(New York) -- The HIV/AIDS epidemic in the Caribbean could be combated more effectively if the U.S. removed restrictions on how its aid funding is used, Amnesty International said in a new report. The organization found that privacy violations of citizens in Guyana and the Dominican Republic living with HIV/AIDS contribute to discrimination that undermines efforts to curb the spread of the virus.

"To combat the AIDS epidemic in the Caribbean effectively, policy makers in countries receiving aid should be permitted to utilize funds in ways that will enable them to uphold international human rights standards," said Larry Cox, Executive Director of Amnesty International USA (AIUSA). "The Bush administration should resist congressional attempts to cut current funding levels for HIV/AIDS initiatives and should remove the funding conditions which hamper universal access to effective treatment."

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) directs a large portion of its funding to programs that promote abstinence until marriage. Because PEPFAR requires recipient organizations to explicitly oppose both prostitution and abortion, it prohibits many sexual and reproductive health service providers from receiving aid. In addition, U.S. funds can be used to purchase antiretroviral treatments, but only those produced by pharmaceutical companies that have entered into partnerships with the United States -- not the cheaper generic treatments.

These restrictions are among a host of factors hindering progress on HIV/AIDS in the Dominican Republic and Guyana. Amnesty International's 32-page report, "I am not ashamed!": HIV/AIDS and human rights in the Dominican Republic and Guyana, documents rampant abuses in the treatment of those living with HIV/AIDS, from employment and healthcare discrimination to violation of patient confidentiality.

The report includes testimonies of:

• A Guyanese woman living with HIV/AIDS, who said: "I don't want them to think I am one of those people."
• A support counselor for people living with HIV/AIDS working in a clinic in Boca Chica, Dominican Republic, who said: "Everyone knows [the HIV test result] before the patient -- the janitor, other patients, nurses, everyone."
• Ramón, a Dominican living with AIDS who lost his job as a worker in a fruit juice factory after his doctor disclosed his HIV status to his employer without his consent.
• A human rights worker in the Dominican Republic, who said: "While the government is receiving lots of funding from the donors for HIV/AIDS work and treatment, people are dying only thirty minutes away from Santo Domingo with its shiny private hospitals. In the last two years, I have seen many, many people die needlessly for lack of medicines."

Fearful of the injustices they will invariably face if they test positive for HIV/AIDS, many Caribbean citizens are unwilling to get tested or treated for AIDS, thereby foregoing preventative measures and allowing the virus to continue spreading.

"The governments of the Dominican Republic and Guyana must take immediate steps to end all forms of discrimination against citizens living with HIV/AIDS," said Eric Olson, AIUSA Acting Director of Government Relations. "National legislation must be adopted and enforced to ensure that the rights of people living with HIV/AIDS are no longer violated and to help curtail the epidemic."

AIDS is the leading cause of death among Caribbean men and women between the ages of 15 and 44 and the region has the second highest percentage of people living with HIV/AIDS after sub-Saharan Africa.

Although pragmatic tools like condoms have proven essential in preventing new HIV infections, the report found that Dominican and Guyanese citizens receive little information about sexually transmitted diseases and virtually no information about condoms. AIDS prevention programming in both countries emphasizes abstinence and fidelity rather than condom education and distribution -- due in part to the strong influence of the Catholic Church, but also to conditions set by foreign aid donors.

According to the report, only 33 percent of Dominicans and 50 percent of Guyanese citizens requiring antiretroviral treatment actually receive it, due both to inadequate distribution systems and costs relating to travel, doctors appointments and testing.

In nearby Jamaica, a recent Amnesty International report on violence against women found that a pandemic of sexual violence, coercion and assault against women and girls puts them at risk for HIV infection. Adolescent girls there face the highest risk of infection, yet restrictions on funding limit their access to the best information and tools for prevention.

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"I am not ashamed!": HIV/AIDS and human rights in the Dominican Republic and Guyana: Read the report. »

Contact: Wende Gozan, 212/633-4247, or Ben Somberg, 212/633-4268

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