Who We Are

Caribbean Vulnerable Communities Coalition (CVC) is a coalition of community leaders and non-governmental agencies that are advocates and service providers, working with and on behalf of Caribbean populations who are especially vulnerable to HIV infection or often forgotten in access to treatment and healthcare programmes.

These groups include men who have sex with men (MSM), transgender persons, sex workers, people who use drugs, orphans and other children made vulnerable by HIV, migrant populations, persons in prison and ex-prisoners, and youth in especially difficult circumstances.

These groups are subjected to high levels of stigma and discrimination. They also lack the social and legal protection afforded other members of society and are socially excluded because their behaviour may be deemed delinquent, deviant or criminal.

Stigma, discrimination and social exclusion place affected persons at significant disadvantage in their struggle against HIV and AIDS and in realizing their right to health. Gender and gender identity, sexual orientation, youth, poverty and language differences exacerbate the vulnerabilities.

In some countries, HIV prevalence is as high as 27% among sex workers and 32% among men who have sex with men. Young people between 15 and 24 years old account for the highest number of new HIV infections. Data on HIV prevalence in persons of trans experience is limited in the Caribbean, but elevated where available, at 17% or more in the Dominican Republic (based on data from three studies with limited samples of persons of trans experience) and perhaps as high as 52% in Jamaica. CVC is working to remove barriers of stigma and discrimination and to reduce the prevalence of HIV among the key populations. We take action to ensure increased access to services, to promote a human rights framework for policy and programmes at national and regional levels and to build the capacity of the most vulnerable populations for effective self-advocacy.

Populations We Serve

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Marginalized Children & Youth

The AIDS epidemic has orphaned approximately 250,000 Caribbean children...

Marginalized Children & Youth

The AIDS epidemic has orphaned approximately 250,000 Caribbean children...
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Mobile / Migrant Populations

Population movement has its risks and those who are most vulnerable include refugees...

Mobile / Migrant Populations

Population movement has its risks and those who are most vulnerable include refugees...
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Sex Workers

In Guyana, Jamaica, and the Dom. Rep., HIV among female sex workers is estimated at 17%, 5%, and 2% respectively...

Sex Workers

In Guyana, Jamaica, and the Dom. Rep., HIV among female sex workers is estimated at 17%, 5%, and 2% respectively...
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MSM

It is estimated that MSMs account for 10% of HIV transmission in the Caribbean and...

MSM

It is estimated that MSMs account for 10% of HIV transmission in the Caribbean and...
Read More
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Drug Users

Globally, HIV prevention efforts have focussed on injecting drug users, one of the highest...

Drug Users

Globally, HIV prevention efforts have focussed on injecting drug users, one of the highest...
Read More
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Transgender Persons

Transgender people are confronted by the challenges of punitive national laws and...

Transgender Persons

Transgender people are confronted by the challenges of punitive national laws and...
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Our Vision

CVC’s Vision is for a:

A region where inadequately served and vulnerable populations have equitable access to justice, health, and other social services.

Our Mission

CVC mission is to mobilize the voice, visibility and participation of the diverse groups we serve , to impact the regional HIV response and to create an enabling environment by which to end the conditions and consequences of marginalization.

Specifically, CVC seeks to:

· Give voice to marginalized communities and empower them to reduce negative health outcomes, increase socio-economic opportunities and improve the lives of vulnerable populations in the Caribbean.

· Advocate for human rights, social justice and sustainable health and development systems in which vulnerable populations in the Caribbean enjoy the same human rights, socio economic opportunities and well-being as other citizens.

· Advocate for and facilitate the development of infrastructure to support culturally and contextually appropriate and accessible HIV management for vulnerable populations.

