On Sunday at a one-day Caribbean Summit on HIV/AIDS in St. Croix, health officials said widespread ignorance about the disease and discrimination against those living with it are hampering regional control efforts.

Excluding Cuba, which has a relatively low HIV rate due to testing and treatment programs, the Caribbean has the second-highest rate of infection after sub-Saharan Africa. An estimated 500,000 people in the region, or 2.4 percent of the total population, are infected. In 2005, around 24,000 people in the Caribbean died of AIDS-related illnesses, making it the leading cause of death among persons ages 15-44, said Barry S. Featherman, president of the Inter-American Economic Council, which organized the conference.

Experts said HIV/AIDS is still largely perceived as a "gay disease." Discrimination by employers and others is so rampant that people with the disease often delay seeking medical treatment.

Combating HIV in the region is "going to be a political challenge because, unfortunately, we live in a society that is very homophobic. It's something we are going to have to overcome," said Douglas Slater, health minister for St. Vincent and the Grenadines.

U.S. Rep. Donald M. Payne (D-N.J.), co-chair of the Congressional Caribbean Caucus, said prevention and treatment efforts in the region are lacking. "I haven't seen this overall realization, like 'Houston, we have a problem,'" he said. The 15-member Caribbean Community, called Caricom, must do more to secure international funding for controlling the spread of the disease, he said.

Economists at the University of the West Indies say their research shows that failing to slow HIV/AIDS will have a major impact on Caribbean economies since those infected tend to be younger and comprise a large part of the region's work force.

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