Antigua and Barbuda: Information on the situation of people with HIV/AIDS, including societal attitudes and treatment by government authorities, access to health services, drugs and medical treatment and on whether heterosexual and homosexuals living with HIV/AIDS are treated differently

The following information was provided in a 27 March 1997 telephone interview with an HIV/AIDS researcher with the Caribbean Epidemiological Center (CAREC) in Port-of-Spain, an organization affiliated with the Pan-American Health Organization (PAHO). The source is presently involved in coordinating HIV/AIDS programs in the eastern Caribbean, including Antigua and Barbuda.

Antiguan society is not very open towards homosexuality or discussion of HIV/AIDS-related issues. Homophobia is widespread, and is complicated by the stigma of HIV/AIDS.

For the most part, the national  HIV/AIDS strategy in Antigua and Barbuda consists of a counselling program. The president's wife actively participates as a counsellor. The national HIV/AIDS program in Antigua centres around prevention counselling (i.e., use of prophylactics and general information on how HIV is transmitted) but educational materials do not focus on any marginalized high-risk groups. CAREC has been trying to promote targeted interventions for high-risk groups (i.e., homosexuals, bisexuals, sex workers and intravenous drug users) but to date there has little government support for such measures.

The stated methods of HIV/AIDS transmission in Antigua and Barbuda are as follows: 35 per cent, homosexual contact; 25 per cent, heterosexual contact; and 33 per cent, unknown. In the category of individuals who stated an 'unknown' method of transmission, 90 per cent are men. The remaining seven per cent are comprised of intravenous drug users, haemophiliacs, children born to HIV-positive mothers, etc.

Since 1987 the official government position has been that HIV transmission in Antigua and Barbuda is primarily a heterosexual phenomena. The problem of homosexual or bisexual transmission of HIV is not addressed in the national AIDS program. The fact that certain homosexual acts are against the law compromises the government-funded National AIDS Strategy's ability to seriously deal with these issues.

Treatment of secondary and/or opportunistic infections affected by HIV and/or AIDS depends on the financial resources of the individual. The government of Antigua and Barbuda has indicated that it intends to bring in a program to provide HIV-positive pregnant women with AZT during pregnancy, but such a program has not yet been implemented. There has been no commitment by the government to provide AZT or other drug treatments to other individuals with HIV/AIDS. The Ministry of Health does not provide free therapy, and medical services depend on the individual's ability to pay.

CAREC has not been able to collaborate successfully with the government on AIDS/HIV treatment issues and education programs for homosexuals and bisexuals, and has instead chosen to coordinate such activities with local NGOs and grassroots organizations.

Discrimination against people with HIV/AIDS is widespread. A member of a marginalized group who has HIV/AIDS may be excluded from access to the state health care system. Employers are legally permitted to demand an HIV test before giving an offer of  employment, and have the discretion to refuse to hire person who tests  positive. People who test HIV-positive also are dismissed from their jobs; a tendency which is particularly evident in the food and hospitality industries.

The following information was provided in an 18 March 1997 telephone interview with an HIV/AIDS education consultant and member of the Steering Committee for the Caribbean Forum for Lesbians and Gays (CFLAG) coordinated by Orguyo, the Curaçao Association of Gays and Lesbians.

Homosexuality and HIV/AIDS both carry a serious stigma in Antiguan society. A widely held belief is that people who have HIV/AIDS acquired it through homosexual contact. Antigua and Barbuda has a national AIDS program, but it is not very aggressive in terms of content or exposure. Antigua and Barbuda have no support groups for people with HIV/AIDS, although CFLAG is presently organizing such a group on the islands.

 There is little access to the range of HIV/AIDS treatments and therapies known in Canada. For example, AZT, a common but expensive HIV/AIDS drug therapy, is not readily available in the country and has a cost beyond the means of an average Antiguan. HIV/AIDS treatment and therapies are not covered by government health services, although some of them may be available from private health care practitioners. Only the most basic treatments are available to combat opportunistic and/or secondary infections associated with HIV/AIDS. If a person has limited financial means and is unable to afford the cost of treatment or therapy, there is no alternative.

The families of people living with HIV/AIDS tend to be supportive of the person after they have received counselling, but the community at large often remains suspicious. Members of the infected person's extended family often keep themselves at arm's length, and outsiders will avoid contact with a person with HIV/AIDS. Almost immediately after it becomes known that a person has HIV/AIDS, the person would lose his or her job, either by being fired or asked to resign.

Please find attached a PAHO report on HIV/AIDS programs in Antigua and Barbuda.

This Response was prepared after researching publicly accessible information currently available to the DIRB within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim to refugee status or asylum.

References

Caribbean Epidemiological Center (CAREC), Port-of-Spain. 27 March 1997. Telephone interview with researcher.

 Steering Committee for the Caribbean Forum for Lesbians and Gays (CFLAG), Caraçao. 18 March 1997. Telephone interview with member.

Attachment

Pan American Health Organization (PAHO). 15 September 1995. "Country Health Profiles: Antigua and Barbuda."  [Internet]  [Accessed 20 Mar. 1997]