· Develop and support culturally appropriate prevention programmes and models geared towards vulnerable populations

· Establish strategic partnerships built on trust

· Monitor and evaluate the impact of projects and programmes on vulnerable populations

Climate Justice

Climate justice begins with recognizing that key groups are differently affected by climate change. Generally, many victims of climate change also have disproportionately low responsibility for causing the emissions responsible for climate change in the first place – particularly youth or people of any age living in developing countries that produce fewer emissions per capita than is the case in the major polluting countries.

Low-income communities, people of color, indigenous people, people with disabilities, older or very young people, women – all can be more susceptible to risks posed by climate impacts like raging storms and floods, increasing wildfire, severe heat, poor air quality, access to food and water, and disappearing shorelines.

Achieving climate justice would mean putting equity and human rights at the core of decision-making and action on climate change. “Nothing for us without us”

The Environment

The nonliving part of the environment has three main parts:

  1. the atmosphere (air and gases that surround Earth)
  2. the hydrosphere (all oceans and bodies of water, including the moisture in the air)
  3. and the lithosphere (the outer layer of the Earth’s land mass, including rocks and soil)

People, animals, plants, and all other living things rely on the nonliving parts of the environment to survive. The part of the environment where life happens is called the biosphere.

The biosphere is made up of many ecosystems. These are communities of living things and the nonliving things that they rely on.

Source: Britannica Kids

Climate Change

Such shifts can be natural, due to changes in the sun’s activity or large volcanic eruptions. But since the 1800s, human activities have been the main driver of climate change, primarily due to the burning of fossil fuels like coal, oil and gas.

Burning fossil fuels generates greenhouse gas emissions that act like a blanket wrapped around the Earth, trapping the sun’s heat and raising global average temperatures.

The average temperature of the Earth’s surface is now about 1.1°C warmer than it was in the late 1800s (before the industrial revolution) and warmer than at any time in the last 100,000 years. The last decade (2011-2020) was the warmest on record, and each of the last four decades has been warmer than any previous decade since 1850.

Many people think climate change mainly means warmer temperatures. But temperature rise is only the beginning of the story. Because the Earth is a system, where everything is connected, changes in one area can influence changes in all others.

The consequences of climate change now include, among others, intense droughts, water scarcity, severe fires, rising sea levels, flooding, melting polar ice, catastrophic storms and declining biodiversity.

Source: UN

Santo Rosario

Director

Santo Rosario a sociologist by training is the Executive Director of the Centre for Integrated Training and Research (COIN). Over the past 19 years his work has supported and strengthened disenfranchised groups empowering them to set up their own organizations. Examples of this include “Amigos Siempre Amigos,” an NGO by and for the MSM community, which is now a leader in the field; and MODEMU, the first Sex Workers Association in the Dominican Republic and indeed the Caribbean. Rosario is a co-founder of the National Coalition of AIDS Service Organizations (ONGSIDA) which helps coordinate civil society’s response to HIV/AIDS in the Dominican Republic.

Joan Didier

Member

Joan Didier, Executive Director (volunteer) of the St. Lucia AIDS Action Foundation (AAF) which is an umbrella NGO based in St. Lucia that works with a wide range of stakeholders, including the private sector, persons living with HIV and AIDS, youth, men who have sex with men, and sex workers.

She is the Director of the OECS Regional Co-ordinating Mechanism for the current OECS Global Fund Grant. Miss Didier is an experienced Trainer and Facilitator with expertise in Voluntary Counseling and Testing, Behavior Change Communication, Advocacy and Human Rights. She has been instrumental in helping to get the St. Lucia private sector involved in HIV and has succeeded in helping the private sector to develop HIV policies for their enterprises. She is a human rights advocate and assisted in the organization of the PLHIV support group TLC. Miss Didier has represented both St. Lucia and the OECS at several regional and international meetings.

R. Anthony Lewis

Secretary

R. Anthony Lewis, PhD. serves as CVC Board Secretary. He has been an advocate and strategist on human rights and social justice issues since he was a teenager, and went on to work as a reporter specializing in, among other things, HIV and AIDS reporting (1993 – 1995). He was Director of Advocacy and Public Education at Jamaica AIDS Support between 2003 and 2005 and also worked in Targeted Interventions for MSM, inmates and sex workers. He is a trained translator who speaks French, Spanish, English, Jamaican and Haitian Kreyol.

