Jamaica is one of two UNAIDS priority countries in the Caribbean. While the island has a generalized HIV epidemic, its key populations continue to be disproportionately affected. Sex workers are estimated to have an HIV prevalence of 2% and prisoners 6.9%. The most affected communities are gay men and other men who have sex with men (with an HIV prevalence of 29%) and transgender women (with an HIV prevalence of 51%). 

Since the introduction of public antiretroviral therapy in 2004, access to treatment and care services has dramatically increased. Among pregnant women living with HIV, more than 95% receive treatment to prevent transmission to their children. 

The country is working to address gaps in linkage to care and treatment retention. The government, civil society and development partners recognize that in order to do this they must collaborate to address the challenge of stigma and discrimination.

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Ending stigma and discrimination is critical to expanding HIV services in Jamaica

In 2017, a Jamaican actress starred in an educational video about HIV treatment adherence. It was an upbeat, innocuous reminder to people living with the virus to eat healthily, exercise and take their medicine every day.

After she made the film, the young woman faced some strong reactions—bookings dried up, strangers in the street pointed at her and her daughter faced teasing at school. Although she herself is HIV-negative, it was a sharp reminder concerning the stigma and discrimination faced by people living with HIV.

Earlier in 2019, Jamaica’s Minister of Health, Christopher Tufton, appeared in a public service announcement with the young actress to tell people that a person’s HIV status was no reason to discriminate against them. “There is still a lot of work to be done and while I was disappointed by the reactions to the video, I have seen and heard enough to understand that HIV-related stigma and discrimination is still a big challenge in the community and something we have to work on,” he said.

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UN Cares: putting people first in Jamaica’s HIV response

Erva-Jean Stephens works as a Strategic Information Adviser in the UNAIDS Country Office in Jamaica. She describes her role as using evidence-informed data to shape programmes and policies that contribute to the country’s development.

Ms Stephen’s professional career is entwined with an activist’s desire to see better health outcomes for ordinary Jamaicans.

“I try to serve people first,” says Ms Stephens. “People reach out to me because I make myself accessible and I easily relate to their needs. I naturally build networks outside of the work environment that I think might be beneficial to the work we do.”

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Jamaica: tackling HIV-related stigma and discrimination

Rachel Allen (not her real name), who lives in Kingston, Jamaica, was coming to terms with testing positive for HIV and trying to get on with her life. When she decided to go to nursing school, she was horrified to discover that the school required her to take an HIV test as part of the application process.

Jane Williams and Paul Brown (not their real names) were in love and wanted to start a family. But when health-care workers learned that Ms Williams was living with HIV, they expressed their disapproval. One nurse told her she shouldn’t have a child because of her status. One doctor called her “wicked”.

These are experiences that are all too common among people living with HIV, according to Jumoke Patrick, Executive Director of the Jamaica Network of Seropositives.

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The power of transgender visibility in Jamaica

“Is it safe to do their work?” Renaè Green and Donique Givans go silent for several seconds. “I am still scared,” says Ms Green, the Associate Director for Policy and Advocacy at TransWave Jamaica. “I don’t like to go to certain spaces. If anyone wants to participate in one of our campaigns, we explain the risks. You don’t know what kind of backlash you might experience.”

Ms Givans, who is the organization’s community liaison officer, knows this all too well. She wasn’t up front about her gender identity with her father when she began becoming more visible in her advocacy work.

“He doesn’t want anything to do with me now,” she says, her voice shaking a little. “He told me to go and not to come back to his house. So, we do let people know they might have difficulties.”

TransWave was formed in 2015 following a lesbian, gay, bisexual and transgender health and gender-based violence training, conducted by WE-Change and supported by the Jamaica Forum for Lesbians, All-Sexuals and Gays and Jamaica AIDS Support for Life.

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Confronting the link between HIV and gender-based violence in Jamaica

Monique McDonald is an HIV peer educator who tells the story of her childhood with unflinching courage. “I was sexually abused by my uncle at the age of 12 and contracted HIV.”

Ms McDonald has written about her experiences in a book called I am now free. It uses her old diary entries to describe the abuse she suffered as a child and her journey to recovery. Today, she supports young women living with HIV, helping them to come to terms with their status and advising them on adhering to treatment. She has also founded the Ashley Fund to help other sexual abuse survivors to continue their education.

She admits that it’s been a long road.

“I was so depressed, I didn’t know who to trust,” she remembers. “How could this happen, and everybody turned their eyes?”

Rushell Gray reflects on her past with a similar mix of sorrow and disbelief.  

“As a young girl everybody turned a blind eye and blamed me. I was the AIDS girl walking around in the community. Nobody said, “this man needs to go to jail.” At one point I almost gave up because the stress was too high,” she said. 

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