HIV/AIDS is a communicable disease that we’ve heard about for decades. It used to be considered a death sentence until better research, education and advances in treatment improved quality of life for persons living with HIV (PLHIV). Coordinated efforts among international donors, the government via the National HIV/STI programme, and civil society groups, make HIV/AIDS one of the most supported public health issues. Does the LGBTQIA community, and specifically trans persons, benefit from this bounty?
First, here’s a 7 minute video that explains in simple terms what HIV/AIDS is and the treatment involved.
If you can’t see the vid here’s an alternative resource: HIV Basics.
What’s the situation in Jamaica?
International aid as it relates to disease control and reduction has shifted towards more partnership with local government and civil society groups to implement programmes. In (i) July 2015, the Ministry of Health recently announced that The Global Fund–an international financial institution created to combat HIV/AIDS, TB and malaria–will invest in Jamaica’s National HIV/STI programme for the next three years. PEPFAR (United States President Emergency Plan for AIDS Relief) will also fund the programme. At that press briefing, and recently at the World Learning Caribbean Grant Solicitation Management (CGSM) Programme, Ferguson placed the government’s mission within the framework of human rights — he was committed to reducing stigma and discrimination. In naming vulnerable groups, it’s important to note that he acknowledged the transgender community specifically:
“In addition, men who have sex with men and their female partners accounted for almost 40 per cent of new infections in 2012. I want to further note that MSM who reported being involved in sex work reported an HIV prevalence of 41 per cent, transgender women 45 per cent, and transgender populations in sex work reaching as high as 56 per cent.”
In the (ii) JIS report, JFLAG, along with the National AIDS Committee, and Eve for Life, are listed as groups in partnership with Nat HIV/STI programme.
These are important steps — for far too long there has been no targeted research of the trans community. Trans women, especially, were grouped under MSM, leaving the problem obscured. However, prejudicial laws against sexual orientation and gender identity remain in such critical documents as the constitution; the Sexual Offences Act; the Offences against the Persons Act; and, in relation to (iii) sex work, the Constabulary Act and the Towns and Communities Act. This prevents the government from creating and implementing a truly comprehensive policy that would enable all Jamaicans to access the best healthcare possible. As we are stigmatised or invisible in the eyes of the law, it follows elsewhere.
Released in 2014, the (iv) National HIV/STI annual 2013 HIV epidemiological profile conflated sexual orientation with sexual practices. Risk behavioral factors are described as “heterosexual practice” versus homosexual or bisexual. This limits the usefulness of the data. If persons felt comfortable enough to provide more accurate personal data, government and civil society groups could create better profiles of the various sub-groups in the population and modify plans to better address and target their needs. Indeed, “44% of men reported with HIV (and 41% of men reported with AIDS)” did not disclose their sexual practices, which was partly attributed to such a reluctance.
There is no data provided on female “homosexual practice”.
As it relates to gender, the situation is worse. TransWave is still trying to find the source of Minister Ferguson’s statistics as it relates to transgender persons, for only “male” and “female” are covered in the MoH 2013 profile. (Is it local or international data?) There is a strange column in the sexual practices data table for “Unknown Gender” but the term is not defined. Without reliable data we cannot expect to get the best value from the millions donated.
Groups like J-FLAG, Colour Pink, and Jamaica AIDS Support for Life (JASL) work to identify key population groups like the transgender community and collect data which can help to fill in the gaps.The Health Policy Project (funded by PEPFAR & USAID) run training workshops in the Caribbean to equip medical professionals to best serve transgender health care needs. However, the reality is that the government is the major provider for health care in the island. Civil society groups — who progress in an environment which hinders rather than enhances their efforts — can only work in complement to and not act as a sufficient substitute. Our regional medical universities, partly-funded by CARICOM, ought to be at the forefront of research in this area.
While TransWave applauds the government’s support of civil society organisations who address such marginalised groups as LGBTQIA and sex workers, its tendency to only address such groups within a HIV/AIDS narrative only helps to “other” the community as victims and creates associations with issues perceived as “societal problems”. It promotes stigmatisation. (It’s a common complaint among trans activists groups in the region that they can only get funding for HIV/AIDS projects.)
The government should take its human rights agenda to heart. Once Jamaica commits to respecting and honouring the inherent dignity in all citizens, everyone can be empowered to do the best work for it and each other.
For counselling, support or info on how to get tested:
J-FLAG Social Services: (876) 754-2130
JASL: (876) 925-0021/2; email: firstname.lastname@example.org
(i)”Jamaica Gets Millions in HIV Funding” – Ministry of Health
(iii) Resources and Publications – JASL
(iv) HIV Epidemiological Profile 2013, Facts and Figures (PDF) – National HIV/STI Programme