HIV/AIDS and VIRGIN ISLANDERS
The federal Centers for Disease Control and Prevention rates the Virgin Islands as reporting the fourth-highest incidence of new HIV infections among all states and territories on a per capita basis. About 1 percent of the V. I. population has tested positive for HIV (approx. 1,000 people).

According to a federally funded study in the Virgin Islands, women committed to what they believe is a monogamous relationship may be at the greatest risk of contracting HIV or AIDS of any group in the Virgin Islands. The 2001 study, resulting in the Rapid Assessment, Response and Evaluation (RARE) report, was designed to identify those groups of people most likely to engage in the kinds of behavior that can lead to HIV infection. The RARE project is part of The Crisis Response Teams Initiative, established as a public health assistance program from the U. S. Department of Health and Human Services.

Heterosexual women living with a single sex partner are most at risk because so many of them are married to or having relations with men who have multiple sex partners, female and/or male, and/or are using drugs injected by needle or obtained in exchange for sex. One of the greatest factors seen at play is denial - denial by women that their husbands or boyfriends were unfaithful, and denial by the men that the people they were cheating with were having sex with other people.

Another special concern in the Virgin Islands is the risk posed by men having sex with men (MSM). This is a deeply guarded secret, that almost no one will discuss openly, making it hard to gain the trust of such individuals and collect information from them.

Because of cultural taboos in openly admitting to or discussing homosexuality and the practice of men having sex with men, this population is clearly a significant risk group for the transmission of HIV/AIDS, both among themselves and to the women they may be involved with.

Teen-agers, followed by persons over age 50 are also at high risk in the Virgin Islands. Researchers said these two groups have one thing in common: the belief that nothing can happen to them. The drug Viagra may be putting seniors at greater risk. Older people having sex are less likely to use condoms, which could protect them from HIV.

The survey's findings on the "where" of contracting HIV in the Virgin Islands were consistent for all three islands. Respondents answered: anywhere there's night life - clubs, bars, strip clubs, brothels and dance halls.

St. Thomas beaches, alleyways, public markets and abandoned buildings are cited as the hot spots for transmission of the virus; as well as public service buildings such as schools, prisons, hospitals, homeless shelters and churches.

Because our community is so small, people are concerned about the privacy of their health care information. For confidential information on how HIV is spread, and where to go to get counseling in the Virgin Islands, click here to see phone numbers at the end of this page.

The other major factor cited in the spread of HIV in the Virgin Islands is the large number of people passing through the territory as tourists, boaters or immigrants, legal and illegal.
Reference for this section: Shimel, 2002.

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THE CDC'S 2006 INFECTION RATE FINDINGS
The latest research from the CDC reveals that the HIV epidemic is - and has been - worse than previously known. Approximately 56,300 new HIV infections occurred in the United States in 2006. This figure is roughly 40 percent higher than CDC's former estimate which was based on limited data and less precise methods of tracking.

Gay and bisexual men - referred to in CDC surveillance systems as men who have sex with men (MSM) - represented a significantly greater proportion of estimated new infections in 2006 than any other risk group. The term "men who have sex with men" is used in CDC surveillance systems because it indicates the behaviors that transmit HIV infection, rather than how individuals self-identify in terms of their sexuality.

Blacks - The rate of new infections among non-Hispanic blacks was seven times as high as that among whites in 2006, or 45%.

Hispanics - The rate of new HIV infections among Hispanics in 2006 was three times as high as that among whites, or 17%.

Whites - Whites accounted for 35% of estimated new HIV infections in 2006.

Asians/Pacific Islanders and American Indians/Alaska Natives -Asians/Pacific Islanders accounted for 2 percent of new infections and American Indians/Alaska for roughly 1 percent of new HIV infections in 2006.

Gender - Men accounted for the large majority of estimated new HIV infections in the U.S. in 2006 at 73%. Among women, incidence rose gradually until the late 1980s, declined towards the early 1990s, and has remained relatively stable since then.

Age - More infections occurred among young people under 30 (aged 13 - 29) than any other age group (34%), followed by individuals 30 - 39 (31%). These data confirm that HIV is an epidemic primarily of young people and underscores the critical need to reach each new generation of young people with HIV prevention services. Individuals over age 50 continue to represent a relatively small proportion of new infections.
Source: Centers from Disease Control and Prevention

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WOMEN, CHILDREN, AND CULTURE
Women
Social and cultural factors cause women in some settings to feel powerless to insist on the use of a condom. HIV/AIDS remains among the leading causes of death for U. S. women age 25-44, especially among women of color. Women who use non-injection drugs are at great risk of acquiring HIV sexually, especially if they trade sex for money or drugs. African American and Hispanic women represent less than 25% of all U. S. women, yet they account for 77% of all AIDS cases in women. Over the last decade, the proportion of cases among Hispanic women infected heterosexually rose from approximately 30% to 60%.

