We presume a half-million people are infected. It s off the charts. Excluding Cuba, where extensive testing and prevention keep rates low, the Caribbean has around 25 million people. That means one in 50 may be infected four times the U.S. rate. As in Africa a decade ago, there is growing incidence among women, heterosexual males, children and young people.
Poverty is a factor.
Equally important are a complex of destructive societal norms, experts say, including early sexual experience, taking multiple partners, a religious bent discouraging discussion of sex and a distaste among men toward condoms and submissiveness by women who don t insist on them. Virulent homophobia also induces bisexuals to lead secret double lives and causes people to assume wrongly that AIDS is mainly confined to the gay community. Governments, with exceptions like the rich Bahamas, seem overwhelmed. Only some pregnant mothers are helped with AIDS medicines. B ut help may be on the way.