At the time of appraisal, the Caribbean had the highest HIV prevalence rate among adults outside Sub-Saharan Africa. In Barbados, the rate was 1.5% (2005), and the National Strategic Plan of Barbados 2005-2025 identified HIV/AIDS as one of the major threats to its overall success as it endangered the country's human capital. The First HIV/AIDS Project in the country achieved high levels of awareness, treatment, and care, but was less successful in inducing the level of sustained behavior change required to impact the epidemic's prevention and control. For example, knowledge among youth on sexual relations as a way of transmitting HIV was at 95% but condom use rates were only 21% among that subpopulation.
To address these challenges, Barbados drew on World Bank funding for a follow-up project aimed at supporting the implementation of their National Strategic Plan. This follow-on project (The Barbados Second HIV/AIDS Project) was designed to encourage adoption of safe behaviors and increase access to prevention, treatment and social care, particularly for key high-risk populations. The Project also focused on organizational and institutional capacity building, as well as improvement in utilization of quality data. The use of disbursement-linked indicators ensured a focus on results and allowed for the development of the first HIS system in the country, which benefited the entire population and improved data collection going forward.
The Barbados Second HIV/AIDS Project aimed to support implementation of the National Strategic Plan and to provide institutional strengthening via training and technical assistance. In line with support in these areas, the following key outcomes were achieved:
- Percentage of young men and women aged 15-24 years reporting the use of a condom the last time they had sex with non-marital non-cohabitating sexual partner went from 21% (2006) to 72% (2014);
- Percent of young women and men aged 15-24 who have had sexual intercourse before the age of 15 decreased from 20% (2006) to 12% (2014);
- Percentage of people living with HIV on first line antiretroviral regimen achieving virologic success within the first six months of treatment went from 60% (2008) to 93% (2014);
- Percentage of MSM who received an HIV test in the last 12 months and who know their results doubled from 50% (2009) to 100% (2014).