The islands of the Caribbean have HIV rates second only to those of sub-Saharan Africa. Two hours from South Florida shores the island of Hispaniola has the highest rates in this hemisphere.
There, in the Dominican Republic and Haiti, heroes have fought the epidemic with little but conviction and courage – some with new help now from U.S. money, some continuing without, but all with optimism.
In the popular tourist destination of the Dominican Republic, sex workers have infection rates at least three times higher than the general population. In the streets of Santo Domingo, the port town of Haina and beachside Boca Chica, they are stigmatized. This is their moment, says a doctor who calls them the "Heroines of HIV."
With new cases far outpacing access to treatment, a vaccine to prevent HIV transmission, or at least prevent progression of the virus in infected people is the only hope of controlling the epidemic, doctors and other research advocates say.
HIV has taken a terrible toll on a struggling population in Haiti, but a doctor researching and treating the virus since its appearance here says the people have marshaled their forces to and will win the battle against epidemic.
When the people in the poverty crushed squatters settlement of Cange said they needed a clinic 25 years ago, the then visiting medical student Paul Farmer listened. He has been listening and working with the people here ever since, and in the 25 years that have passed a medical complex rose on this spot that has set a worldwide standard for HIV care.
Dr. John May found his calling behind prison walls where he believes he can make a difference in inmates health and in their lives. The American doctor takes his conviction behind the walls of Haiti’s National Penitentiary where he challenges conditions there and continues to fight infectious diseases.
Some of the highest HIV rates in the United States can be found in Palm Beach County, where one in 42 black residents are estimated to be living with the virus. Here people who have fought AIDS for more than a quarter of a century here say opportunities to stem a growing minority epidemic were missed.