He has represented CVC in a number of regional and international fora, including the 17th Conference of Commonwealth Education Ministers meeting, the International AIDS Conference in Mexico City, the Global Forum on MSM and HIV Pre-Conference, training meetings of the PANCAP law, ethics and human rights program; and the PANCAP Regional Condom Policy process with a mandate to ensure it addressed an enabling environment for condom access for youth, sex workers, gay and bisexual men, and other at risk groups.

ethnography of masculine sexual work carried out by Columbia University and Amigos Siempre Amigos (ASA) in the Dominican Republic, as well as other studies to design and develop educational material on human sexuality, HIV and AIDS, and Sexual Transmission Disease (STD).

Ethel Pengel

Member

Ethel Pengel is the founder and CEO of the Double Positive Foundation which is an NGO in Surinam catering for women and girls affected by and living with HIV. As someone who is herself a woman living with HIV, she has been involved with numerous local and regional entities inclusive of the Caribbean Network of Sero-Positives (CRN +). She is a member of Suriname’s Country Coordinating Mechanism (CCM) and a member of the Advisory Board of the Ministry of Health regarding HIV/AIDS.

She has managed two grassroots organizations (Stichting Broko Doro and Stichting Mamio Namen project Suriname) both of which had an enviable track record of providing care,support and income generating opportunities for persons living with HIV.

Ian McKnight

Member

Ian McKnight, MSc, has been involved in HIV development work since 1991 when he co-founded Jamaica AIDS Support for Life (JASL), serving as its Executive Director from 1991 until 2002. He later served as Director of Targeted Interventions and Director for Social Marketing and Public Education. He was the Violence Prevention Specialist and Media and Communications Specialist on JA-STYLE, a USAID-funded/Ministry of Health adolescent reproductive health project and later became the Programmes Manager of the Caribbean Vulnerable Communities Coalition (CVC) from 2006-November 2009 and Executive Director from 2009 – 2013.

As a Facilitator, McKnight has given service to PANCAP/CARICOM’s “Champion for Change” initiative and the Saint Maarten National HIV Programme’s Advocacy and Policy Development Training. As a trainer, McKnight’s clients include UNIFEM, Fluid Bodies Project in New York, the Caribbean HIV AIDS Alliance, Kwanza Productions and Value Added Services.

Jaevion Nelson

Co-Chair

Jaevion Nelson holds an MSc in Social Development and Communication from the University of Wales, Swansea in the United Kingdom where he was a Chevening Scholar; and a BSc in Management Studies (Marketing) from the University of the West Indies.

He has over seven years of work in social development and communication. He has experience working in civil society as a programmer and advocate on issues relating to governance, sexual and reproductive health and rights, violence prevention, human rights, youth rights and participation and communication.

Some of his previous positions include being a reporter at Jamaica’s oldest newspaper – the Gleaner Co. Ltd.; Teacher at the Convent of Mercy Academy “Alpha” and Programme Officer & Campaign Coordinator at the Violence Prevention Alliance (VPA), where he managed two national peace campaigns. He has lobbied US foreign policymakers on Capitol Hill in Washington DC on issues relating to youth sexual and reproductive health, human rights and HIV. He has represented civil society at several human rights, youth development and HIV meetings, including speaking on panels on Capitol Hill and the UN High level Meeting on HIV.

Howard Gough

Treasurer

Howard Gough graduated with honors from the Caribbean Graduate School of Theology with a Master of Arts degree in Counseling Psychology. While studying advanced psychiatric nursing in 1986 Mr. Gough became fascinated with drug addiction. This curiosity took Howard first to London on a European Union-funded scholarship where he used one year to qualify for a two-year diploma in Mental Health studies with emphasis on addiction management.

