Cultural Issues for HIV/AIDS Clients in the Caribbean: Myths and Realities
By Dr Patrick C. Coggins, PhD, JD, LLD (Hon.)
Jessie Ball duPont Endowed Chair Professor & Director of Multicultural Education Institute, Stetson University, DeLand, Florida
Since the 1980s there has been a worldwide epidemic of HIV/AIDS that has infected in excess of 60 million people of which over 22 million have died in the last 20 years. Of the 222 million people in the Caribbean and Latin America, over 61% live in extreme poverty. Only 33% of this population in the region use condoms or contraceptives. Thus, a sharp rise in infection of pregnant women and youth ages 15-24 continues. Over 40,000 died of AIDS in 2005, making HIV/AIDS the leading cause of death among adults 15-44 years. Over 2 million in Latin American and the Caribbean are HIV positive and 300,000-510,000 people are living with HIV/AIDS in the Caribbean including over 30,000 being infected in 2005. CARICOM comprises of Antigua and Barbuda, Bahamas, Barbados, Belize, Dominica, Grenada, Guyana, Haiti, Jamaica, Montserrat, St. Lucia, St. Kitts and Nevis, St. Vincent, Grenadines, Suriname, Trinidad and Tobago, where over 4 major languages, 30 or more dialects, ethnic and racial religious diversity exist. The Caribbean is the second most infected region in the World, next to Sub-Saharan Africa for HIV/AIDS; 75% of HIV infection is heterosexual transmission from commercial sex, diverse sex partners, severe poverty, high unemployment; 12% men on men and the rest from intravenous drug use. Approximately 2-3% of each countrys population is infected with HIV/AIDS.
Cultural myths, stigmatism, discrimination, religious values, poverty, economic, depression, low education levels and lack of access to good healthcare continue to be the root cause for the increase in HIV/AIDS amongst men, women, youth, children, regardless of age, race/ethnicity, or economic status.
Bahamas, Guyana, Belize, Dominican Republic, Haiti, Trinidad and Tobago are leading countries with HIV/AIDS, while Jamaica, Cuba, Suriname, Barbados experience relatively low infection rates of less than 2 percent of their population.
The results showed that even among highly educated college age youth, no contraceptives or preventive methods are taken to reduce HIV and STD infections. UNAIDS and UNESCO recommend early testing at ages 15 and up, more money spent or treatment, prevention education, use of contraceptives, address poverty and slow down and the control commercial sex trade; deal with gender inequality to allow for women to be less vulnerable; reduce unemployment, and, most of all make it a national policy to change HIV/AIDS from being the leading cause of death.
This study found that resistance of the Church to contraceptives and its focus on the moral aspects of HIV/AIDS seriously compounds any prevention efforts by local government. Additionally, the cultural barriers and myths continue to stymie the attempts to control the HIV infection rates. However, it should be noted that there are promising HIV/AIDS prevention and reduction models being carried out by Brazil, Barbados, Dominican Republic, Cuba, Jamaica and Trinidad and Tobago to mention a few. I recommend that prevention and treatment focus on 1) address the cultural myths, 2) reduce the poverty levels that feed commercial sex for tourists, 3) increase education programs that explain the problems associated with multiple partners, 4) increase the use of condoms, coupled with abstinence and safe sex must be emphasized to slow down the HIV infection rates, 5) implement Culturally Competent interventions that includes training of the professionals and providers regarding the cultural issues involved in interventions with Caribbean clients and families, 6) make HIV/AIDS a national priority and a national public education campaign that will not hurt tourism but enhance the safety of everyone, and 7) the United Nations, USA, European Nations and other countries must use their financial and human resources to help the Caribbean countries and its diverse population and groups to present and treat the HIV/AIDS epidemic in the Caribbean.
ABOUT THE AUTHOR
Dr. Patrick C. Coggins, a native of Georgetown, Guyana is a distinguished professor and author whose influence extends beyond academic into the state, national and international dimensions. Being a South American has underscored his perspective that society must ensure that all individuals are provided with adequate education and health care opportunities to pursue a successful life wherever they choose to live and work.
He is the Founder/Director of the Multicultural Education Institute that provides training and consultation on Managing Cultural Diversity in the schools and workplaces. He focuses on Counseling Substance abuse and other clients from a Cultural Perspective, Cultural Diversity training for Counselors, Administrators and Policy Makers in medical, human and other services. Dr Coggins was the Administrator of the Hill Health Center and the Drug Dependency Institute of Yale University Medical School. He has provided training and consultation to Morehouse Medical School and Emory Medical School on Valuing Cultural Competence in the delivery of Health Care services. He conducted workshop for health care doctors an and nurses and other health department professionals in the counties of Dade, Broward, Palm Beach, Hillsborough, Orange and Pinellas. He has served as a consultant on Cultural Competence, Alcohol and substance abuse issues to several federal agencies of the united states including the Center For Substance Abuse Treatment, Center for Substance Abuse Prevention SAMHSA and the National Institute on Drug Abuse where he served as regional director for the New England states working with the states on training of Substance abuse personnel. He was credited with authoring two volumes entitled Confidentiality of Drug Abuse Treatment, 1980.
Dr. Coggins heads the Multicultural Education Institute since 1991. He is the Distinguished Professor of Social Justice who devotes his time to research and teaching cultural diversity issues including Teaching Minority Students, Using Cultural Competence to Close the Achievement Gap, Strategies for Increasing managing Cultural Competence in the workplace, effective strategies for treating diverse substance abuse and HIV/AIDS clients, As a consultant to the National Education Association, Washington, D.C., he works on the KEYS project addressing the achievement gap. He has served as Eminent Scholar in residence for Palm Beach School District where he developed the frameworks for teaching Multicultural Education, African American history, and multicultural and Hispanic studies. He consults with health care departments, government agencies and schools on how to enhance Cultural Competence.
Patrick C. Coggins is Jessie Ball duPont Chair Professor of Social Justice & Founder/Director Multicultural Education Institute, Stetson University, DeLand, Florida 32723. (386) 822-7360. E-mail