Geisha Kow­lessar

Car­ni­val is in full gear.

Fetes, scant­i­ly-clad gy­rat­ing women and al­co­hol ga­lore. But this com­bi­na­tion can lead to a dead­ly end-HIV and sex­u­al­ly trans­mit­ted dis­eases (STDs), in­clud­ing the hu­man pa­pil­lo­ma virus (HPV). And de­spite in­creased con­dom-aware­ness cam­paigns, spe­cial­ly tar­get­ed for the sea­son, Dr Pe­ter Gen­tle is warn­ing that the pop­u­lar la­tex con­tra­cep­tive is far from safe. "T&T is de­ter­mined that con­dom sex is safe sex and that is ab­solute­ly stu­pid," he said. "The fail­ure rate of con­doms is cu­mu­la­tive, which means the more in­ter­course one has, the more like­ly of be­ing in­fect­ed." He said there was a fail­ure rate of be­tween ten and 25 per cent with con­dom use in pre­vent­ing the spread of HIV."And with HPV the fail­ure rate is as high as 80 per cent be­cause the virus comes off your body out­side of the area cov­ered by the con­dom," he said.

He point­ed out that the virus came out of the pri­vate parts of the body. Win­ing, one of the main in­gre­di­ents dur­ing the Car­ni­val rev­ellery, may al­so prove fa­tal. Ac­cord­ing to Gen­tle, the HPV virus is al­so trans­mit­ted via skin con­tact. "If you have on a thong and you're win­ing on some­body who has on a thong, you are trans­mit­ting the HPV virus which comes off the na­tal cleft be­tween your legs," he said. "When peo­ple are en­cour­ag­ing chil­dren to wine that is a dan­ger­ous thing to do in terms of spread­ing the dis­ease." Gen­tle said HPV had been tak­en over by chlamy­dia as the most com­mon STD in T&T which is trans­mit­ted by vagi­nal, oral and anal in­ter­course.

Ris­ing STDs rate

Ac­cord­ing to sta­tis­tics, Gen­tle said 50 per cent of peo­ple car­ry­ing one STD were al­so like­ly to have mul­ti­ple in­fec­tions. Say­ing con­doms were ini­tial­ly in­vent­ed to pre­vent preg­nan­cy, Gen­tle said there was al­so a high fail­ure rate where that was con­cerned. "With some of the STDs, the fail­ure rate re­gard­ing con­doms is as­tro­nom­i­cal­ly high es­pe­cial­ly with her­pes and syphilis," he said. "The most com­mon STD in T&T is chlamy­dia but he­pati­tis B is 100 times more in­fec­tions than HIV and they all cause liv­er and jaun­dice prob­lems. "The on­ly two coun­tries in the West­ern Hemi­sphere where the HIV rate is not de­creas­ing is T&T and Haiti...T&T is in very se­ri­ous trou­ble," Gen­tle cau­tioned. He said de­spite a vac­cine avail­able for HPV, on­ly a small per­cent­age of the pop­u­la­tion was able to shell out $1,300 for it.

STDs high among stu­dents

Twen­ty five per cent of stu­dents at­tend­ing the Uni­ver­si­ty of the West In­dies (UWI) cam­pus at St Au­gus­tine and at the Uni­ver­si­ty of T&T (UTT) are in­fect­ed with STDs, ac­cord­ing to Gen­tle. "It's scary," Gen­tle said.

"Some of the stu­dents at UWI and UTT are to­tal­ly promis­cu­ous and I have been there to speak to them be­cause they are find­ing con­doms on the floor of UTT every day...They told me that them­selves." When asked if they were aware of what HPV was, Gen­tle said, five per cent or less of the stu­dents knew about the dis­ease. "And when you ask them about chlamy­dia, they look at you as if you're mad, be­cause they haven't even heard the word," he said. In­stead of dis­trib­ut­ing con­doms, he urged that peo­ple ex­er­cise faith­ful­ness and stick to one part­ner. "We need to change the at­ti­tude of peo­ple to­wards promis­cu­ity in sex and un­faith­ful­ness in mar­riage and we will nev­er do thing by pro­mot­ing con­doms for safe sex."

