Ainsley Reid is the face of HIV/AIDS in Jamaica. Smiling in a bright yellow shirt under the words "Positive Truly Positive," Reid, 43, is part of a campaign on the island to raise awareness about HIV and fight the stigma and discrimination. On posters, billboards and television ads, he looks strong and healthy and is, as the campaign says— "getting on with life."

But "getting on" has taken some time. Over a decade ago, after he was diagnosed with HIV, he says he felt so ashamed that he wanted to die. Not long after his diagnosis, he lost a job with the government after colleagues found out he was positive. Colleagues actually ran away from him, he says, when they saw him. After he became involved in HIV/AIDS activism and began to speak openly about his status, Reid was harassed by a mob in Kingston, beaten, stabbed and left for dead.

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Sadly, the attack against Reid was just one of many in Jamaica in recent years, driven by homophobia and fear of AIDS. In 2004, Brian Williamson, a prominent Jamaican gay rights activist, was murdered with a machete; as he lay bleeding, a crowd celebrated over his body. A year later, Steve Harvey, another well-known gay AIDS advocate, was shot and killed on the eve of World AIDS Day. Last February—on Valentine's Day—Gareth Henry, the head of Jamaica's LGBT organization, was nearly killed by a mob after taking part in a "Call for Love" event. Some of the police officers who arrived on the scene attacked him too, as they shouted "batty man," the Jamaican equivalent of "faggot." Tired of the threats and abuse, Henry fled Jamaica and now lives in Canada.

An estimated 25,000 people in Jamaica are living with HIV. That's just a portion of the estimated 230,000 throughout the Caribbean living with the disease. The Caribbean is the second most heavily affected area of the world, after sub-Saharan Africa. The region's prevalence rate is 1 percent, which means that 1 in every 100 people living in the islands is positive. In some countries, the disease is particularly widespread: Haiti, Guyana and the Bahamas have rates over 2 percent. Cuba has the region's lowest prevalence, of just .2 percent. The prevalence rate in Jamaica is 1.5 percent.

The numbers are driven, activists say, by socially accepted intolerance and ignorance. Reid's activism, which he says he's determined to continue "no matter what they do to me," is part of a larger effort to battle HIV/AIDS and fight against the stigma and discrimination that fuels it. Throughout the Caribbean, HIV is spread primarily through heterosexual sex, and in Jamaica, women make up close to 50 percent of new cases. Sex between men is also an important factor in transmission. No one is sure how many gay men in the Caribbean are HIV positive. Figures are difficult to collect because so many gay and bisexual men are afraid to disclose either their HIV status or sexual orientation.

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Similar to the AIDS epidemic among African Americans, both gender inequality and homophobia feed HIV transmission in the Caribbean. Men know that they risk violent attacks just for being gay. Fear drives gay men underground outside of the reach of HIV/AIDS education and services. Many remain "down low," involved in sexual relationships with both men and women who may not suspect they are having sex with anyone else.

"In the Caribbean, it will not be possible to effectively do prevention work against HIV and AIDS until we accept and give due rights to the MSM [men who have sex with men] minority in the same way that white people in the southern United States have had to accept and give rights to the black Americans that live among them," said Mario Kleinmoedig, a prominent Caribbean gay rights activist from Curacao. Last year he was called a "faggot" and knocked unconscious by two men in his front yard.

As Ainsley Reid found out, being proud of who you are can be deadly. The generally upbeat Reid, now a program officer with the Caribbean Conference of Churches, grows somber as he tells the story of his 2001 attack.

It occurred just after he had returned from an international AIDS conference. Reid had stopped in an area called Half Tree in the center of Kingston on his way home. As he walked through the plaza, he says, he was feeling optimistic that meaningful HIV prevention and treatment was possible in Jamaica. Then he spotted a group of men looking at him.

"They didn't look like they were going to attack me," Reid recalls. "But then I heard one of them say, 'Me could kill you mon.' They rushed toward me and stabbed me here, in the neck."

Reid stops and points to a thick, inch-long scar on the right side of his neck, before continuing.

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"They used a machete to chop my arm. Then I felt an ice pick go in my back. I fell back, and my head hit a fire hydrant. I was bleeding, but no one wanted to help me because they didn't want to touch me.

A nurse passing by in her uniform finally stopped, and asked why no one was helping, Reid recalls. Hers was the last voice he heard before he lost consciousness.

When he arrived at the hospital, he told the nurse who had helped him that he was HIV positive. She recognized his name and cautioned him not to tell any of the other nurses about his status. Still, word spread and many were afraid to assist him, stitching his wounds quickly and carelessly, to minimize contact.

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During the attack, Reid was also robbed. The men stole his phone, laptop and palm pilot. He got up the courage to call his phone and was surprised when a man answered. "I said, 'I'm the person you attacked,'" Reid recalls. The reply came back as cold and brutal as the attack itself: "All the persons who have AIDS—me want to kill them."

Reid has recovered fully and refuses to live in constant fear. He says he walked around terrified for a long time afterward and went to counseling to learn to forgive. The attack, he says now, has strengthened his resolve to be involved in activism and awareness campaigns.

Caribbean officials have also strengthened the region's response to the epidemic. In October, the Pan-Caribbean Partnership Against HIV/AIDS (PANCAP) will begin a four-year $7.73 million strategic plan to fight HIV/AIDS in the Caribbean. And the recently launched Caribbean Broadcast Media Partnership on HIV and AIDS channels targeted HIV messages into the area's prime-time media slots and helps educate DJs, editors and other media reps about the disease.

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Caribbean activists like Reid and Kleinmoedig continue to speak out against homophobia, gender inequality, AIDS stigma and the rigid male sex roles that drive all of these forms of discrimination.

"Contracting HIV isn't just about having unprotected sex," says Reid, who was infected through unprotected sex during what he recalled as his "wild days." He has been married since 1999; his wife, Althea, is HIV negative. "It's about the image of maleness. To be an ideal man means having a lot of women, having a big penis. Reggae music promotes the idea that to be an ideal man you have to have enough women, enough sex. There is nothing about being faithful, or being a good man, a good father or about responsibility."

Kleinmoedig agrees. "There are deep roots in the way we treat sexuality in our region," he said. "We come out of a slavery society. For 200 to 300 years, the Caribbean male was a sexual commodity. He was supposed to breed with as many women as possible, to produce as many children as possible. That was our history and explains why both strong women and sex between men are such a threat."

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A couple of years after the attack, Reid said he got a sign that his work was making a difference. During an event where he was speaking, a man—one of his attackers—walked up to him. As Reid tensed, the man surprised him by saying that he had changed his views. And he apologized.

"That felt good to me," said Reid. "Because of the work I'm doing, I have gone from thinking I was the worst person in the world, to seeing myself as someone who's doing well—who's informing and inspiring people to do good."