In an interview with Trinidadian Newsday in mid-December 2019, Terrence Deyalsingh, Minister of Health of Trinidad and Tobago, made a controversial statement when he suggested that if the drug that prevents HIV, known as PrEP (pre-exposure prophylaxis ), if available, would encourage promiscuity.
Minister Deyalsingh made similar comments at the signing ceremony of the Joint United Nations Program on HIV and AIDS in 2016, aimed at eliminating the spread of HIV by 2030. At the ceremony, the minister made it clear that the Government would not allow access to PrEP through the public health system.
Deyalsingh's attitude towards HIV / AIDS prevention highlights Trinidad and Tobago's current struggle with HIV stigma and lack of sex education.
Although PrEP has been shown to reduce the chances of contracting the HIV virus, Deyalsingh said the government will not subsidize the PrEP drug because the promotion of its ministry's HIV / AIDS campaign is care after exposure, not prevention. He said that if people want the drug, it is available in the private health sector.
Deyalsingh mentioned exceptions to the rule, and citizens felt that his comments exacerbated the strong stigma of HIV / AIDS.
In the interview with Newsday, Deyalsingh explained that a worker in the health sector accidentally stuck a needle, for example, or in cases of sexual assault, those involved would have the treatment if there is a possibility of contracting the virus. While the World Health Organization classifies PrEP as an “essential medicine,” the minister explained his position:
PrEP is to give (…) to people before exposure or with no exposure to HIV… It means that knowingly you are going to engage in some sort of behavior that would cause you to be at a higher risk of getting HIV and you want to take a drug to prevent yourself from getting HIV. (…)
That is not government policy (…) It's a simple as that.
PrEP is giving (…) to people before exposure to HIV … It means that, knowingly, you are going to participate in some behavior that would put you at greater risk of contracting HIV and you want to take a drug to avoid getting HIV. (…)
That is not a government policy (…) as simple as that.
His comment was received with much criticism, especially from the approximately 29,000 citizens living with the virus – a small number, thanks in part to the initiatives of government agencies and non-governmental organizations dedicated to education, prevention and reduction of stigma. HIV AIDS.
HIV positive patients often face discrimination because of their health condition, and many cannot afford the necessary drugs through the private health system.
The Trinidad and Tobago Family Planning Association (FPATT) has insisted that the Government should make the drug available to the public, and has indicated that citizens have the right to access medication in the health sector public.
Donna Da Costa Martinez, executive director of FPATT, called the minister's statement “short-sighted”, rebuked Deyalsingh for contributing to the narrative that the drug encourages promiscuity, rather than educating the public about its purpose: to be a “useful tool to prevent HIV ”:
The statement is not only short-sighted but harmful, as the deciding factor then becomes grounded in a moral debate about human sexuality, an integral part of who we are and what we do.
The statement is not only short-sighted but also harmful, since the decisive factor is then rooted in a moral debate about human sexuality, an integral part of who we are and what we do.
Lack of sex education
The Family Planning Association, the Minister of Sports and Youth Affairs, Shamfa Cudjoe, and Minister Deyalsingh, representing the Ministry of Health, have stated that the country needs massive reforms in sex education, but the Ministry of Education.
Deyalsingh is in favor of sex education and admits that the fact that it is not taught contributes to the wrong information among young people:
Let’s not try to put our heads in the ground. Let’s just open our eyes, face the realities and make sure that we introduce sexual education adequate for the age of the students in schools.
Let's not hide the truth. Let's open our eyes, face reality and make sure we have sex education appropriate for the age of schoolchildren.
In any case, several religious entities in the country condemn the concept of sex education, especially the Council of Evangelical Churches of Trinidad and Tobago.
Despite the state mandate to have a secular vision when it comes to laws and policies, government officials, usually from the Ministries of Health and Education, are usually condescending to the interests of the country's diverse religious population and use religion as his reason for not developing a comprehensive sex education curriculum.
As a result, successive governments have had a “no intervention” policy when it comes to sex education, and many schools opt for a withdrawal approach, especially because of the fact that most schools in the country have religious affiliations.
Currently, the ministry has a Primary Health and Family Life Education (HFLE) curriculum with the goal of teaching children about sex, sexuality and sexually transmitted diseases. However, the program is not mandatory for teachers. As the ministry does not have many specialized teachers to teach the subject, they depend on the “goodwill of the teachers”:
These are the topics covered in the syllabus. And even after the MOE offered the teachers the option to NOT teach anything regarding sexuality; offering to send someone in specifically for that part… they STILL REFUSED to teach it. pic.twitter.com/be7zi7DDQ3
– miss (@jay_bean_) July 3, 2018
Of course … the program will be planned regardless of whether they have someone to teach or not. I even heard a teacher say “we will schedule it, we will only have a free period”.
These are the topics covered by the curriculum. And even after the Ministry of Education offered teachers the option of NOT teaching anything about sexuality, and offered to send someone specifically for that part … they continued to REFUSE to teach them.
In addition to this lack of sexual education there is much unplanned pregnancy and lack of knowledge about how sexually transmitted infections are contracted and persisted.
Dr. Kale Ferguson, chairman of the AIDS Coordination Committee, said in a speech in 2019 that the education of young people is key to preventing HIV and reducing stigma. The “most at risk” HIV group in Trinidad and Tobago are women between 15 and 24 years old.
For his part, Colin Robinson of the Defense Coalition for the Inclusion of Sexual Orientation (CAISO), which has promoted the use of PrEP as a preventive measure, has accused Minister Deyalsingh of “moral hypocrisy.”
According to Robinson, with his refusal to implement a policy to allow PrEP, the minister stands in the way of protection. He explained that the decision to make the drug available in the public health system rests solely with the minister, and regretted the ministry's position and said “We are not really strengthening communities to stop HIV.”
Other Caribbean territories, such as Guyana, have already implemented the use of the drug to prevent HIV and save lives.
Until the end of 2019, Minister Deyalsingh had not responded to the claims surrounding his statement.