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Dr. Mentor Melville, County Medical Officer of Health, directly attributes the dramatic increase in HIV infection in the island to the advent of sex tourism and the prostitution and pornography associated with it.
She also attributes a misguided sense of revenge for the epidemic. “There is also a certain class of people who go around telling you “somebody give mih, so I giving it back’” she says.
Sex tourism in Tobago mainly involves European and North American women and local men. The trade is run with business-like efficiency by “tourist agents” and unlisted guest houses, with advertisements in European magazines announcing “package deals” including the services of a local male or female.
In 1995, a Swiss visitor, known locally as “Simonetta”, was deported as an undesirable after announcing on the local television news that she was HIV positive and had engaged in unprotected sex with numerous local men.
Some of her partners flatly refused to believe her HIV status and rejected being tested themselves. Two years later, there is still no legislation specifically addressing HIV infection issues.
There are also female prostitutes, with a number of Trinidadian women taking up temporary residence in the island during the height of the winter tourist season.
Compared to Trinidad, the more industrially developed island, Tobago is a curious mixture of conservatism and sexual permissiveness.
In an economy where tourism is the only industry apart from the flagging farming and fishing sectors, virtually all shops remain closed on Sundays while workers attend church, or sea-side baptisms, for most of the morning.
In contrast, young people become sexually active at an early age. Men are expected to “have” more than one women at a time, and incest is common — some say rampant. Now that the virus has established a foothold in almost every village, these factors foretell disaster.
AIDS patients die quickly here. About 30 percent do not survive the first 12 months after diagnosis.
Though medical care is free at government run institutions, Tobago’s lone hospital does not have the financial resources to stock the drugs used for treatment of this fatal disease.
This situation is not expected to change with the availability of a new “cocktail” of AIDS drugs. The 10,000 to 15,000 dollars a year needed for treatment is far beyond the reach of almost all residents in this island, population just under 49,000.
Victims die quietly at home, kept away from the knowing eyes of those who visit the hospital almost every day to dispense comfort and kind words.
According to Melville, AIDS education is not working. He believes the only solution is behaviour modification among the population and he recommends a “Scared Straight” programme.
“They do not see the suffering,” he says. “They should see what full blown HIV patients look like and visually experience how they suffer.
Wright adds: “They only hear that an AIDS victim dies and its a nine-day wonder. We need to get the patient suffering to talk; only then more people might understand.”
For the moment, however, HIV infections are the last topic of discussion on the increasingly busy beaches of Tobago, observers say.
Prostitution in Trinidad and Tobago.
Prostitution in Trinidad and Tobago is legal but related activities such as brothel keeping, soliciting and pimping are illegal.  
In Trinidad, Port of Spain is the main place of sex work,   including street prostitution on Roberts and Murray Streets.  New brothels continue to open across the country, particularly in the east where they are incorporated into small bars and rum shops and are difficult to detect.  Many of the sex workers come from Colombia, Venezuela and Cuba. Some regularly commute between their home nation and Trinidad. 
Prostitution in less common in Tobago, some prostitutes from Trinidad move to Tobago for the tourist season.  
The country is a sex tourism destination.  Tobago is also known as a destination for female sex tourism. 
Being a former British colony, much of the prostitution law mirrors that of the UK:
The 1921 Summary Offences Act  Section 46: any woman loitering about and soliciting passers-by for the purpose of prostitution, on the second occasion, may be deemed a rogue and vagabond, and shall be liable to imprisonment for two months The 1986 Sexual Offences Act  Section 17: Any person who procures another for prostitution; or procures another to become an inmate of or to frequent a brothel; is guilty of an offence and is liable on conviction to imprisonment for fifteen years Section 19: A person who detains another against that other�s will in any brothel, is guilty of an offence and is liable on conviction to imprisonment for ten years. Section 22: A person who keeps or manages or acts or assists in the management of a brothel; or being the tenant, lessee, occupier or person in charge of any premises, knowingly permits the premises or any part thereof to be used as a brothel or for the purposes of prostitution; is guilty of an offence and is liable on conviction to imprisonment for five years. Section 23. (1) A person who� (a) knowingly lives wholly or in part on the earnings of prostitution; or (b) in any place solicits for immoral purposes, is guilty of an offence and is liable on conviction to imprisonment for five years Human trafficking is dealt with by the Trafficking In Persons Act 2011. 
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