Dr Duane Sands, Minister of Health. Photo: Shawn Hanna/Tribune staff
By MORGAN ADDERLEY
Tribune Staff Reporter
madderley@tribunemedia.net
HEALTH Minister Duane Sands yesterday suggested the government consider a nationwide HIV testing campaign in the wake of a Ministry of Health report that estimated 1 in 50 people in The Bahamas has the virus.
"We should be demanding that every single adult in The Bahamas knows their HIV status," Dr Sands told The Tribune yesterday.
On Wednesday, The Tribune reported on Index Mundi's statistics that the Bahamas ranks 17th in the world for HIV/AIDs adult prevalence rate.
This is the highest rate in the region, and highest in the world outside Sub-Saharan Africa.
"A lot of people have been mortified by the reality of the national HIV prevalence," Dr Sands said. "But that surprise or that response fails to acknowledge the fact that we didn't get here by accident."
One major factor Dr Sands attributed the prevalence of the disease to is the national tendency toward conservatism -- a conservatism that does not necessarily translate to behaviour.
He added that solving this problem, is going to require a "dramatic shift" in how we view the "actual practices of Bahamians".
"I think we have to first of all understand that the level of conservatism as it relates to human sexual behaviour has not served us well," the Health Minister said.
"Two, we need to be a lot more progressive in terms of teaching our young people, and our not-so-young people, about the real risks of sex."
"We need to make available condoms or barrier methods universally. And that requires a conversation about how far we should go."
He continued: "We should be demanding that every single adult in The Bahamas knows their HIV status. Every single one. Whether you're married, unmarried, single, or believe that you're in a monogamous relationship."
When asked how often individuals should get tested, Dr Sands suggested a campaign.
"I certainly think in the first instance, we ought to have a campaign that every single Bahamian who is sexually active gets tested within the next 12 months. Now, in terms of the frequency subsequently, that would vary from individual to individual."
Those with multiple partners should get tested more often.
"There are many things that we acknowledge about life in The Bahamas, but we don't acknowledge the fact that sex is the national pastime," Dr Sands said.
"We further don't acknowledge that Bahamians engage in sex with multiple partners, that we engage in homosexual and bisexual relationships, and if we do, then we have a proclivity to stigmatise men who have sex with men and commercial sex workers."
The Health Minister also acknowledged that there are other sexually transmitted infections (STI) people have.
Unfortunately, the database is not as "robust" or "validated" as the local data on the prevalence of HIV.
However, Dr Sands said, "There is a direct correlation between the transmission of HIV and other STIs," adding that people who carry HIV generally also carry chlamydia and herpes.
Noting that people also suffer from syphilis, gonorrhea, and other STIs, Dr Sands reiterated that everyone has a right to quality healthcare.
He said that his ministry will be "ramping up" its capacity to test anyone who wishes to be tested at little or no cost.
He added they are working to make testing available with a level of confidentiality and discretion so people are less afraid to get tested.
"There are not only blood tests but saliva tests that are quite reliable, that don't require any discomfort on the part of the individual. And where there results can be made available within 15 or 20 minutes."
Dr Sands added that making testing available at any health clinic is one of the plans for 2018/2019.
The Health Minister also said there strains of HIV in the country that are resistant to some therapies.
"The other problem that we have is notwithstanding the fact that we have universal availability of antiretroviral drugs, we now know that there are strains of HIV in The Bahamas that are resistant to first- and second-line therapy," Dr Sands said.
"And so, we are now having to expand the potency of medications available to Bahamians for the treatment of HIV. And if we don't do this, then what happens is that these resistant viruses will spread throughout our community."
While first-line therapy is available and free, the fact that there are "small numbers of individuals" who are infected with resistant viruses means the country has to access new drugs, which are "dramatically more expensive".
Dr Sands said that the more resistant strain is not cause for alarm. However, he said Bahamians should be concerned about what has been our reality "for more than 15 years".
"We have, once again developed a level of complacency. And a part of reminding Bahamians of what is happening in our community is a call to action. That, hey, it cannot be business as usual."
"That any sexual relations with any partner ought to be predicated by responsible behaviour. Which means Know Your Status and Know the Status of the individual that you're about to have unprotected sex with. "
"Let me take this a little bit further. There are individuals involved in relationships with persons who they believe to be monogamous. But those individuals are not. They may be having sex with multiple partners. And so, every body ought to know their status. And you ought to know the status of every person you're sleeping with."
Dr Sands also reiterated that HIV can now be a "chronic disease". However, living with it requires management.
