U.S. Contributing factors to these trans-national phenomena include:
- geographic proximity and facility of air travel between the two regions,
- constant bi-directional flow of people, goods, services, etc., to and from the circum-Caribbean region as a vacation destination hotspot,
- the need for migrant farm workers and domestic workers in the U.S.
- access to dual citizenship policies shared between the U.S. and many nations of the circum-Caribbean region,
- dual social networks in both regions which assures migrants of support systems on both home fronts
- U.S. policy regarding deportation of ex-prisoners.6
The Conversemos Initiative, is an interdisciplinary community wide approach to reduce prevalence of HIV/AIDS through prevention and treatment services in accord with the United Nations goal of Universal Access by 2010. Conversemos aims to integrate multiple components of health and prevention services into existing public health and social services systems in
7 selected countries of origin as well as in the U.S. in an effort to expand access to Afro-Latin@ transnational communities. Key leaders from Afro-Latin@ communities both in countries of origin and in the U.S.will be trained 8,9. to work locally with:
- public health departments to scale up targeted voluntary counseling and testing programs, and encourage compliance with HIV/AIDS medical treatment
- social service agencies both public and private to expand HIV prevention and social support services around economic, and socio-political issues such as: self esteem, housing, job protection, empowerment, disclosure, confidentiality, etc.
- media outlets (print, radio/TV, electronic) and cultural entities (dance groups, vocal and instrumental artists) to produce and disseminate (through broad/deep community penetration); culturally and linguistically appropriate, relevant HIV/AIDS prevention messages/images/symbols that encourage protection, prevention as well as compliance with medical care and medication regimen for those already infected.
- regional and international funding sources to collect and analyze individual and cross-site data that provides evidence of the effectiveness of the Conversemos Initiative.
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1. Human Development Sector Management Unit, Latin America and the Caribbean Region, The World Bank. Report No. 20491-LAC, June 2000
2. UNAIDS/WHO, 2005
3. UNAIDS/WHO, 2005
4. Leu-Bent, M. Preliminary Assessment of the Impact of HIV/AIDS on Afro-descendant populations of he Americas, Submitted to Dr. Jacob Gayle, Ford Foundation.
5. Leu-Bent, ibid.
6. New York State Correctinal Systems Report 2006 Data on repatriation of prisoners from New York State indicates that 11.3%of the 62,732 (99% males) prisoners in the state are foreign born of which 65.5% are from the circum-Caribbean region including 9.1% from Central America. Upon their release either to their local U.S. communities or deported back to their country of origin, the majority of these men will resume their former heterosexual lifestyle without alerting their partners of any violence or other incidents that occurred while incarcerated.
7. Bayne-Smith, Marcia "Daughters of the Diaspora" An Intergenerational Model for HIV/AIDS Prevention. A Curriculum and Intervention Program Proposal funded by The Office of Women’s Health (OWH) in the Department of Health and Human Services (DHHS), Sept. 2006.
8. Bayne-Smith, Marcia, HIV/AIDS Prevention program based on modifications to CDC’s DEBI – Sista program, implemented by the Caribbean Women’s Health Association, Inc. and funded by New York City Department of Health/Mental Health, March 2006
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