Cayman needs to improve HIV surveillance

| 02/12/2022 | 34 Comments

(CNS): As the world marks HIV Day today, Friday, Cayman Islands officials have said that surveillance of the virus needs to improve, given the risks of the transient population and the lack of comprehensive sex education and sexual health programmes. Six new cases of HIV were identified in the country this year and a total of 18 have been recorded since 2020. Since 1985, the Cayman Islands has seen 188 cases of HIV and 83 people have gone on to develop AIDS.

These numbers are low compared to the rest of the world and especially in the Caribbean Region, which has the second highest prevalence of the virus outside Sub-Saharan Africa. Globally, around 38.4 million people were living with HIV in 2021, with an estimated 1.5 million becoming newly infected last year. As many as 650,000 deaths were attributed to AIDS-related illnesses in 2021 and about 5.9 million people did not know that they were living with HIV in 2021.

Chief Medical Officer Dr Nick Gent has warned that Cayman is still vulnerable to the spread of HIV. “It is true that the number of persons who are living with or impacted by HIV and AIDS in Cayman seems low in comparison to the millions of persons living with it globally, or even regional neighbours where it is estimated that tens of thousands of persons are living with the virus,” he said. 

“However, we have to recognise that Cayman has specific vulnerabilities to the spread of HIV, not least of which are its transient community and lack of comprehensive sex education and sexual health programmes and messaging, which, if not addressed, can become a public health emergency,” the CMO added.

The Ministry of Health and Wellness is now pushing for the collection of data for the purpose of ensuring that programming and intervention are data-driven and can play a key role in HIV prevention and treatment.

“Strengthening our surveillance of the incidence of HIV and AIDS within our jurisdiction is, of course, one of our key outputs from an epidemiological perspective,” said National Epidemiologist Rachel Corbett.  “However, there is further analysis we can do to understand whether we are detecting cases at an early stage, which can then limit onwards transmission and prevent premature mortality. We can also consider the incidence of other sexually transmitted infections (STIs), for example chlamydia, which may have more noticeable symptoms requiring medical intervention.”

She explained that the behaviours that put people at a higher risk of STIs also put people at greater risk for contracting HIV. By monitoring “other aspects of sexual health, or ill health”, the health services can provide more relevant messages and encourage safer behaviour, she said.

The theme for World AIDS Day 2022 is “Equalise”, UNAIDS’ call to action to encourage support and use of proven practical actions needed to address inequalities that make individuals and communities vulnerable to the spread of HIV and to help end AIDS.

“We know that we have persons who are living with HIV and AIDS (PLWHAs) in our community,” said Health Minister Sabrina Turner. “We also know that they were significantly impacted by the COVID-19 pandemic, yet we have not managed to break the chains of stigma which are associated with this illness, keeping us from discussing these facts openly and honestly.”

She added that this was one of the many reasons why the team was reviewing existing partnerships, practices and programming to address the gaps in access, education and services, not only for those living with the virus but for the community as a whole.

HSA’s Public Health Department will be hosting free HIV testing between 30 November and 2 December in Grand Cayman, and between 7-8 December in the Sister Islands. 

Free HIV and STI testing is also available year round at Public Health by appointment. Anyone wishing to get tested or needing more information should contact the Public Health Department on 244-2889 or 947-2299.


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Category: Health, Medical Health

Comments (34)

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  1. Anonymous says:

    firstly, we need to be honest and state who is at risk:
    gay men
    women who sleep with bi-sexual men.

    CNS: Also, every heterosexual man who has slept with anyone at all without knowing their full and detailed sexual history. Also, every heterosexual woman who has slept with anyone at all without knowing their full sexual history. Or to put it another way, anyone of any sexual identity who has had casual sex or whose partner has had sex with someone else. Virgins are probably OK unless they have shared a needle with an infected person. If we’re being honest.

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    • Beach Cleaner says:

      My thumbs up is for the CNS response.

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    • Anonymous says:

      Thank you CNS.
      To the original poster, your complete misunderstanding of the situation is a fundamental part of the problem, and is why we need better education.

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    • Anonymous says:

      This CNS response is the best ever. And there is some competition from the Covid press conference days. The opening comment ‘bisexual’ is the word that I laughed at. Well done CNS.

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    • Anonymous says:

      it’s virtually impossible for a hetrosexual man to acquire hiv through sex with a woman.
      politically incorrect but true

      CNS: This is not a political issue, you nitwit. It’s a health issue. A man is less likely to be infected via his penis during heterosexual sex, BUT IT IS NOT IMPOSSIBLE (apologies for shouting). In 2018 in the US, about 10% of new HIV diagnoses in men were through sex with a woman. (Source: the CDC) And if he does get infected, he is much more likely to pass it on to the women he then has sex with.

