ABSTRACT
A review of surveillance data on AIDS and HIV infection in the eighteen English-speaking Caribbean countries and Suriname suggests an evolving pattern of AIDS apidemic in the Caribbean, with different countries at various stages of transition. The epidemic began in 1983 among homosexual and bisexual males, and then was followed by an increase in AIDS cases resulting from heterosexual contact, the current predominant mode of HIV transmission in Trinidad and Tobago, the Bahamas, Jamaica, Barbados, and many other countries. This rapid transition from homosexual to heterosexual transmision appears to have been facilitated by sociocultural and behavioral patterns which may be considered typical of the Caribbean population. Overall, three has been a declining trend in male to female ratio of cases, except in Guyana, which so far has only reported cases among males. Perinatal transmission is already a major problem in many countries-19 percent of cases in the Bahamas are among children under 15 years of age. Serosurveys conducted in Trinidad and Tobago, Jamaica, Antigua. St. Vincent, and other countries show high HIV seroprevalence among homosexuals (14-40 percent), prisoers (4.0-10.0 percent), prostitutes (1.5-13 percent) and cocaine users (2.0 percent); at present prevalences in the general population continues to be low