"In order to do well with HIV, it requires continuous engagement with a competent, capable, compassionate physician or healthcare team. It's going to be monitoring the number of viral particles in the blood [etc]."
It is only when you have control of the infection that you can lead a normal life."
"For those individuals who are not HIV positive but who are engaged in high-risk behaviour, you ought to avail yourself of prophylactic treatment."
"If you're going to be having sex with men or sex with commercial sex workers, or sex with multiple partners."
Comments
joeblow 6 years, 5 months ago
Sands keeps missing the point. The high HIV rates are symptomatic of more deeply rooted social issues. If we can create a culture of higher standards and moral values all of our social ills would decrease, including HIV.
Pastor_Cedric_Moss 6 years, 5 months ago
I fully agree: Dr. Sands is missing the point big time!
In the face of our nation's HIV reality, which is driven by both heterosexual and homosexual sexual promiscuity, it's easy to call for every sexually active adult to be tested or for every sexually active Bahamian (which would include minors) to be tested (both statements are attributed to him, so I'm not sure which he is calling for).
But I wonder if Dr. Sands would be willing to admit that carnival, considering the sexual promiscuity that it promotes, should be banned from our streets and public spaces? I also wonder if he would be willing to support raising the age of heterosexual sexual consent from 16 to 18 to match the age of homosexual sexual consent? This would no doubt go a long way in helping to reduce the rate of HIV infections among this age group of minors, many of whom are infected with HIV by older men. I also wonder if he would be willing to support similar laws that were passed in the UK whereby cable television companies can only offer pornography to customers who specifically request it, rather than allowing Cable Bahamas and BTC's FLOW TV to mass peddle their pornographic offerings on the menu of every customer of theirs? I doubt it. And that's because Dr. Sands and those who think like him believe that a lack of condom usage is the reason for HIV infections, thus condom usage is the solution to HIV infections.
In all the reported quotes from Dr. Sands, none of them called for abstinence on the part of single people and the need for fidelity among married people. But that's old fashioned and unprogressive.
But the reality is that with nationwide testing, precious little, if anything, will change. Joeblow is right: "The high HIV rates are symptomatic of more deeply rooted social issues. If we can create a culture of higher standards and moral values all of our social ills would decrease, including HIV."
Dawes 6 years, 5 months ago
In the 1980's Bahamas had the highest per captia AIDS rate in the world. So we can't blame Carnival. One of the reasons for this was the stigma we put on homosexuals (from the public and the Church), which meant that many men lead a fake life, being married whilst still being homosexual. This was one of the reasons for the spread of AIDS as the man would get it and then pass it on to his wife who may or may not have been sweethearting. If people were allowed to be who they wanted to be then this number would never have got so high. In addition providing sex education is not going to end the world and in fact might actually save a number of people.
PastorTroy 6 years, 5 months ago
The idea of 'Banning' sexual promiscuity is impossible in the Bahamas, the internet offers much, much more flesh than some water down Carnival event. We just need to raise our overall standards in The Bahamas, spiritually, morally, EDUCATIONALLY, politically etc, but when so many of our so-call 'leaders' are living in glass houses who is bold enough to throw in rock in anyone yard?
Aegeaon 6 years, 5 months ago
I'm sorry, carnival has NOTHING to do with this random acts of tomfoolery around these parts. It's just backwards thinking on our behalf. Besides, at the very least, our carnival isn't full on nudity unlike Trinidad's version. Sure, it looks stupidly risky but it ain't anymore lewd than it is. You really don't know the full sense of pornography and nudity, and if it is so. That parade would be shut down. But there's NO evidence.
This pretty much proves that Christianity is becoming more and more despised and hated because of how humanity has desecrated it and dishonored their own people for being different.
Chucky 6 years, 5 months ago
you obviously forget where you are, we are a nation of beings not much better than animals, and in some cases not even a good.
Talk face to face with a politician, but be careful, usually theyre stuffing their face and spraying food all over your conversation.