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      • Anonymous says:

        I think what the individual is trying to say is that, gay men, generally bisexual men, who have sex with other men, may contract the disease, then have sex with other women, passing it along, which in turn is then passed along to heterosexual men who had sex with those women.  I can attest the majority of this disease is passed via gay men as I had a co-worker who was openly fully gay that contracted it, didn’t know he had it until he felt extremely ill….now if he was bi and had sex with other women, then we know the rest of the story and spread of the disease to heterosexual…so let’s not kid ourselves, it’s just now down to getting tested, wearing a condom etc, cause you never know who is carrying it around 🤷‍♂️

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    • Anonymous says:

      @12:00 an CNS:
      The CNS summary is to the point.
      Those at risk are: anyone who has sex with anyone without knowing their sexual history and without knowing their current HIV status.
      Also bear in mind that HIV is not the only Sexually Transmitted Disease (STD) in these islands. Like HIV, some STD’s are also incurable, and some do not require an exchange of fluids in order to acquire or transmit an infection.

  2. Anonymous says:

    Work permit holders have to do the test and then what? Are they even denied the permit if it’s positive?
    People who are in Cayman without the right to work aka rich people are positive and allowed rights and subsequently given status. Why are they allowed the right and not others? Is it $$$?

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  3. Anonymous says:

    A very good start would simply be FREE CONDOMS. Much more cost effective than treatment and/or providing for unwanted children.

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    • Anonymous says:

      Alas, STD, birth control, and wellness education all blocked by Abrahamic right wing. Change would save lives.

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  4. Wrap it up says:

    People need to be accountable for themselves, sad to say but I personally know of HIV infected persons who sleep around WITHOUT always telling the other party. Some assume that if they are undetectable they cannot transmit which is NOT gauranteed because its dependent on other factors. So for every person they sleep with and every person, that other person sleeps with, there goes that rise. I think the realistic number is higher. Surveillence to some extent would mean tracing down key sources of new cases and possibly imposing some laws to protect people from those who are aware of their status and deliberately risk your life.wrap it up and get tested folks.

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    • Anonymous says:

      this person needs to be arrested as it should be a criminal offence, knowing that they have the virus

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  5. Bored of bigots says:

    The basic bigots calling for mandatory testing for work permits holders needs to realise this is 2022 not 1992.

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    • Anon says:

      There is mandatory testing for AIDS for work permit holders.

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      • Dave says:

        It is no different as I know an caymanian do have AIDS. AIDS do not choose expats, anyone can have it, female or Male. Caymanians easily fly overseas and bring it back.

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      • Bored of the bigots says:

        I think the medical ignorance in this post proves the point.

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    • Tired of stupidity says:

      @Bored of bigots – There is nothing wrong with testing foreign workers for HIV. Many countries test visitors for communicable diseases. Were you off planet for the past 3 years? The push back here in Cayman, is because many “First World” foreign workers don’t see themselves as foreign workers and they get their knickers in a twist when they have to abide by the same rules as other “foreigners”.

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    • Anonymous says:

      The word bigot is thrown around so easily these days without any context. This is bigoted. It’s common sense. No one is treating individuals with aids and HIV like pariahs like how they did in the past. However, it is necessary to keep an eye on numbers and cases for the good of public health.

  6. Anonymous says:

    Why is there no sex education in schools? Starts around age 11 in the uk. Disgraceful that safe sex is not taught to kids here.

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    • Anonymous says:

      Sexual education is taught here in both private and public high schools. Not sure why you would want to be teaching it to kids.

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      • Anonymous says:

        because these kids watch their moms have babies with multiple men and thus the cycle continues unless we teach sex Ed from 11 on.

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      • Anonymous says:

        Really? Maybe I’m wrong. Should be teaching condoms, sexual intercourse, LGBTQ awareness from age 11. You sure they are doing that!

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    • Anonymous says:

      As with most social issues here (equal marriage, sex education, homo/transphobia, not being able to do your shopping on a Sunday), the root cause is that some people believe that an old book says you can’t.

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      • Anonymous says:

        @3:05:
        To those who would reject the “old book”, I shall proffer this: The concept of “human rights” and equal rights” is no less purely a human construct than that book you reject because you believe that it is a man mad construct.

        To borrow from a brilliant monologue that demonstrates that the idea of inherent, immutable human rights is a myth:
        Everyone in this country is running around yammering about their damn rights. “I have a right, you have no right, we have a right.”
        Folks I hate to spoil your fun, but… there’s no such thing as rights. They’re imaginary. We humans made ’em up. Like the boogie man. Like Three Little Pigs, Pinocio, Mother Goose… the same way some people claim we made up the idea of God and the Bible, we made up the idea of human rights.

        Rights are merely an idea that exists in the imagination. They’re just imaginary, a philosophical construct, no more. They’re a nice idea. Nice. But that’s all. Nice…and fictional, an illusion.

