June 03/2002 - The number of Dominican women who die of AIDS could reach record levels in the next few years if the rate of HIV/AIDS infection among the female sex is not checked, health officials here have told the Sun.

    Between 1987, when the first AIDS case was diagnosed here, and 1991, there were 31 deaths attributed to the pandemic. Eight of these were women. Seven of the eight died in 1990, the only year that the female mortality rate surpassed the male (5).

    From 1992 to the end of 2001,there have been an additional 71 deaths, 19 of them females.

    But officials here say more and more females are testing HIV positive.

    "(In the late 1980s and early 1990s) the ratio of men to women was in the region of 9 to 1 (but) now it's approaching a ratio of 3 to 1," said a senior medical practitioner who spoke to the Sun on condition on anonymity.

    "In 1980s and early 90's, AIDS was associated with homosexual activity but there's an increasing trend towards heterosexual activity," said the official, who blamed the spread on promiscuity, adding that "in a culture where sexual prowess is sometimes seen as a badge of honour, it's not surprising that more woman are being infected."

    Confirming the increasing number of females being diagnosed with HIV/AIDS, Dr. Roger Radix, the chief medical officer, also pointed a finger at people engaged in bisexual activity. "The number of bisexual men (infected is higher) and they tend to pass it in larger proportions to women, Radix said. The Health Promotion Resource Centre only provided information on the number of men and women infected with HIV/AIDS, and does not keep statistics on homosexuals and bisexuals.

    AIDS is already the leading cause of death in the Caribbean among the 15 to 45 age group, and the number of cases is growing without showing signs of a plateau, according to the Caribbean Epidemiology Centre (CAREC), the leading regional institution monitoring the pandemic.

    Official figures from CAREC indicate that at least one in every 50 people in the Caribbean has AIDS or is infected with HIV, the virus that causes AIDS. At present there are 386 known cases of HIV in Dominica - including 140 who are living with AIDS - or one in every 184 Dominicans. However, based on estimates that for every one known case, there may be five unknown cases, the ratio could be one in 36; higher than the Caribbean average.

    Those diagnosed with AIDS cannot expect to live longer than two years, one medical expert said. "On average, people tend to die within two years of diagnosis," the expert told the Sun.

    But in recent months there has been some hope as antiretroviral drugs, which less than a year ago could cost up to US$10,000 annually per person, are now available at affordable prices at the Princess Margaret Hospital.

    For example, one of the most popular medicines, AZT, is available at EC$2.18 per capsule and EC$13.20 per 100ml of the suspension, chief pharmacist Errol Thomas told the Sun. However, since April, when the drugs became available, only five people have sought prescriptions, Thomas said.

    The Government has also initiated a programme to prevent mother-to-child transmission where pregnant mothers who are HIV positive are treated with antiretroviral drugs, and arrangements are made, with the assistance of the Pan American Health Organisation (PAHO), to provide treatment for infected babies.

    "Over 800 mothers were tested last year and only four were HIV positive," said chief medical officer Radix. Up to the writing of this article, three had delivered, and of the three, only one baby tested positive.

    In spite of these programmes, people involved in the fight to stem the spread of HIV complained that not enough was being done to assist in the fight. The leaders have seldom spoken about AIDS and the National AIDS Committee hardly met during the year that Castle Bruce MP Loreen Bannis chaired the committee, one source complained.

    Bannis told the Sun that the committee had held some meetings and had undertaken some activities. But for details, she referred us to a member of the committee. That member was out of state up to the time of the writing of this story.

    But chief medical officer Radix defended the political directorate, saying that politicians did not like bad news and that AIDS was bad news. However he said that it was becoming more acceptable for the politicians to talk about the pandemic.

    "Our minister of health is speaking about it. Where as it may not have been the politically correct thing to do, it's becoming more acceptable," Radix said. He also revealed that the National AIDS Committee was being revamped and that an announcement would be made soon after the health minister Herbert Sabroache returned to the state from an overseas assignment.

    The Sun understands that there will be two committees - an advisory committee to the chaired by Dr. Carissa Etienne and a technical committee to be chaired by Dr. (Charlie put in first name please) Benjamin.

    According to CAREC, one of the factors driving the pandemic, both in Dominica and the rest of the Caribbean, is poverty. But denial and discrimination remain major hindrances to stemming its spread.

    "The stigma is still present. People don't want to mingle (with those living with AIDS)," one family nurse practitioner told the Sun. "Some family and community members are involved in spreading rumours (about people with AIDS), she said.

    One medical practitioner confirmed that discrimination even existed in the medical profession, although the problem was becoming less severe.

    "We have had instances in the past, through fear and ignorance, where AIDS patients have had unsatisfactory treatment (in the hospital). If there is a fear of personal illness from treating patients, this had been one of the major reasons for the way AIDS patients were treated in the past," the medical practitioner said. "But that situation has been improving over the years. Any body coming with AIDS receive care that is reasonable and not significantly different from other patients."

    In Dominica, like in the rest of the Caribbean, the highest incidences of AIDS are found in the 15 to 45 age group, with those between 18 and 28 facing the greatest risk. And while figures were not immediately available for Dominica, CAREC states that in the Caribbean, HIV infection rates among females 15 to 24 years old are two to four times higher than those of all other female age groups in the region, and three to six times higher than in males of the same age.