MR­SA in­fec­tion spread­ing in T&T

Amid a ris­ing STD rate, Gen­tle said the MR­SA (Mul­ti­ple-Re­sis­tant Staphy­lo­coc­cus Au­reus-al­so known as mer­ca, mer­sa, mer­cer in­fec­tion, gold­en staph) in T&T-was al­so rapid­ly spread­ing. "This par­tic­u­lar in­fec­tion is re­sis­tant to every an­tibi­ot­ic ex­cept one which has to be in­ject­ed," he said. "It is as­so­ci­at­ed with promis­cu­ity and it is found in the pe­nis, vul­va and anus. We al­ready have MR­SA in Trinidad. We are right up to date." He said in some in­stances peo­ple had died the from the MR­SA in­fec­tion in T&T.

HIV pop­u­la­tion ris­ing-NACC

An­drew Fearon, deputy tech­ni­cal di­rec­tor of the Na­tion­al Aids Co-or­di­nat­ing Com­mit­tee (NACC) al­so paint­ed a grim pic­ture of the fu­ture of T&T's health, cit­ing that each year some 1,400 new cas­es of HIV were de­tect­ed. But, Fearon said, that fig­ure may rep­re­sent a small por­tion of the pop­u­la­tion who chose to get test­ed. "Since 2004 to present, some 1,400 new HIV in­fec­tions are de­tect­ed each year...We have a steady rate of new in­fec­tions. "This means that the pop­u­la­tion of peo­ple liv­ing with HIV is get­ting big­ger and big­ger and it is an­tic­i­pat­ed to get to prob­a­bly 2.5 per cent of T&T's to­tal pop­u­la­tion in 2015," Fearon said. Due to the avail­abil­i­ty of med­ica­tion, Fearon said peo­ple were "liv­ing nor­mal­ly" with the virus.

He cau­tioned that one of the ma­jor chal­lenges with HIV was that the symp­toms do not demon­strate un­til sev­en or eight years af­ter sex­u­al con­tact.

In­crease of STDs/HIV at Car­ni­val

Car­ni­val isn't just about beads and biki­nis. It's a time where all cau­tion is thrown out the win­dow re­sult­ing in a height­ened sex­u­al ac­tiv­i­ty. Fearon said the sharp in­crease of births nine months af­ter the Car­ni­val pe­ri­od con­tin­ued to be one def­i­nite in­di­ca­tor of in­creased in­ter­course. Warn­ing that peo­ple keep their in­hi­bi­tions in check, Fearon said: "Peo­ple tend to go out to fetes and par­ties. "There is the mu­sic and drink­ing and net­work­ing all these fac­tors which lead to in­hi­bi­tions chang­ing," he added. Eng­lish-born Fearon, who has been liv­ing in T&T for the past six years, said be­cause there was more sex­u­al ac­tiv­i­ty dur­ing Car­ni­val that would ob­vi­ous­ly lead to an in­crease in the HIV in­fec­tion. He said a re­cent study was con­duct­ed in Sea Lots and Point Fortin, ex­am­in­ing the man­age­ment of sex­u­al be­hav­iour of young women. "We found that a lot of the women had mul­ti­ple re­la­tion­ships for eco­nom­ic gain," Fearon said. "In Sea Lots, there the eco­nom­ic gain was to get clothes, cell­phones, shoes and ac­cess to fetes and par­ties at dur­ing the Car­ni­val sea­son...So there were mul­ti­ple con­cur­rent part­ners tak­ing place."

