On World AIDS Day Dr Prince Ramsey, KGCN; MB; BS; OD; OM, clinical care coordinator discusses one of the more technical aspects of HIV and AIDS

Clinical Care Co-ordinator for HIV/AIDS Sir Prince Ramsey is calling for mandatory HIV testing for people entering the prison system, pregnant women, sex workers and police recruits.

These groups, he said, should be targeted in an effort to protect them and others from the spread of the HIV virus.

Speaking first about prisoners in an interview with The Daily OBSERVER yesterday, Sir Prince said, “I think they should be isolated before they are placed in the general prison population until their results are in. You get a test on the day you arrive and if six weeks after, your results still show negative, then you go into the general population. If you are positive, you should be isolated … be with other HIV patients.”

Explaining the reason behind his view, Sir Prince said, “Once you have an all-male institution, there will be homosexual activities and although a man may not be a homosexual he may be forced into it. He may be raped or he may rape someone with HIV and he becomes positive.”

Making it clear he does not support homosexuality, the doctor said it would be wiser to distribute condoms in prison or do the mandatory HIV/AIDS test followed by the necessary action based on the inmate’s test result instead of doing nothing, because many prisoners have to return to society.

“People go in negative and come out positive. Yes, persons are saying don’t give them condoms but when they are exposed to it and they come out, they have families, a girlfriend, a wife or a male partner and those persons are then exposed to it,” Sir Prince said. “I am not telling them to go into the prison and practice homosexuality but people have to realise that these people come back into our society and then others are exposed to the virus.”

Sir Prince said there are more than one ways to conduct the tests and it’s free through the AIDS Secretariat.

In the case of prisoners the Rapid Test (an oral test from saliva) can be done where there might be need for urgency in obtaining the results.

“There is no doubt the prison is overcrowded and there isn’t the required space to do things the way we’d prefer, but there is the rapid testing where one can get the result of a test within a day,” he said. “We have the equipment over five years now. I have been doing rapid testing, over 35,000 tests and you can get the result in as little as seven minutes.”

Sir Prince added, “we’re always putting the cart before the horse,” which he explained meant, “persons enter the prison with the illness and we don’t know and sometimes they don’t know until they become ill and by that time they would have already been exposed to other persons by will or by force and that is exactly what we need to avoid.”

Just last week Minister of National Security Dr Errol Cort announced that there are four HIV/AIDS patients in the prison.

The HIV/AIDS clinical care co-ordinator also feels that sex workers should do compulsory testing and though the trade is illegal, those who ply it underground ought to ensure that their employees are tested to prevent the spread of the virus.

Pregnant women and police recruits, he said, should have mandatory tests. He said pregnant women should do the tests and commence treatment once found to be positive to prevent mother-to-child transmission.

All cases in Antigua where HIV-positive expectant mothers began treatment to prevent transmission of the virus to the baby have been 100 per cent successful, Sir Prince said.

“The cases where there was a transfer from mother to child are the cases where persons refused to get tested or refused treatment,” he noted.

In the case of police recruits, Dr Prince said the strenuous exercise that officers in training undergo, coupled with the HIV virus breaks down the immune system and the infected person becomes ill more often. People who are HIV positive ought to abstain from such strenuous activity, alcohol, cocaine, marijuana, among a number of other things.

Currently the Defence Force is the only group that carries out mandatory HIV/AIDS tests across the region.

Last year in Antigua & Barbuda, there were nine HIV/AIDS-related deaths, while in 2008 there were 16 such casualties and according to Sir Prince “those persons who died were not taking medication at the time.”