Children
In 2002, 2.3% of the cases of HIV/AIDS reported in the Virgin Islands , consisted of children.
Reference: Florida/Caribbean AIDS Education and Training Center, 2002

An HIV-positive mother can transmit HIV to her child during pregnancy, labor, birth or breast feeding. Transmission from mother to child accounts for 91% of U.S. pediatric AIDS cases. Treatment with HIV drugs has reduced this transmission by 75%.

One test bay save your baby's life. HIV infection has increased among women from all walks of life. If you are pregnant and have HIV infection, it can be passed on to your baby. However, there are steps that you can take to protect your baby from getting infected and help yourself stay healthy longer. Go to www.USFCenter.org/Pregnancy.

Culture
Men of color who have sex with men (MSM) account for an increasingly greater number of AIDS cases. Possible contributing factors include economic issues, such as high rates of poverty, unemployment, and lack of access to health care, as well as cultural factors, such as the fear of being considered homosexual. Because HIV is stigmatized as a homosexual disease in communities of color, MSM may be reluctant to identify themselves as gay or bisexual, and therefore fail to seek HIV testing or treatment. Because these men may not believe they are at high risk for HIV, they may unintentionally put their female partners and future children at risk.
Source for this section: National Institutes of Health.

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WHAT IS AIDS?
AIDS (acquired immune deficiency syndrome) is a disease caused by a virus called HIV (human immune deficiency virus). HIV attacks the body's immune system. A healthy immune system is what keeps people from getting sick. When people have AIDS, their bodies can't fight disease. They get sick easily and have trouble getting well. They usually die of an infection or cancer.
Source: National Institutes of Health

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HOW DO PEOPLE GET HIV?
HIV can only be passed from person to person through body fluids, like blood, semen and vaginal fluid. The most common ways HIV is passed are:

By having unprotected anal, vaginal or oral sex with an infected person.
By sharing needles and syringes for injecting drugs with an infected person.
Children born to infected mothers can also become infected during pregnancy.

How it is NOT spread - Although HIV can be found in the saliva of infected people, there is no evidence that the virus is spread by contact with saliva, which has natural properties that limit the power of the virus to infect. There is also no evidence that the virus is spread to others by kissing. No one knows, however, whether so-called "deep" kissing, involving the exchange of large amounts of saliva, or oral intercourse increases the risk of infection. Scientists also have found no evidence that HIV is spread through sweat, tears, urine, or feces.

Studies of families of HIV-infected people have shown clearly that HIV is not spread through casual contact such as touching, hugging, sharing food utensils, towels and bedding. The virus can't live very long outside the body, so you can't get it through casual contact, shaking hands, swimming pools, hot tubs, door knobs, water fountains, telephones, or toilet seats. HIV is not spread by biting insects such as mosquitoes or bedbugs.
Source for this section: Centers for Disease Control and Prevention

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RISK FACTORS FOR HIV INFECTION
You should be tested for HIV if you:

• Are a man and have had unprotected sex with a man.
• Are a woman and have had unprotected sex with a man.
• Use illegal injected drugs.
  
• Have had blood transfusions or received blood products.
• Have had many sex partners.
• Have a sex partner with any of the above risk factors.

Having a sexually transmitted disease such as syphilis, genital herpes, chlamydia, gonorrhea, or bacterial vaginosis appears to make people more susceptible to getting HIV infection during sex with infected partners.
Source for this section: National Institutes of Health

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SAFER SEX
The best ways to protect yourself from getting infected with HIV are to:

• Not have sex with a person who is infected or is having sex with others.
• Practice "safer" sex if you do have sex.
• Not share needles and syringes.

What is "safer" sex?
The "safest" sex is no sex. If you are having sex, "safer" sex is sex between 2 people who don't have HIV infection, only have sex with each other, and don't abuse injectable drugs.

Safer sex also means using condoms if you have any doubts about whether your partner is infected or whether he or she is having sex with someone else. Use male latex condoms every time you have sex.

If a man doesn't want to use a male condom, use a female condom. Female condoms may not be as effective as male condoms, but they offer some protection. Never let someone else's blood, semen, urine, vaginal fluid or feces get into your anus, vagina or mouth.
Source for this section: National Institutes of Health

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THE RIGHT WAY TO USE CONDOMS
Using condoms the right way is important to make sure you are protected. Latex condoms should be used during all sex acts, including anal, vaginal and oral sex. For oral sex on a woman, she can use a condom split lengthwise to place between her body and her partner's mouth.

