Is HIV/STD control in Jamaica making a difference?

Jamaica established a comprehensive HIV/sexually transmitted disease (STD) control program in the late 1980s explicitly defining the AIDS epidemic as an HIV epidemic and emphasizing prevention. Findings are presented of an assessment of the impact of the comprehensive HIV/STD Control Program upon the HIV/AIDS epidemic based upon AIDS case reports; the HIV testing of blood donors antenatal clinic attenders food service workers STD clinic attenders female prostitutes homosexuals and other population groups; the monitoring of syphilis cases; and results of national knowledge attitude and practice surveys conducted in 1988 1989 1992 1994 and 1996. The annual AIDS incidence rate in Jamaica increased marginally over the past 3 years from 18.5/100000 population to 21.4/100000 in 1997 with HIV prevalence in the general population groups tested being about 1% or less. HIV prevalence rates have risen to 6.3% in STD clinic attenders 10% and 20.6% among female prostitutes in Kingston and Montego Bay respectively and as high as 30% among homosexuals. Syphilis rates and the number of congenital syphilis cases have declined. The proportion of men aged 15-49 years reporting having sex with a non-regular partner declined from 35% in 1994 to 26% in 1996. The percentage of women reporting having ever used condoms increased from 51% in 1988 to 62.5% in 1992 and 73% in 1994 and 1996 while condom use with a non-regular partner increased from 37% in 1992 to 73% in 1996. 81% of men ever used condoms and 77% had used them with non-regular partners. Gay men inner-city adults and people aged 12-14 years all reported increases in condom use while condom sales and distribution increased from around 2 million in 1985 to 10 million in 1995.