Epidemiology of AIDS and HIV infection in the Caribbean

A review of surveillance data on AIDS and HIV infection in the 18 English-speaking Caribbean countries and Suriname suggests that the epidemiologic pattern of AIDS in the Caribbean is evolving from an epidemic that began in 1983 among homosexual and bisexual males to one in which cases are increasingly resulting from heterosexual contact, with different countries at various stages of transition. Overall, there has been a decline in the male to female case ratio. Perinatal transmission is already a major problem in many countries--19% of cases in the Bahamas are among children under 15 years of age. Serosurveys conducted in Trinidad and Tobago, Jamaica, Antigua, St. Vincent and the Grenadines, and other countries show high HIV seroprevalence among homosexuals (15-40%), prisoners (4-10%), prostitutes (up to 13%), and cocaine users (2%); at present, prevalence in the general population continues to be low.