        But if you think you DO have rights, let me ask you this, “where do they come from?” Some people say, “They come from God. They’re God given rights. Oh boy…here we go… Where do the people who claim God is a fictional character say rights came from? Thin air? If they DO say that, they would be correct.

        Rights are not universal, they vary according to geopolitical circumstances. Rights that exist here, might not exist there; rights that exist there, might not exist there. And they depend on time. Old rights pass away, new rights evolve. And so it goes. Rights are merely human constructs and are circumstantial and depend on where and when you live.

        Now, if you STILL think you do have absolute and immutable human rights, I have one last assignment for ya: Next time you have some time on your hands get on the Internet and have a look at all the many ways that you can lose your rights, all the ways that Government can take away your rights. Bottom line: rights aren’t rights if someone can legally take ’em away. They are privileges. All we have ever had in this country and ever will have is a list of TEMPORARY privileges; privileges that government grants us a license to enjoy, but only for as long as we follow the rules. And if you read the news, you know the list gets shorter, and shorter, and the body of rules gets longer and longer.

        Lastly, the licenses to enjoy the privileges you claim to be “rights” are–in a democracy–issued and controlled by those in political power. Thus, if the people of the old book have the power and say you have have no right to do whatever, then you indeed have no right in that regard. Sometimes, those holding a position of higher power may overrule the denial of the license, providing further evidence that the powers that be make up and control the illusion that you call “rights”.

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  7. Anonymous says:

    A long list of questionable clauses throughout all 45 Sections of this Registry Bill have been submitted through public consultation. When we (those of us who have actually READ it) can see the complexities and possible implications of some of these clauses, the public consultation window is narguably way too short.The few ‘fixes’ outlined thus far – that they claim can easily be sorted during Parliamentary session – DO NOT fully address these concerns.

    It is clear to see that this ‘ID’ and register (expantionable database) is intended to be much MORE than currently disclosed or even understood by our local ‘leaders’. The fact that they themselves have not questioned it or noticed the issues until pointed out by the public makes it clear that none, if any have even read the Bills themselves. But as usual, the majority will welcome it under the guise of offering ‘convenience’ while chastising and ridiculing -with ‘anti vaxxer’ and ‘conspiracy theory’ rhetoric – their fellow citizens who are trying to warn them and actually look out for their best interests.

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  8. Brigitte says:

    Just recently, WORC dropped the requirement for work permit holders to submit the 3-page Medical Examinations Form and replaced it with a one-page Medical Declaration Cover Letter. In the section to be filled out by the medical examiner there are 2 drop-down arrows which clearly leads to a menu from which the examiner is to choose the option that best fits the patient’s health status. So, we understand how the government intends to improve the surveillance of “the transient population.” (BTW, after the medical examination, are all the medical examiners personally entering the patient’s data into what I am assuming is a HAS database or is this private medical data being entered by others in the office?).

    So how does the government intend to surveil Caymanians for HIV? Perhaps this is/was one of the hidden reasons for the ID Register. We have been told that the ID Register will no longer be mandatory for Caymanians but as of Saturday morning, no one I know has seen the revised Bill which is needed if the public is to understand the impact of the proposed changes. Therefore, it is still possible that Caymanian’s requiring government services are coerced into the ID Register because service to them might be dependent on their enrollment in the ID Register. Once in the ID Register, their data will be mined, surveilled and farmed out just like it will be for work permit holders.

    Look at section 29 (1)(b) in the Identification Register Bill, 2022. “Access to the Register and use of information by public authorities.” Under this section, “a public authority may use identification information from the register for the purpose of – research or statistical analysis to facilitate public administration or policy development”. Is this the section of the law that will allow work permit holders and Caymanians willing to participate in the ID Register to have their health records surveilled?
    As stated in the article, the “Ministry of Health and Wellness is now pushing for the collection of data for the purpose of ensuring that programming and intervention are data-driven and can play a key role in HIV prevention and treatment.”

    Exactly how does this ministry intend to collect my health data to satisfy their surveillance objective?

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    • Anonymous says:

      Ordering a physical card that relates to your file is being made optional, the system will not be. We don’t know if that means the DVRL will have your HSA file, or just the successful hackers.

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  9. Anonymous says:

    A little too late after removing mandatory testing fo work permit holders. BTW do you know there are meds available that makes the virus undetected in tests? Waste of time and peoples money for another project.

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    • Anonymous says:

      Test not removed, form required removed from application. Test still needs to be done and instead of submitting on previous form the doctor must right a cover letter noting findings.

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  10. Anonymous says:

    HIV/AIDS is no longer a death sentence, one can live with the virus for a very long time, however, you MUST have good insurance to be able to afford the treatments. I’m shocked that there are so many young pregnant young people, particularly with Caymanians as they aren’t required to take a HIV tests in order to get a work permit so…
    WRAP it up boys! and Girls, you must insist on that too!

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