Yesterday, my colleague Suzanna, who works downtown, was privy to the circulation of this bus (photos courtesy of her). This bus is a mobile testing unit for HIV/STI and syphilis. It is run by the Ministry of Health and the idea is to go to where the people are who might have neither access nor information about getting tested and why they need to do so.

A couple of weeks ago, I was also witness to a free mobile testing clinic (about 35 people passed through), and it was efficient, effective, confidential and respectful. (Not unique to Jamaica, there still seems to be a stigma attached to AIDS/STIs here, so confidentiality is an essential component of reaching people and convincing them to get tested and treated if need be. Guaranteeing confidentiality in a small, remote community can also be a problem, one of the workers said).

Overall, the Ministry of Health has a comprehensive effort aimed at preventing HIV/STI, check it out here, but the Ministry’s National HIV/STI Programme is a $236 billion effort, funded by various agencies, including CIDA, USAID, the WHO and the UN. Much of the advertising seems to take a lighthearted tone and uses Patois, like on the bus.

Here are some facts about Jamaica’s rate of infection (taken from a 2011 Ministry report):
From 1982 to 2011, there have been 16,264 cases of HIV/AIDS in Jamaica.

Kingston & St. Andrew, St. James, and St. Catherine, with 50% of the Jamaican population, account for 56% of reported HIV cases. This distribution remains unchanged from 2010.

The most urbanized parishes have the highest cumulative number of reported HIV cases: Kingston & St.Andrew – 1570.1 cases per 100,000 persons, and St. James – 2094.6 HIV cases per 100,000 persons.

Parishes with significant Tourism based economies have the next highest level of cumulative number of reported HIV cases since the start of the epidemic: 1162.5 cases per 100,000 persons in St Ann, 1058.3 cases per 100,000 persons in Westmoreland, 1033.1 cases per person in Hanover, 994.8 cases per person in Trelawny.

All 4 parishes that comprise the Western Region are counted among those with the highest cumulative number of HIV cases.

Six parishes had an increase in HIV cases reported in 2011. The percentage increase in the number of reported cases range from 10% in Westmoreland to 116% in St Mary).

The Ministry’s strategy (and the introduction of a free antiretroviral treatment program and prophylactics in 2004) appears to be working, according to the figures:

In 2011, one thousand two hundred and fifty (1250) persons with advanced HIV (661 males and 589 females) were reported compared to 1503 in 2010.

The total number of reported AIDS deaths in Jamaica between January 1982 and December 2011 is eight thousand four hundred and ninety eight (8498).

Overall, the number of reported AIDS deaths has decreased since the introduction of public access to ARVs. Three hundred and thirty-three (393) AIDS deaths (234 males and 159 females) were reported in 2011 compared to 665 in 2004. This represents a 41% decrease in AIDS deaths since the inception of Universal Access to ARVs in 2004, and a 33% decrease when compared to 2001 (588 AIDS deaths).

The number of deaths reported in St Catherine (37 deaths) represents a 62% decline since the introduction of ARVs in the public sector. However, reported deaths in Manchester and St Elizabeth increased and represent the highest number of deaths for these parishes (16 and 20, respectively) since the introduction of ARVs.

The proportion of reported cases from the most urbanised parishes has decreased in recent years. Fifty-seven percent (57%) of reported AIDS cases in 2011 were from the most urbanized parishes (KSA, St. Catherine, and St. James). This proportion remains the same as 2010, but has decreased from 70% of cases in 2008 and 60% in 2009.