While every sexually active person is at some risk of contracting HIV there are some communities, which are more susceptible than others. Most of these communities can be found, to some degree, here in the Turks & Caicos Islands.
Females are twice as likely as males to contract HIV from an infected partner during unprotected heterosexual sex, because of their anatomy. Women and girls are also more vulnerable to HIV due to gender inequality. A woman's power to refuse sex (or to negotiate the use of a condom) may be limited if she is economically and/or socially dependent on a man.
Even though it is common in many Caribbean cultures for men to have unprotected sexual intercourse with multiple partners, women are often still unable to ask their partner to use a condom for fear of distrust or abuse.
Most HIV infections worldwide are sexually transmitted. Therefore sex workers are at higher risk. Not only because they have multiple sex partners, but also because in many places sex workers have no rights - which means they are powerless to insist on condom use or resist violence or forced sex.
Typically, HIV first becomes prevalent within vulnerable groups in urban areas, and then extends into the rural areas as the epidemic spreads. In sub-Saharan Africa, urban dwellers who are HIV+ usually return to their rural homes when they become sick, so that their families can care for them, and then look after their children when they die. This causes major problems in the rural communities because the families cannot afford to spend time taking care of their sick family members in place of working to have enough money to support the household. In addition to this, rural areas often have little or no access to HIV prevention, care or support.
Men who have sex with men (MSM) are another vulnerable group. This is not a sexual identity, but rather a behaviour. Many men who have sex with men do not consider themselves gay or bisexual. In some situations sex is forced, for example in prisons.
Sex between men occurs in every society, with no exceptions. The only difference is that in some cultures sex between men is extremely stigmatized, and publicly denied. In these circumstances the female partners of men who have sex with men are generally unaware of their partner's affairs, putting them at risk as well.
In a number of countries HIV prevalence is much higher among prisoners than in the general population. HIV spreads quickly through prisons because many inmates who have been convicted of drug-related offences are able to continue their habit while in prison. In addition to this, homosexual activity occurs regularly in men-only environments such as prisons. Although a good deal of sex is consensual, some prisoners commonly assert dominance using forced sex.
Inmates must rely on prison authorities for access to information on HIV (and other STIs) and to health services, and also to supply them with condoms and clean needles. However, in some cases these authorities prefer to act as if sex and drug use do not happen - instead of dealing with the implications of having illegal activities occurring inside the prisons.
In conclusion, while it may be said that unprotected sex will occur regardless, preventive measures like educational programmes geared at abstinence, one faithful partner, and/or proper condom use should be encouraged if we are to ensure that our citizens enjoy an HIV free status.
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