Dr Joel Teelucksingh
In T&T, too many people living with HIV or disabilities “eat the bread the Devil kneads”—not because of their choices, but because of the choices our society makes for them. They eat the bread of stigma, when all they ask for is dignity. They eat the bread of discrimination, when all they seek is opportunity. They eat the bread of bureaucratic neglect, waiting months for a grant, a prosthesis or a simple appointment. They eat the bread of a system that allocates sympathy instead of resources and compassion instead of policy.
On World AIDS Day and the International Day of Persons with Disabilities, we are reminded that inequity never happens by accident. It is baked into the structures we refuse to reform. And so the most vulnerable among us continue to survive on the crumbs while leaders give speeches instead of solutions.
And yet, within these invisible walls of shame, I’ve seen extraordinary resilience. I’ve seen patients with HIV volunteer as counsellors, turning their pain into purpose.
I’ve seen people with disabilities become educators, entrepreneurs, athletes; rewriting what strength looks like. The human spirit, when given a chance, always finds a way to rise.
Our region still faces challenges with HIV testing and disclosure. Men are less likely to get tested. Women fear rejection or violence if they share their diagnosis. Adolescents born with HIV now grapple with transition into adulthood —navigating medication, relationships and a society still catching up with understanding.
For people living with HIV, the battle has evolved from survival to acceptance. Antiretroviral therapy has transformed what was once a death sentence into a manageable chronic condition. Yet prejudice lingers like a stubborn shadow. Too many still lose jobs, relationships and dignity because of misinformation and fear.
While countries around the world are scaling up the use of pre-exposure prophylaxis (PrEP)—a game-changing medication that significantly reduces the risk of HIV transmission—T&T has fallen behind.
Despite the overwhelming evidence supporting its effectiveness, PrEP remains inaccessible to most of the population, leaving vulnerable groups like sex workers at heightened risk.
Instead of recognising PrEP as a vital public health tool, some policymakers dismiss it as a means to enable “risky behaviour.”
There’s a quiet cruelty in the world that those who live without illness or impairment rarely notice: the staircase without a ramp, the job application that never calls back, the whispered judgement after someone mentions “HIV.” These are not infections of the body but infections of the soul — stigma, discrimination, exclusion.
We often forget that HIV itself can lead to disability — through neuropathy, visual impairment, recurrent infections or cognitive decline. And many people with disabilities are at higher risk of acquiring HIV because of poverty, gender-based violence and lack of access to information or care. The intersection between these two communities is profound, yet rarely acknowledged.
Despite all the speeches about inclusion and empowerment, the reality is stark in this country: children with disabilities have shockingly few school options. In a nation that boasts of being “developed,” parents are forced into a heartbreaking scavenger hunt—begging for a space, pleading for assessments, waiting years for placement or giving up entirely because the system gives them nothing.
Government after government has promised “special schools,” “inclusive education” and “support services,” yet the truth is that many of our most vulnerable children are left out, left behind, or left at home. Where is the urgency? Where is the investment? Until our leaders start confronting this silent national failure, children with disabilities will remain segregated, not by their conditions, but by our country’s lack of care.
People with disabilities are significantly less likely to receive sexual and reproductive health education. Many are excluded from testing programmes because healthcare workers assume they are not sexually active. This false moral comfort—that “they don’t need it”—has cost lives.
When health information is provided in Braille or sign language, when school doors open to children with learning differences, when workplaces embrace diversity not out of obligation but conviction, that’s when inclusion becomes real.
The same holds true for people living with HIV. Accessibility also means ensuring that medication is available in rural areas, that mental health support is part of treatment, that confidentiality is respected in small communities.
Our faith traditions in the Caribbean often speak of compassion, justice and mercy. Yet too often, these words are lost in doctrine and judgement. True faith builds bridges, not walls. It reminds us that “the least of these” are not burdens to be tolerated but blessings to be honoured.
Governments have a duty to legislate inclusion. Schools must teach empathy as much as literacy. Employers must adapt workplaces to human diversity. Media must stop portraying disability as tragedy and HIV as scandal.
Ultimately, the greatest change begins in conversation; in how we speak to each other. Every time we choose kindness over curiosity, respect over ridicule, we dismantle centuries of prejudice.
On World AIDS Day and the International Day of Persons with Disabilities, we are called to see beyond conditions and categories to see the soul. When we treat health as a human right and inclusion as an act of grace, we begin not just to cure, but to heal.