He returned to Jamaica in 1989 and began the development of drug treatment programmes on behalf of the government. He first crafted the treatment programme for the Detoxification Unit at the University Hospital and then moved to co-develop ‘Patricia House’ a residential, rehabilitation centre which he managed for 22 years. He has also served as consultant to CARICOM; as a Caribbean trainer for the London-based Richmond Psychosocial Foundation; Lecturer at UWI, Northern Caribbean University and the Mico Teachers’ College in Jamaica. He has traveled extensively across the Caribbean, Central and North America, Asia and Europe, in a bid to advance his understanding of addiction and the people affected.

Ivan Cruickshank

CVC Executive Director

Mr. Cruickshank has been a member of the senior management team at CVCC since 2009 and has extensive experience in the field of HIV which has given him intimate knowledge of the Human Rights and HIV and AIDS landscape as well as the community-based response to development.  He has represented CVCC at the regional and global levels with distinction over the years.

Currently Ivan serves in several major leadership positions in Jamaica’s HIV response, including Chairing both the Jamaica CCM and the National Technical Working Group for Enabling Environment and Human Rights as well as serving as a member of the Board of Governors of the National Family Planning Board – Sexual Health Agency as well as the Prime Minister’s Advisory Council. In addition, he serves as Chair of the Equality for All Foundation and is a past member of the Boards of Jamaica Network of Seropositives, and the Jamaica Youth Advocacy Network

Dona Da Costa Martinez

Chair

Dona Da Costa Martinez, EMBA, Co-Chair of CVC joined the Family Planning Association of Trinidad and Tobago (FPATT) in August 1985 and has served as its Executive Director since 1999. She is the Chairperson of the Prevention Sub Committee of the National AIDS Coordinating Committee (NACC) and is a member of several other multidisciplinary committees including a Technical Working Committee on Sexual and Reproductive Health appointed by the Ministry of Health.Under her leadership at FPATT, the organisation has introduced “De Living Room”, the only centre in Trinidad and Tobago providing comprehensive sexual and reproductive health care services to young persons under age 25; health care services for sex workers, and other at risk populations; the integration of voluntary counseling and testing for HIV into SRH services; post abortion counseling; and advocating for the provision of safe abortion services for women who choose to have one.

Quincy McEwan

Member

St. Lucia

Name of organization

Target population

Summary

United and Strong

LGBT

This project provides peer education training, information, health education and communication materials, and sensitization exercises to the LGBT community as well as health care professionals and support services organizations; and the nation through press releases that inform about HIV, human right, stigma and discrimination.

Antigua and Barbuda

Name of organization

Target population

Summary

Caribbean Family Planning Affiliation (CFPA)

MY

This project is geared at sensitizing the public on marginalized groups through the distribution of IEC Materials as well as supporting marginalized youth in addressing their sexual and reproductive health by providing increased access to a minimum package of prevention services inclusive of information, education and materials for HIV/STI prevention; talks, condoms, lubricants, condom demonstration, as well as referral to HIV testing, support groups, primary health care and safe spaces.

Women Against Rape Inc (WAR)

Marginalized Women

The project implements a peer outreach program where peer educators connect with vulnerable and marginalised women to increase their knowledge of STI-HIV/AIDS, sexual health, gender base violence and human rights; increased access to comprehensive sexual health services, HIV testing and counselling, GBV reporting and counselling, increased access to safer sex commodities, educational materials; and referrals to friendly networks including health and legal referral services; increasing human rights awareness and scaling-up of community mobilisation through sensitization of front line workers including health care providers and law enforcement.

Antigua Resilience Collective Inc (ARC)

Migrant Sex Workers

 This is a peer education project aimed at training a cadre of female spanish sex worker peer educators who will connect with the sex worker population in Antigua and Barbuda to educate, counsel and support their peers on HIV/STI transmission, safe sex, and violence towards female Spanish sex workers. The project will build the individual capacity of each peer educator with advocacy skills, knowledge of human rights issues, safe sex practices and safe networking with peers.