Using contraceptive creams, foams or jellies with the spermicide (sperm-killer) called nonoxynol-9 along with a latex condom may improve your protection. This spermicide may kill HIV as well as sperm. The spermicide works best when put in the vagina too, rather than just on the condom.

Use only water-based lubricants (such as K-Y jelly) with condoms. Oil-based lubricants, such as petroleum jelly (such as Vaseline), baby oil or lotions, cause the rubber in condoms to break. Don't reuse condoms.
Source for this section: Centers for Disease Control and Prevention

Protect Yourself! Remember the sayings: "No glove, no love!", and "No condom, no sex, no compromise".

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SHOULD YOU BE TESTED FOR HIV?
Testing is the only way to know if you have HIV, and testing is the first step to getting medical care, counseling, and support if you need it.

You should get tested for HIV infection if you think you're at risk. Most HIV antibody tests are accurate if they are done 3 to 6 months, or longer, after you think you may have been infected. It takes this long for the antibodies to show up in the blood.
Source for this section: National Institutes of Health

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TAKING THE TEST FOR HIV
For info on taking the test in the V.I., go to the bottom of this page or click here.

These steps can help you prepare to take the test:

Source for this section: National Institutes of Health

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HOW THE HIV TEST WORKS
The HIV test shows if you have signs in your blood of the virus that causes AIDS. HIV testing has four steps.

There are HIV tests you can do at home If you are afraid to talk with someone about HIV, or to be tested locally. You can buy home HIV test kits at drug stores, which offer the advantage of privacy and anonymity. However, they are expensive and may not be covered by most health insurance plans. If you don't find them at V.I. drug stores, have a friend send you one from the States, or take a trip up north. If the test result is positive, you need to see a doctor right away. Your healthcare providers will give you the support you need before and after the test. You don't get this type of support with home tests, until you finally see a doctor.

A POSITIVE HIV Test means you have the HIV virus that causes AIDS. It will mean you can get medical care and support services to help you if you need them. For info for help in the V.I., go to the bottom of this page, or click here.

If you have tested positive for HIV, you must tell your past and present sexual partners. They should get tested too. Also tell any future sex partners. If you are now in a relationship, ask your doctor or nurse about how to explain your HIV status to your partner.

Let any other doctors you may have, and your dentist know that you have HIV. This will help them give you the care you need. Your privacy will be respected, and your doctor and dentist can't refuse to treat you just because you have HIV.

Medical care right away can help you stay healthy longer, avoid getting some illnesses caused by HIV, and get early treatment for illnesses that do occur.

A NEGATIVE HIV Test is not a guarantee that you don't have HIV or won't get it in the future. You should talk to your doctor or nurse and learn about ways to protect yourself from getting infected.
Source for this section: National Institutes of Health

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COPING WITH AN HIV POSITIVE DIAGNOSIS
Finding out that you are infected with HIV can be frightening. One way to fight your fear is to learn as much as you can about the disease. Knowing about HIV and AIDS will also help you take the best care of yourself. The best information comes from your doctor or your counselor, or from the national or local community AIDS resources. Don't allow your feelings about your past behavior, your lifestyle or the possibility that you gave HIV to others keep you from seeking help and information.

If you've been told you have HIV, give yourself permission to be afraid. It's OK. But don't let this fear keep you from doing all you can to help yourself. Here are some things you can do:

• Get medical checkups at regular intervals even if you're feeling well.
• Ask your doctor how often you should have a checkup.
• Always use a latex condom.
• Always practice "safer sex." If you don't know how, find out! Your doctor can give you information.

Help your body fight infection by:

• Drinking less alcohol and using less tobacco, or give them up entirely.
• Eat a balanced diet.
• Get regular exercise.
• Get enough sleep.
• Find out what causes stress in your home life and your work life and do whatever you can to reduce this stress.
• Don't share needles for drugs, steroids, piercing or tattooing.
• Get regular dental checkups-bleeding gums can increase your risk of infecting someone else.

The good news about HIV is that early treatment is helping many people with this infection live longer, healthier lives. It's normal to feel sadness, anxiety and fear when you first learn that you have tested positive for HIV. However, if you have trouble sleeping, eating or concentrating, or if you have thoughts of suicide, tell your doctor. If you are depressed or feel anxious, treatment can also help you feel better.
Source for this section: National Institutes of Health

Volunteer to work for an AIDS organization. Facing your fears directly can be a good way to cope with them. There are two such organizations in the Virgin Islands: VICARE and HOPE. See info at bottom of page.

