Public health academia has known for decades that to effectively curb the global crisis of HIV/AIDS we have to remove institutionalized oppression that re-enforces homophobia. It is not a panacea but it is a major part of the solution.

Countries that criminalize homosexuality marginalize MSM which pushes them underground and helps to fuel the HIV epidemic. Treating people with dignity and respect facilitates effective HIV education and prevention. It reduces the discrimination many Caribbean Lesbian, Gay, Bisexual and Transgender experience when accessing health services.

Studies and the resulting data have consistently demonstrated that homophobia contributes to higher HIV infection rates and that internalized homophobia also increases your risk of HIV infection. People who place a high discount rate on their lives tend to participate in higher risk behaviours.

The decriminalization of homosexuality to reduce the global crisis of HIV/AIDS is a policy endorsed by the United Nations, World Health Organization, Pan American Health Organization, and many non-governmental organizations. This is the consensual public health approach. Twelve of the fifteen CARICOM member states still criminalize homosexuality as of date.

I was astonished to read recently that the Prime Minister of St. Vincent and the Grenadines, Ralph Gonsalves is warning against mixing the fight against HIV and gay rights. He was quoted as saying, "I don't accept the thesis that to make further advances for HIV and AIDS, that we need to do the decriminalization of homosexual activity among men in private..".

A report in the Lancet, one of the world's leading medical journals concluded from available data that "most global cases of HIV are not due to homosexual transmission" but harassment, silence, intimidation and homophobic laws are a major hindrance on the efficacy of HIV outreach and prevention.

It compromises the fight against HIV and AIDS.The Prime Minister is misinformed and bigotry is the virus' best friend. Meanwhile in St. Vincent and the Grenadines this is the data we have from the UNAIDS Youth Data Sheet 2013. In 2005 only 25% of the 15-24 age group had ever received an HIV test, while only 9% of those who were tested in the last twelve months knew their result.Twenty four percent of all HIV cases at the end of 2011 were persons less than 24 years old. In 2010 to 2011 there was a 7% increase in the testing levels in the under 24 population.

President Reagan's legacy on refusing to deal with HIV/AIDS in the 1980's allowed the epidemic to flourish with the loss and debilitation of many lives. In 2011 it is estimated that 230,000 people are living with HIV in the Caribbean. There were 13,000 new infections in 2011 and 10,000 people died from AIDS (UNAIDS).