Belize

Name of organization

Target population

Summary

Productive Organization for Women in Action (POWA)

LGBT/PLHIV/MY

The project uses peer education to strengthen girls and women in leadership and decision making skills; provide knowledge and support for referral services and continued access to education.

Promoting Empowerment Through Awareness for Lesbian and Bisexual Women (PETAL)

Lesbian/Bisexual Women

 This project aims to expand women’s knowledge and leadership capacity to advocate about gaps in violence and discriminatory laws in Belize through workshops on gender-based violence among other topics.

Empower Yourself Belize Movement (EYBM)

MSM/MY/YSW

This project focuses on using mobile technology and peer to peer methodology to engage, empower and educate targeted populations on their Sexual & Reproductive Health and Human Rights and facilitate access to relevant services to maintain healthy lifestyles.

Haiti

Name of organization

Target population

Project Summary 

Kouraj

Website/Facebook/Twitter

Gay men/MSM

This project delivers peer education to men who have sex with men in Port-au-Prince in three neighbourhoods.

Movimiento Socio Cultural Para Los Trabajadores Haitianos/as (MOSCTHA)

Website/Facebook/Twitter

Marginalized youth in the border town of Ouanaminthe, Haiti

This project works with marginalized youth to deliver peer education and strengthen youth advocates for structural change.

FEBs

Website/Facebook

Men who have sex with men 

In the north-west of the country, this project will deliver a peer education program targeting MSM; build capacity of MSM leaders, and sensitize community leaders to reduce stigma and discrimination.

Fondation SEROvie

Website/Facebook/Twitter

Men who have sex with men

In Port-au-Prince this project will target MSM.

Suriname

Name of organization

Target population

Project Summary 

Foundation He & HIV

HIV+ Men who have sex with men

This project provides outreach, referrals, testing and care and support for low-income HIV positive men who have sex with men.

Suriname Men United

Website/Facebook

Men who have sex with men

This project reaches gay-identifying men who have sex with men and develops media spots to address LGBT stigma and discrimination. 

“BUILDING ON WHAT WORKS: REPLICATING MODEL PROGRAMMING AND ADVOCACY INTERVENTIONS AND DEEPENING CARIBBEAN COMMUN

Guyana

Name of organization

Target population

Project Summary 

Artistes in Direct Support

Website/Facebook

Marginalized youth

This project targets young men who have sex with men and aims to give them the life-skills and sexual reproductive health information they need as young men.

Youth Challenge Guyana

Website/Facebook

Sex workers

This project reaches low-literacy sex workers in mining communities with a minimum package of services.

Volunteer Youth Corps Inc.

Website

Marginalized youth

This project provides peer education, income generation training and case management for marginalized youth.

SASOD

Website/Facebook/Twitter

LGBT

This project addresses stigma and discrimination towards LGBT people in Guyana through targeted campaigns.

Dominican Republic

Name of organization

Target population

Project Summary 

TRANSSA (Trans Siempre Trans)

Website/Facebook/Twitter

Transgender women living with HIV

provides a minimum package of services to HIV positive transgender women as well as information about safer feminization processes and access to primary healthcare.

GAYP

Website/Facebook/Twitter

Men who have sex with men

delivers an LGBT-led community radio show addressing a wide range of health and human rights issues in the community.

CAJIR (Consejo Asesor Internacional de la Juventud Rural)

Facebook

Marginalized youth

This is a peer education model with marginalized youth in an impoverished, rural community called Vallejuelo.  Youth are exposed to sexual reproductive health information through film nights.  Community health centers are sensitized on the needs of these youth.

