Picture this: A country with white sandy beaches, azure oceans, ecologically diverse forests, nearly 100 percent literacy, universal health care and a 0.0001 percent rate of HIV infection. Never-never land? No, it’s Cuba.
The island nation has a long history of fighting HIV well. While its original approach was harsh—until 1993, everyone who tested positive was forced into quarantine indefinitely—its contemporary treatment and prevention methods deserve a medal. Cubans receive free health care—including antiretroviral (ARV) treatment. Only 38 babies have been born with the virus since 1986. Sex education is so comprehensive and administered so early it arms adolescents with an encyclopedic knowledge before they become sexually active. HIV testing is free and is widely available. And complimentary condoms can be found almost everywhere from snack shops to pizzerias.
But the situation isn’t quite as ideal as it seems. Only about half of the 11,674 HIV-positive Cubans are on ARVs. The U.S. trade embargo has been blamed for limited access to newer ARVs (the country only makes the older drugs, although 1,100 citizens get modern meds via the Global Fund to Fight AIDS, Tuberculosis and Malaria). And the country lacks the resources to enact a “test and treat” policy—testing everyone for HIV and giving treatment to those who are positive—even though the country is a model test case for the approach. So, it turns out Cuba’s containment of AIDS is close, but still no cigar.