Modeling the HIV/AIDS epidemic in the English-speaking Caribbean.

The study reported here examines the past and potential future impact of HIV/AIDS in 19 nations of the primarily English-speaking Caribbean. The authors use DemProj, a demographic projection model, to explore two different HIV scenarios. In the low scenario adult HIV prevalence stabilizes at 2% in the year 2000, and in the high scenario adult HIV prevalence stabilizes at 5%. By the year 2010, annual AIDS incidence exceeds 11,000 cases in the low scenario and 28,000 in the high scenario. In both scenarios, 70% of the cases are in young adults 20-45 years old and 12% are in children 0-15. Age-specific mortality is more than doubled in the 20-40 age range in the low scenario, and more than quadrupled in the high scenario. The impact on death rates is also severe among children 0-10. In assessing the economic impact, the authors estimate that the total annual costs of the epidemic will approach US$ 500 million (in constant 1989 US$) or 2% of GDP in the low scenario, and will exceed US$ 1,200 million or 5% of GDP in the high scenario.