Dispelling myths and removing stigma crucial as HIV cases persist
Combating myths and misconceptions around HIV in Bermuda will be crucial in ending the infection as a public health problem by a global target of 2030.
Ahead of World Aids Day being observed today in Bermuda and globally, Ann Marie Moore, the sexual and reproductive health programme co-ordinator for the Department of Health, said advancements in medicine can help those with HIV live normal lives, in some cases with no risk of infecting others.
She was speaking as cases in Bermuda are on the rise with five reported this year and eight last year compared with none in 2023 and two in 2022.
She also said it was imperative that the community seek professional medical advice and remove stigmas attached to diagnosis.
Human immunodeficiency virus is an infection that attacks the body's immune system while Acquired Immune Deficiency Syndrome is the name for a collection of serious illnesses caused by the virus.
Ms Moore told The Royal Gazette: “You need to get treatment until your status becomes undetectable, that is the biggest thing to raise awareness of.
“Only since treatment was revolutionised did we start seeing the number of people dying of Aids decline. It was a death sentence then but now you can live long and well with HIV so that it doesn’t develop into Aids. With treatment, your viral load can be undetectable so you can’t pass it on to another person.
“If you continue to take medication, you will not transmit because it wont be detected.”
“There shouldn’t be any fear attached to having a diagnosis in this day and age.”
Annabel Overton, a midwife, added: “It’s important that people know that because that could be part of the barrier.”
Speaking to the rise of false information online, Ms Moore said: “I want people to rise above the misinformation and seek advice from reputable sources such as ourselves. Don’t use social media to get your information because a lot of that is personal opinion rather than evidence-based research. That will hinder the progress towards 2030 and beyond where we might see the elimination of HIV.
“Fear is driving a lot of the stigma. Because HIV is lifestyle linked, people may misconstrue how you caught HIV. You don’t have to be promiscuous to catch it, it can be the one and only time that you have sex that you pick that up. We are all at risk of getting HIV if we indulge in sex.”
She said that within the island’s small population, fears persist about lack of confidentiality.
“People don’t need to worry about confidentiality when they come here. Information is kept safe and secure,” Ms Overton insisted. “What comes into these four walls, stays in these four walls.”
Ms Moore said it was also important to raise awareness of treatment and support services including the Sexual Reproductive Health at the Department of Health where she works.
She said: “We have free services that include healthcare, emotional support and access to life-saving treatment.
“We have in-house social workers, we work closely with the infectious infection specialist as well as the Mid Atlantic Wellness Institute.”
Ms Overton said: “Testing is free at the clinic whether you are insured, uninsured or underinsured.”
Ms Moore added: “Treatment is funded so that you will be able to get your medication at very little cost to you.”
HIV is spread from the body fluids of an infected person, including blood, breast milk, semen and vaginal fluids, and from a mother to her baby. It can be prevented and treated with antiretroviral therapy where as untreated HIV can progress to Aids.
Ms Moore said Bermuda was fortunate to have eliminated mother-to-child transmission.
Ms Overton explained: “We screen very regularly during pregnancy, at the beginning, in the middle and towards the end as well.
Ms Moore added: “So if it is detected, the mother can be treated and it can prevent that transmission.”
Ms Moore and Ms Overton said that the facility it is working with LGBTQ+ support and advocacy charity OutBermuda as well as with HIV/Aids charity Star.
“We work through schools, health fairs, pop-ups events, Sexual Health Awareness Week and other events throughout the year to ensure everyone has the information they need,” she said.
December 1: World Aids Day
Mid-February: Sexual Health Awareness Week
April 7: World Health Day
June: HIV Pop-Up Testing
A report published at the end of 2022 contains information received by the Epidemiology and Surveillance Unit from 1982 through to January 31, 2023.
It showed that as of December 31, 2022, it was estimated that there were 295 persons known to be living with HIV in Bermuda, giving an overall prevalence of 0.5 per cent
Since 1982, HIV has been diagnosed in 792 persons in Bermuda. Of these, 606 persons have had a diagnosis of Aids and 497 have died either from or with HIV infection.
As of December 31, 2022, it is estimated that there are 295 persons known to be living with HIV in Bermuda, giving an overall prevalence of 0.5 per cent
HIV incidence peaked from 1984 to 1987 followed by a steady decline over the next 15 years. There was then an increase in persons diagnosed from 2005 to 2008. This increase may be partly due to improved awareness of the availability of testing. Since then there has been a general decline with less than ten new HIV diagnoses reported per year from 2011 to 2022. There were two new HIV diagnoses reported in 2022
Aids incidence peaked in 1995 with 49 persons reported with HIV diagnoses in that year. This has declined since then with ten or fewer persons reported with an Aids diagnosis annually since 2004. There were no new Aids diagnoses reported in 2022
Deaths among persons with HIV continue to be low, likely owing to advancement and availability of care, treatment and support
Additionally, the deaths are occurring among persons of older ages and the reported causes of death among persons with HIV may not be directly related to their HIV infection
There were no reported deaths among persons with a prior diagnosis of HIV reported in 2022
The majority of HIV/Aids diagnoses and deaths have occurred among Black males aged 25 to 44 years. For diagnosis of HIV, sexual contact is the main risk factor (heterosexual contact followed by men having sex with men). However, there have been slightly more Aids diagnoses and deaths among persons with injection drug use as their main risk factor
• Information provided within the HIV in Bermuda Summary of year ended December 31, 2022 received by the Epidemiology and Surveillance Unit
World Aids Day is commemorated every year globally on December 1.
Members of the public can attend the event at Victoria Park in Hamilton from 1pm to 2pm today and are encouraged to wear red as the red ribbon is the symbol of solidarity with people living with HIV/Aids.
The global commemoration is themed “Overcoming disruption — Transforming the Aids response”, calling for “sustained political leadership, international co-operation and human-rights-centred approaches to end Aids by 2030.
Ms Moore said Bermuda needs to continue to align with organisations such as the WHO, UN Aids and the Pan American Health Organisation.
“Sharing information and exchanging the latest research is a good way to continue to improve HIV services,” she said.
“Who would have thought in the Eighties and Nineties that we would get to this stage? At one time, we thought the world was going to end there and then because it was keenly felt, but look at where we are.
“That in itself is a miracle and a huge breakthrough, and we want to continue on improving and researching and always looking for best practice.”
• Sexual Reproductive Health at the Department of Health is located in the Hamilton Health Centre at 67 Victoria Street, Hamilton. The facility can be contacted by phone in confidence on 444-1711 or WhatsApp on 441-332-8895 for the Women’s Clinic, and by phone on 246-7711 or WhatsApp at 441-332-8881 for the Communicable Disease Clinic
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