RESUMO
OBJECTIVE: To describe the HIV/AIDS epidemic in Jamaica. METHODS: Data from the national surveillance system for HIV infection and AIDS based in the Epidemiology Unit, Ministry of Health, were reviewed. These include case reports; HIV screening of blood donors, migrant farmworkers and US visa applicants; sentinel surveillance among antenatal clinic (ANC) attenders and sexually transmitted disease (STD) clinic attenders; and various serosurveys. RESULTS: A total of 669 AIDS cases were reported in Jamaica from December 1993 representing a cumulative AIDS case rate of 28 per 100,000 population. Since 1987 the annual AIDS case rate doubled every 2 years with 69% of individuals having died with AIDS. Heterosexual transmission predominates with the cumulative adult AIDS male-to-female case ratio declining from 2.8:1 in 1988 to 1.9:1 in 1993. A total of 55 children with AIDS account for 8.2% of all cases. The HIV infection rate per 1000 in 1993 was 3.8 among blood donors, 1.4 among ANC attenders and significantly higher among STD clinic attenders (men 6%, women 2.7%), homosexuals (9.6%), female prostitutes (12%) and individuals with repeat STD infections (10%). Consistent condom use increased from 27% in 1989 to 47% in 1993. CONCLUSIONS: HIV infection was introduced into Jamaica from abroad through several different routes including the Jamaican homosexual community, migrant farmworkers, female prostitutes, and informal commercial importers. HIV transmission is well established locally and is spreading more rapidly in Western Jamaica and along the North Coast, which may reflect increased sexual activity associated with tourism. Although awareness of AIDS and HIV is high and condom use has increased considerably, there are no grounds for complacency concerning the HIV/AIDS epidemic in Jamaica.