Fundación Red de Jóvenes Unidos de Guachupita

Facebook

Marginalized youth

This is a youth-led peer education and empowerment model with marginalized youth in several of the most underserved and stigmatized barrios of Santo Domingo; where unemployment, drug-use, gangs, and family violence impact young people’s access to healthcare and result in teenage pregnancy and STI’s.

Centro de Promoción y Solidaridad Humana (CEPROSH)

Website/Twitter

Migrant sex workers

uses peer education in Creole to target migrant Haitian women engaged in transactional sex and sex work in Puerto Plata.  It includes sensitization of duty-bearers such as police and health services to address structural violence and barriers to health services.

Red Nacional de Jóvenes viviendo con VIH/SIDA(REDNAJCER)

Website/Facebook/Twitter

Marginalized youth

This project builds on the findings of the community monitoring system built in Phase I, and will sensitize SAI’s (centers of attention, care and support for PLHIV) about the findings of the Phase I study which showed high levels of perceived and real discrimination towards marginalized youth.

Fundoreda

Website/Facebook/Twitter

Drug users

This project is a drug user-led, needle exchange program targeting both non-injecting and injecting drug users in Santo Domingo.  The project also includes sensitization trainings for decision-makers on the structural determinants of drug use and HIV, and highlights barriers for drug-user access to services.

Este Amor

Men who have sex with men

This is a peer education model with 15-25 year old men who have sex with men in the Eastern Province of the Dominican Republic.  The project tries to reach young men who have sex with men with a minimum package of prevention services as they become sexually active.

Movimiento de  Mujeres Unidas (MODEMU)

Website/Facebook/Twitter

Sex workers

This is a peer education model reaching non-identifying, home and street-based sex workers in Barahona, one of the poorest provinces of the Dominican Republic.  The project provides a minimum package of services for women and transgender sex workers, many of whom experience high levels of gender-based violence.

COTRAVETD

Website/Facebook

Trans sex workers

This peer education model aims to increase access to primary and sexual reproductive health care services for transgender women sex workers.

Social Mobilization & Capacity Building

Vulnerable communities, including, drug users, sex workers, marginalized youth, the disabled , men who have sex with men and, persons of trans experience, and other groups vulnerable to HIV need to be included in national and regional policy discussions and decision making related to HIV responses in the Caribbean. Meaningful inclusion requires some training and social mobilization processes to equip representatives with a mandate and understanding of their constituency needs; effective communication and committed leadership. CVC works to build capacity in these areas to enhance groups’ and individuals’ self-advocacy.

CVC has supported regional and national meetings of specific networks and coalitions where issues affecting the communities are discussed, joint advocacy positions taken and action plans developed.

CVC offers members and grantees regular training opportunities under specific, funded programmes. Areas of training have included:

  • Health care rights
  • “Sex Positive” – sexual and reproductive health and rights education
  • - Harm reduction
  • - Motivational interviewing
  • - Advocacy
  • - Project management and development including monitoring and evaluation and finance and accounting
  • - Introduction to communications
  • - Monitoring and Evaluation

Jamaica

Name of organization

Target population

Project Summary 

National Council on Drug Abuse (NCDA)

Website/Facebook

Drug users

This model integrates peer education and mobile outreach to people who use crack in Kingston, Jamaica.

Jamaica AIDS Support for Life

Website/Facebook

Men who have sex with men and sex workers

One of the region’s oldest civil society organizations reaching sex worker and MSM peers, JASL is scaling-up the quality of its interventions with increased training of its peers in sexual health.

Sex Workers Association of Jamaica 

Facebook

Sex workers

This sex-worker led project aims to provide empowerment and human rights education for sex worker peers and sensitize police officers in Jamaica.

ASHE

Website/Facebook/Twitter

Marginalized youth

This project provides theatre/edutainment interventions and voluntary counseling and testing with youth in Kingston.  It has a new social media component for Phase II.

Stand Up for Jamaica

Men who have sex with men

This new project for Phase II intervenes men who have sex with men in prisons in Kingston.