There is no hope. Lest we get a Cat 5 hurricane to wipe away 80 percent of the problem
sarabahama 6 years, 5 months ago
Suggesting we get blown away by a Cat 5 is both ridiculous and disgusting!!
islandgirly15 6 years, 5 months ago
@Joeblow and @Pastor_Cedric_Moss You both are missing the point. Dr. Sands is a health professional and his job is to keep Bahamians healthy. His job is not to fix your moral compass, that is the job of moral leaders. Trying to push an abstinence only message as a healthcare official is malpractice. You want to wade into speculation but he has to deal with the facts. The fact is Bahamians have sex. The fact is we have a high disease prevalence. The fact is there are evidence based methods to reduce disease incidence and prevalence. As a health professional his job is to act based on facts, not based on your perceived moral failings of our nation. Promoting safe sexual practices and creating a more educated public, creates a safer public. You can wage war for the soul of the Bahamas, his job is to ensure we are healthy. None of what you stated will stop people from having sex, and you are only proving all of the points he's made. It's time for us to be frank and honest with who we are as a people. From a medical perspective, he has no choice but to see the country as it is.
joeblow 6 years, 5 months ago
Sorry you missed the point as well. The government has multiple ministries and resources to create a culture shift through education in any area they choose. Where there is sustained education and not just occasional references to sensible sexual practices, behavior will also change. The problem is we FAIL to train our people in areas of critical importance and learning to make proper decisions about not only what you put IN your body but what you DO with your body is of one of those. That's why they tell you to cover your mouth when you cough and don't drink and drive!!! Because you making certain choices can stop others from having a problem as well. So this is not just a moral issue but a health related one as well and is well within his ability to discuss.
People will not practice proper hygiene (bathing, hand washing, brushing your teeth etc) if not TAUGHT by someone and people will keep eating corned beef and hot dogs until they learn why they should not. We simply include the importance of abstinence as an equally important choice as monogamy. That is not only a moral decision, but a healthy one as well!
John 6 years, 5 months ago
One question that was never answered is what his the status of a child born to hiv + parents when he/she becomes sexually active. For more than 20 years now doctors have been saving the lives of HIV children but what consequences is this having today. Secondly there are videos circulating that The Bahamas was selected as a suitable population to test certain diseases, including encephalitis by spraying the virus in the air unknowingly. Then there was the suggestion a few years ago that Bahamians be used to test Aids vaccines. The method would be to inject non infected persons with the vaccine. And while they would test positive for aids they were to not develop the disease. Finally a one in 50 infection rate for Aids would indicate that the Aids rate in The Bahamas has doubled in the past two decades. Understandable is the fact that more persons are on treatment for AIDS but their habits remain unchanged. So the infection rate will continue to skyrocket.
TheMadHatter 6 years, 5 months ago
Sands needs to stop insulting our religion. There is no HIV in the Bahamaa. None !!! And the reason is simple. We don't have sex. We are CHRISTIANS !!!! Christians don't gave sex. We don't even talk about sex.
licks2 6 years, 5 months ago
Yea bouy. . .doc missing the point here. . .I cringed when he made that statement!! Sounds altruistic but he must remember that we have a democracy here. . .each man can get tested if he wants to. . .NO GOVERNMENT MUST TELL HIM HE MUST. . .OR MAKE HIM DO SO!!
Now if the good doc wants to get us to tested. . .set up the testing stations. . .let us come. . .but to have government "make us" get tested. . ."BOUY YOU DON'T KNOW WE AYE". . .
bogart 6 years, 5 months ago
.....youse gat dat right Hatter.....some 3000 churches plus allegedly one woman in white tresspassing on somebody front poarch.?cant be wrong...we is christian ...Sands barkin up da wrong tree blaming dis christian nation.....why even da Preamble says we Christian.....mudda sic...what next...corruption.??...slackness...??inefficiencies....??..family friends...lovers.??....same ol..same ol...??
sheeprunner12 6 years, 5 months ago
There is nothing wrong with making a blood test a part of the annual check-up of everyone ........ and then you can check for ALL kinds of diseases and related matters.
licks2 6 years, 5 months ago
They doing that right now as we speak. . .each public hospital or private doctor's office do that. . .they pull out them long list of things and they "ASK" you what you want done. . .they will check to see who is ya daddy (lol) if you ask them to!! But they will not do any one test you refuse to have done!! So that leads me to believe that that is not want the good doc means. . .he implied "government mandated" test for HIV!! That's gern too far there. . .
John 6 years, 5 months ago
And sometimes we cannot always follow the advice and instructions of the experts or authorities. For example, while the experts advise persons to avoid the sun to avoid cancer, this is the correct advice for white people who absorb sun rays very quickly and have to limit exposure to the sun. But lack of sun allows cancer (mainly breast and prostate) and other diseases to develop in black people and grow at a faster rate than in persons who get regular sunlight.
Spectrum87 6 years, 5 months ago
Must after the strip clubs that are legal but they are armed by officers.