Con­doms in schools

Con­dom ed­u­ca­tion could be in­cor­po­rat­ed in­to the school sys­tem, how­ev­er, it should not be ex­posed to stu­dents un­der the age of 16, Fearon said. "One of the fac­tors we have to think about is, it is rea­son­able to talk about con­doms to chil­dren over 16 years, but be­low the lev­el of le­gal con­sent it presents chal­lenges," he said. "So we have to use con­dom ed­u­ca­tion as part of a school-based ed­u­ca­tion sys­tem." Say­ing the onus was on the Ed­u­ca­tion Min­istry to en­cour­age lec­tures on sex­u­al­i­ty, Fearon said stu­dents must not on­ly be made aware of con­dom use, but al­so HIV, STDs and re­spon­si­ble be­hav­iour.

Fe­male con­doms un­pop­u­lar

Fe­males con­doms are too big, cost­ly, un­com­fort­able and dif­fi­cult to use. These fac­tors, Fearon said, had led to the dis­tinct un­pop­u­lar­i­ty of the con­tra­cep­tive. "Re­search showed that the use of fe­male con­doms hasn't been par­tic­u­lar­ly promis­ing," he said. "Most fe­males tend­ed not to like it main­ly be­cause it's a big con­tra­cep­tive...There is al­so the el­e­ment of com­fort and it takes a bit of ef­fort to use it," Fearon ex­plained.

The un­pop­u­lar­i­ty of the fe­male con­dom was al­so due to the high prices. A pack con­tain­ing three male con­doms is usu­al­ly priced at $10, while one fe­male con­dom could cost as much as $25.

"There are al­so so­cial fac­tors in buy­ing a con­dom," Fearon said. "In phar­ma­cies, con­doms are al­ways be­hind the counter, they are not out front. "It's al­so dif­fi­cult to get com­pa­nies to pro­mote the fe­male con­dom." While more males would pur­chase con­doms, Fearon said on­ly a small per­cent­age of fe­males might be pur­chas­ing fe­male con­doms.

No study on con­dom use

Ju­lia Roberts, re­gion­al rep­re­sen­ta­tive for T&T's Pop­u­la­tion Ser­vices In­ter­na­tion­al (PSI), said a study was yet to be con­duct­ed re­gard­ing the na­tion­al use of con­doms and con­dom sales. "No one has done any type of sur­vey re­gard­ing con­dom use, how of­ten they are pur­chased and used or about the health be­hav­iour gen­er­al­ly in T&T," she said. "It's alarm­ing be­cause we do have peo­ple com­ing in to ac­cess all dif­fer­ent types of ser­vices and those are the cas­es we know about but we don't know about the pop­u­la­tion that are not com­ing in and that is crit­i­cal." Say­ing de­mo­graph­ic health sur­veys were usu­al­ly ex­pen­sive, Roberts said plans, how­ev­er, were on the draw­ing board to be­gin sur­veys in cer­tain ar­eas where pock­ets of the pop­u­la­tion were deemed to be most at risk. Mass dis­tri­b­u­tion of con­doms, Roberts said, was not the an­swer to pre­vent the spread of STDs, but rather so­cial mar­ket­ing ini­tia­tives.

"We work on so­cial mar­ket­ing strate­gies so that peo­ple would see the val­ue for them­selves in pur­chas­ing con­doms," she said. "What we have found is that giv­ing away con­doms free may have a re­verse ef­fect in that some peo­ple may not want to use it and it would not change the be­hav­iour." "We fo­cus on pri­mar­i­ly peo­ple who are sex­u­al­ly ac­tive and try to en­cour­age pos­i­tive be­hav­iour change."

WHAT IS MR­SA

MR­SA is a bac­teri­um that's re­sis­tant to treat­ment with com­mon­ly-used an­tibi­otics. MR­SA stands for me­thi­cillin-re­sis­tant staphy­lo­coc­cus au­reus. Bac­te­ria in the MR­SA fam­i­ly are of­ten re­ferred to as staph in­fec­tions that cause boils and ab­scess. Over time, sev­er­al bac­te­ria have mu­tat­ed, mak­ing them dif­fi­cult or even im­pos­si­ble to treat.