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TREATMENT
The U. S. Food and Drug Administration (FDA) has approved a number of drugs for treating HIV infection. The first group of drugs used to treat HIV infection, RT inhibitors, interrupts an early stage of the virus from making copies of itself. Included in this class of drugs are AZT, and others. These drugs may slow the spread of HIV in the body and delay the start of opportunistic infections.

Because HIV can become resistant to any of these drugs, health care providers use a combination treatment to effectively suppress the virus. When RT inhibitors and protease inhibitors are used in combination,it is referred to as highly active antiretroviral therapy, or HAART, and can be used by people who are newly infected with HIV as well as people with AIDS.
Source for this section: National Institutes of Health

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ALTERNATIVE AND HERBAL THERAPIES
A health treatment that does not fit into standard western medical practice is called "alternative" or "complementary". This includes many different therapies, some of which are available in the Virgin Islands:

• Traditional healing practices such as ayurveda and Chinese acupuncture
• Physical therapies such as chiropractic, massage, and yoga
• Homeopathy or herbs
• Energy work such as polarity therapy or reiki
• Relaxation techniques, including meditation and visualization.

Alternative therapies can reduce stress, relieve some of the side effects of antiviral drugs, or have other benefits. In the United States, over 70% of people with HIV have used some kind of an alternative therapy. Some health insurance plans pay for therapies such as chiropractic or acupuncture.
Source for this section: Centers for Disease Control and Prevention

Herbal Therapies

Many Virgin Islanders use plants and herbs to treat their health. In "Traditional Plants of St. Croix, St. Thomas and St. John, Toni Thomas lists the following local plants as being used to treat loss of appetite, which many people with AIDS experience: Bay Rum, Bay Berry Tree, Cinnamon Bush.

For diarrhea which AIDS patients may experience: Kenip (Genip), Bay Cedar (Bitterbush).

In Mosby's Nursing Drug Reference (Skidmore-Rush, 2006), these herbs are listed for treating viruses or stimulating the immune system: Astragulus, Cat's Claw, Echinacea, Ginseng, St. John's Wort. As an appetite stimulant: Alfalfa, Angelica, Chicory, Fenugreek, Licorice. For diarrhea, : Fenugreek, Green Tea.

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SYMPTOMS OF HIV INFECTION
Many people do not have any symptoms when they first become infected with HIV. Some people will have a flu-like illness within a month or two after exposure to the virus. This illness may include fever, headache, tiredness, enlarged lymph nodes (glands of the immune system easily felt in the neck and groin).

These symptoms usually disappear within a week to a month and are often mistaken for those of another viral infection. During this period, people are very infectious, and HIV is present in large quantities in genital fluids.

More persistent or severe symptoms may not appear for 10 years or more after HIV first enters the body in adults, or within two years in children born with HIV infection. This period of "asymptomatic" infection is highly individual. Some people may begin to have symptoms within a few months, while others may be symptom-free for more than 10 years.

As the immune system worsens, a variety of complications start to take over. For many people, lymph nodes or "swollen glands" may be enlarged for more than three months. Other symptoms often experienced months to years before the onset of AIDS include:

• Lack of energy
• Weight loss
• Frequent fevers and sweats
• Persistent or frequent yeast infections (oral or vaginal)
• Persistent skin rashes or flaky skin
• Pelvic inflammatory disease in women that does not respond to treatment
• Short-term memory loss

Some people develop frequent and severe herpes infections that cause mouth, genital, or anal sores, or a painful nerve condition called shingles. Children may grow slowly or be sick a lot.
Source for this section: National Institutes of Health

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SYMPTOMS OF AIDS
Symptoms of opportunistic infections common in people with AIDS include:

• Coughing and shortness of breath
• Seizures and lack of coordination
• Difficult or painful swallowing
  
• Mental symptoms such as confusion and forgetfulness
• Severe and persistent diarrhea
• Fever
• Vision loss
• Nausea, abdominal cramps, and vomiting
• Weight loss and extreme fatigue
• Severe headaches
• Coma

Children with AIDS may get the same opportunistic infections as do adults. In addition, they also have severe forms of the bacterial infections all children may get, such as conjunctivitis (pink eye), ear infections, and tonsillitis.

People with AIDS are particularly prone to developing various cancers, especially those caused by viruses such as Kaposi's sarcoma and cervical cancer, or cancers of the immune system known as lymphomas. These cancers are usually more aggressive and difficult to treat in people with AIDS. Signs of Kaposi's sarcoma in light-skinned people are round brown, reddish, or purple spots that develop in the skin or in the mouth. In dark-skinned people, the spots are more pigmented.

Many people are so debilitated by the symptoms of AIDS that they cannot hold steady employment or do household chores. Other people with AIDS may experience phases of intense life-threatening illness followed by phases in which they function normally.
Source for this section: National Institutes of Health