The Social Solution for AIDS
By Meredith McGroarty
When those of us who are mainland Americans think of the US Virgin Islands, we envision their hallmark white beaches, pastel-colored houses, and the charming marine animals that appear in advertisements for snorkeling expeditions.
We almost certainly don’t think about the territory’s shockingly high rate of HIV infection or the widespread poverty that contributes to it—two interrelated problems caused partly by the very tourism industry that drives the islands’ economy.
John Wodarski, professor of social work, recently received a five-year, $2.2 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) for a project aimed at preventing HIV infection among young adults in the Virgin Islands. The challenges are many and the need is great, he says.
“Our primary objective is to get young adults tested so they can get the medicine they need,” Wodarski says. “In the Virgin Islands, the service network is extremely fragmented, and it’s hard for people to know where to get tested for HIV or where to get mental health or substance abuse services.”
The Caribbean has the highest incidence of HIV/AIDS in the world outside of sub-Saharan Africa. The US Virgin Islands have significantly lower infection rates than some other Caribbean nations, but they’re still much higher than the rates for the United States as a whole.
By collaborating with various local health agencies and nonprofits, Wodarski seeks to strengthen HIV prevention education, increase participation in voluntary HIV testing efforts, and connect people with available services. The program, which focuses on Virgin Islanders aged 18 to 26 who are at high risk for infection, also sponsors health fairs, distributes condoms, and instructs people on how to properly clean needles.
“The program has been extremely successful thus far,” Wodarski says. “I think we’ve tested about 400 people in the last few years, which is unheard of for HIV. If people test positive, we refer them to the health clinics. If they have any mental health or substance abuse issues, we refer them to the appropriate services.”
For the past decade, Wodarski has been part of a UT project that trains native Virgin Islanders to be social workers. The network created by the program has given Wodarski a strong base of professionals who can more effectively educate members of the local community about HIV prevention and testing.
“They can go on TV and out to schools, bars, and churches—where people hang out,” he says. “And as social workers, they already work with people who have problems or are at risk, and they know how to reach them and others in the same situations.”
The challenges facing HIV prevention and education efforts are significant, and some stem from the islands’ greatest features. The beautiful landscapes draw millions of tourists every year, with tourism accounting for the majority of employment. However, tourism has also created an extremely unequal socioeconomic structure.
“I think there are three classes of people living in the Virgin Islands: the poor, who either can’t find work or have a low-paying job, like as a maid at a resort; professionals like social workers and doctors; and then wealthy people with vacation homes who only stay for a few weeks or months a year,” Wodarski says. “There’s a sliver of very rich people, some professionals, and a lot of very poor people.”
Further hampering prevention and testing efforts is the high mobility of the Caribbean population. The Virgin Islands attract people from all over the region who are looking for work.
“We haven’t seen a real decrease in tourism in the Virgin Islands. The economy there is still fairly good, so many people from other Caribbean nations want to come to work,” Wodarski says.
Another mobile population at high risk for HIV is sex workers, who often come to the Virgin Islands because of the demand presented by the large numbers of short-term employees and tourists. Wodarski says it’s imperative to reach this population. He has instructed social workers to bring materials on HIV testing and counseling to the bars and other areas in which sex workers congregate.
There are significant barriers to stopping the spread of HIV/AIDS in the US Virgin Islands, and it will take a while to see sizable results, but Wodarski says he plans to continue the fight for years to come.
“We don’t intend to leave the islands, even when our grant is up. We’ll get another grant or foundation money or find another way to continue,” he says. “Really, we could be there forever, but at least we’re making a dent.”