TalRussell 6 years, 5 months ago
I people public challenge Comrade Dr. Duane to produce even an ounce credible evidence which supports why he thinks mandatory testing will alter sexual behavioral.... why not spend the public purse's money to educate the many thousands couples who will be getting married not knowing if either partner has HIV... resulting transmission newborns... or maybe Doc wants also think newly married couples will not engage in sex. Hopefully, the red government is not planning keep HIV directory.... and who will have access such directory?
sheeprunner12 6 years, 5 months ago
There is an old saying ........ If it feels good, let it kill you ....... That saying describes 95% of Bahamians ...... Bahamians "feel" macaroni, greasy chicken, Biggie soda, cake & ice cream, free or paid sex, and gapseed ......... Doc Sands cannot change that by any mandatory testing ...... My God, the people are resisting mandatory evacuation in the face of Cat4 hurricanes .......... SMH
Future 6 years, 5 months ago
I always knew it would not be long before Ernie showed his crazy
sheeprunner12 6 years, 5 months ago
Doc Sands is not crazy .......... Bahamians are generally stupid and close-minded aka "conservative" .................. SMT
John 6 years, 5 months ago
@sheeprunner don’t let your own ignorance and prejudice mislead you.
Well_mudda_take_sic 6 years, 5 months ago
Sands will next be demanding that the state force all gay men who test positive for HIV to have their peckers cut off.
Is Sands now acting for the interests of private health insurers? Can you imagine a state controlled register of those individuals who test positive for HIV getting into the hands of private health insurers? Or is Sands proposing to have government compensate HIV patients for whatever private health insurance benefits they may lose as a result of a government enforced mandatory HIV testing policy? And what about all those tourists that come our way? Is Sands proposing they not gain entry to our country without providing Bahamas immigration with adequate proof that they are free of HIV? A number of studies done by international health agencies have concluded that our country's HIV problem is integrally linked to our illegal immigrant problems. In fact, some of these studies have determined that more than 50% of our HIV problem is tied to illegal immigrants from other countries within our region of the world. Is Sands going to suggest we ban all travel to the Bahamas from a country like Haiti?
Yep, we seem to have found yet another MD politician who may not have been among the brightest crayons in his graduating class from medical school.
licks2 6 years, 5 months ago
Excellent points. . .the perfect logical conclusions to doc's statements. . .this one is a no-brainer. . . his statement will get him in hot water fast. . .
hrysippus 6 years, 5 months ago
And just like that The State has a blood sample of every citizen and resident of this country. Does the State own our DNA, Does it have the right to examine it to determine what diseases we are likely to get, whether the man we think is our daddy is really our daddy, our projected life span, our inherited proclivity to engage in unlawful behaviour? You will soon be able to find out a lot about a person by examining their DNA from a blood sample. George Orwell's 1984 is beginning at chapter 1. Or perhaps I am wrong and all our elected and appointed government leaders and workers are honest honourable people and always will be. By the way, are you interested in buying the Paradise Island bridge because I know a man who knows a man....................
Future 6 years, 5 months ago
In defense of Ernie's smarts, if I remember correctly, he had the highest SAT scores in the Bahamas in his graduating year and got full scholarship to any school he desired. Hence, WMTS, it may be more apropos to say: He's BRILLIANT, just not very bright.
Porcupine 6 years, 5 months ago
I heard Hitler was very smart too. We need to defend decency, not book smarts. Perhaps Sands has both.
Greentea 6 years, 5 months ago
I think this is the most honest statement on the proclivities of Bahamians I have ever heard by a politician. The response above is sad. It is important for Bahamians to know their HIV status. I am sure it would root up a lot of crap because many faithful men and women would have to confront the people they live with and gave it to them. We like ignorance though just not the consequences. The consequences of HIV/AIDS is still death and in truth the Bahamas has done an amazing job in keeping the status of people who have been diagnosed as HIV positive private. So all of your DNA/Privacy issues listed above, while not unimportant- have no supporting evidence in the history of HIV/AIDS treatment in the Bahamas. And to hear Pastor Moss spill the nonsense above in relation to this epidemic is beyond sad. The age of consent needs to rise for many reasons- none have to do with HIV/AIDS which was raging in the Bahamas long before carnival.
Truism 6 years, 5 months ago
The consequence of life is death. Enlightened as we are, our great grand parents seem to have had a greater grasp of human sexuality than we do. We were born with the urge some are able to govern it better than others.
joeblow 6 years, 5 months ago
People have been encouraged to let the urge control them rather than them control the urge. Too few want to practice self restraint!
sheeprunner12 6 years, 5 months ago
Bahamian politicians (especially the males) are known for having big sex appetites ...... Therefore, Doc Sands should publicly have ALL MPS and Senators tested live on the Parliamentary Channel and then ask Joe Public to do the same ...... Lead by example.
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