Jamaicans for Justice

Website/Facebook/Twitter

Marginalized youth

This project delivers sexual reproductive and human rights focused interventions with young people in institutions in Jamaica.  It has an advocacy component for structural change.

Strengthening Alliances & Partnership

“Two plus two make twenty-two” - CVC Executive Director.

Strengthening alliances and partnerships are the hallmark of the CVC’s work. Shared arrangements and approaches to prevention, treatment and care of HIV and AIDS are crucial. The structural barriers to accessing treatment and care have been so significant that it is only through combined efforts that effective response is possible and sustainable.

CVC has supported the formation of regional and national networks of specific vulnerable groups, providing capacity building to the new and existing networks. Working at several levels, CVC builds alliances and partnerships to build demand for and foster the enabling environment for prevention, treatment and care based on the human rights of all groups.

CVC mobilises technical and financial resources to support the work of service providing NGOs across the Caribbean helping to expand appropriate outreach, education and treatment services to key populations.

CVC is a member of a number of key organisations engaged in the regional and global response to HIV. These include, the Priority Areas Coordinating Committee of the Pan-Caribbean Alliance against HIV (PANCAP); the Executive Board of PANCAP – the Regional Coordinating Mechanism for the Global Fund Grant; the Governing Council of the African Black Diaspora Global Network and the Regional Advisory Board of the International Organisation on Migration and the Caribbean Regional Harm Reduction Network. Members of the CVC Board are on the governing body of the Caribbean Sex Work Coalition.

Advocacy

CVC spearheads as well as provides support to regional advocacy for stigma free services, social protection of vulnerable groups including removal of legislative barriers to HIV and for appropriate health treatment and care. CVC places a priority on strengthening leadership and social mobilization of groups to act on their own behalf and to impact national and regional HIV and health policy and programmes.

Priorities:

Stigma Free Services - Everyone has the right to quality health care. CVC and partners advocate for health and social services that are free of stigma and discrimination. Studies consistently show that stigma, discrimination drive fear and act as barriers to persons accessing care. As a result, the populations most in need of services are often the least served. Lack of access to health care is caused by several factors such as physical barriers in the case of rural populations, persons in facilities such as inmates, as well as physical challenges or legal, structural and cultural barriers in the case of MSM, Persons of Trans Experience, Sex Workers and marginalized youth. These barriers make specific populations disproportionately more vulnerable to HIV.

Rights-based training for health care and social workers is necessary so they better understand the social issues which affect sexual and reproductive health such as sexuality, gender and violence.

Health workers need to have the supplies and equipment to adequately respond to different needs and maintain universal precautions and at the facility level, enforcement of existing policies and implementation of sanctions when policies and procedures are not followed, is necessary to ensure accountability.

Social Protection - A key advocacy priority is social protection for all - adherence to and respect and fulfilment of everyone’s human rights. All countries have signed international human rights agreements and there needs to be coherence between these and national laws and policies. All persons should have equal access to justice: a legal framework that provides access to equal protection under the law; mechanisms for lodging complaints and securing redress and equal access to legal justice.

CVC advocates for countries to provide a legal framework for equal access to justice, policies that clearly adhere to equal treatment in services, and provide citizens (service providers, policymakers and communities) with information on rights and responsibilities so that persons understand risks and have the ability to make informed choices about prevention, treatment and care.

Transgenders

In most countries in the Caribbean, persons of trans experience are confronted by the challenges of punitive national laws and policies that adversely affect their basic rights, including the right to health, education, justice and social welfare. This often results in exclusion from social and civic participation; harassment and stigmatization; limited access to protection, justice and redress; and inadequate provision of health care services.

Data on HIV prevalence among persons of trans experience is limited in the region. Where information is available, it indicates significantly higher rates of HIV prevalence in women of trans experience. Estimates show that HIV prevalence for women of trans experience in the region range from 8% to 31% and there are few support programmes that address their specific needs. Where programmes do exist, they rarely include access to sexual and reproductive health services.

