For both self-protection and for humanitarian reasons, Americans should be seriously concerned about the explosion of HIV/AIDS in the Caribbean.
The Caribbean region is the second worst HIV/AIDS affected regions in the world, after sub Saharan Africa. Poverty, gender inequalities and a high degree of HIV-related stigma have caused a festering of the epidemic in the region.
Human mobility throughout the Caribbean, between the region and other geographic areas including migration and tourism which brings more than 20 million visitors each year has also been singled out as a major driver of the epidemic.
According to UNAIDS, AIDS remains one of the leading causes of death among people aged 25 to 44 years in the region, and the adult HIV prevalence is estimated at 2.3%.
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The main mode of HIV transmission in this region is unprotected heterosexual intercourse; unprotected sex between sex workers and clients is a key factor in the spread of HIV, reports UNAIDS.
UNAIDS estimates that 330,000 HIV-positive people live in the Caribbean, about 22,000 of whom are children, with 51 percent of people living with HIV, the virus that causes AIDS, being women.
Against this background, there is massive human interaction between the US and the Caribbean, with many Americans attracted to visit the idyllic, sandy and sunny spots in the region.
Statistics from the U.S. Department of Commerce show that 14 percent of the 27,351,000 US travelers in 2004 went to the Caribbean.
While bringing much needed revenue to the region, the impact of tourism has seen a rise in sex work, with poor women and men aged between 18 to 44 selling their bodies as a means of survival throughout the Caribbean.
Many American tourists both male and female perceive the Caribbean region as sexually exotic and free-going. So it's common that when Americans visit the Caribbean, many end up engaging in sexual activity, in a high HIV risk environment.
According to Avert, an international AIDS charity, the Caribbean's thriving sex industry, which serves both local clients and many tourists, features prominently in the AIDS epidemics of certain countries, such as the Dominican Republic and Jamaica.
Americans, particularly tourists to the Caribbean region, should therefore be concerned that they can easily contract HIV if they do not utilize protective measures. It is imperative for Americans who engage in sexual unionships in the region to be concerned about the consistent use of protection to avoid HIV and STI infection.
Given the high rates of American visitors to the region, it is conceivable that the epidemic can rebound in the US, if they do not apply protective measures during sexual contact.
More importantly, if the AIDS problem in the Caribbean continues to grow unabated, there is no doubt that it will spiral into the US. The non-availability of AIDS drugs and treatment in the region may force Caribbean people to illegally migrate to the US where the treatment options are many.
In fact, migration between the islands and to the United States is prevalent in the Caribbean region and plays a key factor in the spread of the disease. In that sense, Americans need to be seriously concerned because they are vulnerable to both HIV and secondary diseases such as TB that immigrants may bring with them.
Having said that, the decimation of entire populations within the Caribbean can destabilize many of the countries, thereby posing a security risk right in front of the US's doorstep.
Americans also have a responsibility to ensure that the tools and methodologies that have worked in their country can be exported to the Caribbean region, albeit, in a culturally sensitive manner.
"The epidemic's full extent is obscured by fear, denial, limited treatment and a lack of public health resources," the New York Times reported on the impact of HIV/AIDS in the region, "What is certain, however, is that a social and economic catastrophe is imperiling many countries as infections steadily climb and AIDS spreads in the general population."
For the ordinary American traveler, this could potentially mean that traveling to the sunny and sandy beaches of the Caribbean may be rendered impossible.
It is incumbent upon the Americans to intensify calls for non-judgmental, humanitarian efforts targeted at the region. The Global Gag Rule which restricts funding for family planning reinstated in 2001 by President George Bush has been a major factor blamed for the restriction of women's access to contraceptives in the region.
The U.S. President's Emergency Plan for AIDS Relief, precludes anyone who does not condemn sex work from getting the money, thereby dampening efforts to fight the epidemic among the most affected women and girls of the region. Evidence already shows that restricting access to contraceptives and promoting abstinence only approaches does not work.
Therefore Americans must demand that the US government show leadership through revoking the Global Gag rule which only serves to worsen the situation of already marginalized women in the Caribbean region and other poorer parts of the world.
And, for purely humanitarian reasons, Americans should be concerned about the suffering of fellow human beings infected or affected by HIV/AIDS in the Caribbean region.
US citizens should alleviate the suffering of these people, unconditionally and without any ulterior motive through provision of material support for purchasing medicine and supplies.
Humanitarian aid can go a long way to save lives and support orphaned children in the region, thereby averting full-scale destabilization of the region due to the epidemic.