World AIDS Day observed December 1st each year is dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection. ‘Stop AIDS: Keep the Promise’ is the main theme for AIDS day observance through 2010, with more specific sub-taglines chosen annually. The tagline for 2007 is ‘Leadership’.

AIDS pandemic
According to UNAIDS estimates, AIDS has killed over 25 million people and there are now 39.5 million people living with HIV including 2.3 million children. In Anguilla, with a small population of approximately 12 thousand people there are 35 known individuals infected with HIV, with estimates of significantly more living with the virus.
Despite recent improved access to antiretroviral treatment and care, in many regions of the world, the AIDS epidemic continues to kill many people. The spread of HIV still continues at alarming rates in some countries and some groups are affected more than others.

Stop AIDS: Keep the Promise -Leadership
Despite recent advances, AIDS is still affecting many individuals around the world. The theme for this year’s observance is timely as there is still need for strong and committed leadership when it comes to HIV/AIDS in many countries including Anguilla. Leadership must be demonstrated at all levels of society in Anguilla such as the family, the church, the community and civil society organisations. Our political leaders must demonstrate by their actions that they are committed to stopping the spread of HIV/AIDS.
All of us must be concerned about AIDS and be prepared to challenge the status quo. We cannot continue to believe that AIDS is not a problem in Anguilla. We must show we care by getting involved in activities that are dealing with HIV/AIDS. The Anguilla Optimist Club’s “Race for AIDS” is a good example of an organisation demonstrating leadership in the HIV/AIDS epidemic and the club must be highly commended.

HIV/AIDS Transmission/Prevention
HIV can be transmitted in three main ways. These are:
• Sexual transmission
• Transmission through blood and other body fluids
• Mother-to-child transmission
In all of these routes of transmission, there are ways by which an individual can reduce or eliminate the risk.
HIV/AIDS awareness is important in decreasing the spread of the virus. Media campaigns and sex education in schools have been shown to be effective in decreasing the spread of HIV. Sex education in schools must be age specific and must start at an early age and continue until children leave school.
Abstinence from sex or delayed first sex has also been shown to decrease the spread of HIV among teenagers and adolescents.
Those individuals who are sexually active must be encouraged to be faithful to one partner and avoid risky sexual behaviours. There is evidence that many individuals in Anguilla continue to engage in highly risky sexual behaviours which continue to fuel the spread of HIV on the island.
Using condoms consistently and correctly must be encouraged if we are going to seriously decrease the spread of the virus by the sexual route.
All pregnant women are encouraged to be tested for HIV so that they know their HIV status so that the risk of transmitting the virus to their newborn can be markedly reduced or eliminated.
All individuals are being encouraged to be tested for HIV. Many individuals may have HIV but because they seem to be living healthy lives without any symptoms just do not know. If people know their HIV status and are positive for the virus they would be less likely to spread the virus and seek medical attention. Individuals who are HIV positive can now benefit by the use of anti-retroviral mediations, which are now available on Anguilla.

Conclusion
HIV/AIDS continue to affect many individuals in many countries including Anguilla. Despite the present advances in the care of individuals who have the virus, people continue to die from AIDS. There is still the need for increased awareness of this pandemic. We must continue to educate our children and adults about this disease and other sexually transmitted infections. HIV prevention must continue at all levels in our society and we must also continue our efforts to improve the care of individuals who have this deadly virus. The need for leadership when it comes to HIV/AIDS is vital if we are going to be successful in stopping this potentially deadly virus.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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