Drug Users

Globally, HIV prevention efforts have focussed on injecting drug users, one of the highest risk populations for HIV. While injecting drug use is not widespread throughout the Caribbean, some researchers have found that HIV prevalence in crack cocaine smoking populations is almost as high as those found in injecting drug users. Crack’s short-lived high and addictiveness creates a compulsive cycle where the user is constantly looking to repeat the first “hit” of crack. Caught in this cycle, users quickly deplete their finances and find fast ways to maintain their use, often exchanging sex for money or drugs. Crack cocaine also increases sexual desire and can increase unsafe sexual practices that put users at risk for sexually transmitted infections including HIV. Once a drug user is HIV positive, crack cocaine use accelerates disease progression. Read more on one intervention supported by CVC

MSM

In the Caribbean, Men who have sex with men (MSM) – those who are gay, bi-sexual or trans-gendered, face the greatest level of stigma, discrimination and social exclusion. Their lack of stigma-free access to health promoting services, legal barriers and the fear that is generated by a hostile environment have exacerbated their risk of HIV and other STIs. It is estimated that MSMs account for 10% of HIV transmission in the Caribbean and studies estimate high HIV rates ranging from 5 to 33%.

Across the region, self-advocacy among MSMs is growing and CVC has played a strong role in supporting this development as well as direct services, anti-stigma and discrimination public education campaigns and initiatives towards legal reform.

For more on CVC recommendations on interventions for MSMs in the Caribbean click here:

Mobile / Migrant Populations

Peoples of the Caribbean have always been highly mobile with movement within the region as well as to metropolitan centres and back.

Population movement has its risks and those who are most vulnerable include refugees, undocumented migrants, persons who are trafficked, displaced or deported. Members of these groups who are women, young or living with HIV or AIDS are especially vulnerable.

The most vulnerable of mobile and migrant populations face human rights abuses and hardships such as forced HIV testing, lack of access to HIV treatment and appropriate, general health care.

Mobile and migrant populations may not have the power to protect themselves, or might participate in high-risk sexual activity for survival. Migrants may experience language and/or legal barriers to accessing services and, in many instances, access to health services is quite limited. It is essential to include mobile populations in the response to HIV/AIDS in the Caribbean in order to improve their access to services for HIV/AIDS prevention, care and treatment.

For more on mobile and migrant as well as other populations most vulnerable to HIV, See PAHO publication here :

Sex Workers

Until recently, Caribbean states characterized the HIV & AIDS epidemics as generalized, rather than concentrated among high-risk populations. This was largely because of stigma and discrimination against vulnerable populations. As a result, an effective response to the spread of the virus among groups such as sex workers, and from sex workers to the wider population, has been lacking. The consequences are striking: for example, in Guyana, Jamaica, and the Dominican Republic, HIV prevalence among female sex workers is estimated to be 17%, 5%, and 2% respectively. By comparison, overall adult prevalence is much lower in all three countries, ranging from 0.9% (Dominican Republic) to 1.7% (Jamaica).

Where there are programmes, these have traditionally been aimed almost exclusively at female sex workers. However, the sex worker community also includes men who sell sex to women, men who sell sex to men, and transgender sex workers.

Click here to see more:

Marginalized Children & Youth

The AIDS epidemic has orphaned approximately 250,000 Caribbean children, according to data given in the US-Caribbean Regional HIV & AIDS Partnership Framework 2010-2014. The Caribbean Regional Strategic Framework on HIV/AIDS 2008- 2012 shows that HIV prevalence rates in young people range from 0.08% to 3.2%. In the Caribbean cultural norms and specific policies and Laws make it difficult for youth to access sexual, reproductive and HIV health services. Girls and young women face risks of abuse due to myths about cures for STIs as well as pressures for inter-generational and/or transactional sex due to poverty.