For­tify the bat­tle lines against HIV/AIDS

Jamaica Gleaner - - OPINION & COMMENTARY -

LIKE MOST of the rest of the world, Ja­maica has made great strides in com­bat­ing HIV/AIDS since the in­fec­tion was first re­ported here nearly three and a half decades ago. The dis­ease is no longer an au­to­matic death sen­tence.

That, in part, is the out­come of med­i­cal ad­vances in treat­ing the dis­ease. It is also the re­sult of a change in hu­man at­ti­tudes and be­hav­iour to­wards the dis­ease and peo­ple who have it. There is sub­stan­tially less stigma and dis­crim­i­na­tion against peo­ple with HIV/AIDS than there used to be. But Dr Myr­ton Smith, the pres­i­dent of the Med­i­cal As­so­ci­a­tion of Ja­maica (MAJ), ob­served in his mes­sage mark­ing yes­ter­day’s World AIDS Day that there is still much ground to cover.

In­deed, there are some telling sta­tis­tics about HIV/AIDS in Ja­maica, bits of which were quoted by Dr Smith in his state­ment. For in­stance, it is es­ti­mated that around 1.6 per cent of the is­land’s adult pop­u­la­tion is liv­ing with the dis­ease, which is around 32,000 peo­ple. Yet, per­haps half of them are un­aware of their con­di­tion. Fur­ther, while HIV/AIDS is pri­mar­ily a sex­u­ally con­tracted dis­ease, the lat­est sur­veys sug­gest that 40 per cent of women and 30 per cent of men don’t reg­u­larly use con­doms in their sex­ual en­coun­ters.

These are cir­cum­stances that con­trib­ute to the con­tin­ued spread, even though at a slower rate, of the dis­ease. But it is in­for­ma­tion that frames the mes­sage that has to be sent, and ex­panded, to greatly lessen, if not to­tally elim­i­nate, the in­ci­dence of HIV/AIDS in Ja­maica.

It is a nar­ra­tive that must en­cour­age peo­ple to take own­er­ship or re­spon­si­bil­ity for their health. That, in this case, be­gins with know­ing their HIV sta­tus, thus es­tab­lish­ing the frame­work for in­ter­ven­tion. But we un­der­stand, too, that is not al­ways easy. Preva­lent at­ti­tudes cause a less-than-ful­some em­brace of this ideal by some at-risk groups, plac­ing them at even greater risk of in­fec­tions. Men who have sex with men fall in this cat­e­gory.


Re­cent data in­di­cate around a 30 per cent HIV preva­lence among ac­tive male ho­mo­sex­u­als, es­pe­cially those with mul­ti­ple sex part­ners. Ja­maica is still largely a ho­mo­pho­bic place, where gay men, fear­ing dis­crim­i­na­tion and stigma be­cause of their sex­ual ori­en­ta­tion, are likely to hide in the shad­ows. Fe­male sex work­ers fare bet­ter, and their rate of HIV has fallen sharply in re­cent years. That, how­ever, doesn’t mean that they are im­mune to the stigma that still pre­vents many from tak­ing full own­er­ship of their health.

In the event, fight­ing stigma and dis­crim­i­na­tion and fur­ther ad­vanc­ing pub­lic un­der­stand­ing of the dis­ease as one that isn’t con­tracted by ca­sual con­tact re­main im­per­a­tives in the cam­paign against HIV/AIDS. There is, too, the is­sue of em­pow­er­ment, es­pe­cially for women, in ne­go­ti­at­ing sex­ual re­la­tion­ships.

It used to be that sig­nif­i­cantly more men than women con­tracted HIV. The sit­u­a­tion has flipped, es­pe­cially among younger women. Part of the rea­sons, per­haps, rests in the data on con­dom use among women, some of whom may have pro­mis­cu­ous part­ners. This ar­gu­ment, how­ever, is not ir­rel­e­vant to men who have sex with men.

Ed­u­ca­tion and aware­ness, there­fore, are ef­fec­tive weapons in the arse­nal against HIV/AIDS.

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