Stigma and discrimination are fueling the HIV epidemic in the Caribbean. Join poet and writer Kwame Dawes as he explores the issues surrounding HIV-related stigma in Jamaica and speaks with the people who are most affected.
Hello, my name is Kwame Dawes. I’m a poet and a writer. I was born in Ghana and grew up in Jamaica. There are two Jamaicas. There is the Jamaica that the tourists know, that many Americans know. That’s the Jamaica of the North Coast, of the beaches, the waterfalls, the all-inclusive hotels, the partying. But there is a second Jamaica -- that is the Jamaica on the South Coast. This is the Jamaica of Kingston; it is the Jamaica in which people live day to day, eke out a living. It’s a Jamaica that knows wealth, it also knows poverty, it knows violence, but it also has a brash, smart energy. It is where the music is created in Jamaica, and it is to this Jamaica that I’ve returned to explore the issue of HIV/AIDS.
DR. PETER FIGUEROA [Director, National HIV/STD Control Program]
If we look at the adult HIV prevalence in the population, we estimate 1.5 percent, and it has been steady over the past eight to ten years. Let’s use the analogy of South Africa, where in the early nineties their prevalence was one percent, certainly under two percent, and literally within a few years it just exploded up to about 20 percent. So it’s very important to recognize that it’s a sexually transmitted infection and once it is in your population it has the potential to spread very rapidly.
RUTH JANKEE [Jamaica National Building Society]
When you talk to people about HIV and AIDS, they just don’t see it as an issue. The belief is that it’s something still, for them -- okay, maybe it’s not a gay disease anymore. We’ve kind of gotten over it. If you’re a man and have it there are still questions about your sexuality. But many people still have the underlying belief, no matter how much information you give them, that it’s certain kinds of people, you know, you have to be wild and crazy in your sexual behavior, or at least have multiple partners. But it’s an issue, and it’s endemic, it’s widespread, it’s not just one sector of society. It’s uptown, downtown, all ages and stages. Everybody is infected or affected.
We met with university students and some graduates and I asked them questions about HIV and AIDS, I asked them questions about what they knew, what their thoughts were. They were lively; they had a lot to say.
What area do people perceive to be in?
MAN 1 [Student]
As he was saying: the gay community, prostitutes. That’s the perception. Where there is a lot of sexual intercourse, a risky lifestyle. Although we’re in a risky lifestyle, we won’t admit it, but that’s what we perceive to be the risky lifestyle.
WOMAN 1 [Student]
That’s why I think the disease is spreading so rapidly. Because I have this stigma against you, I think I’m better than you so I can’t catch it. I’m educated so I can’t get AIDS. I’m only going to have sex with one partner so I can’t get AIDS.
WOMAN 2 [Student]
I think that the majority of the population has basic information about how it is contracted, but the problem lies in translating that basic information into a change in behavior.
WOMAN 3 [Student]
You have some guys in Jamaican society that are not using a condom. They don’t like it, it itches, they’re allergic, “Baby I just want to feel the real you.” Guys have these lines. “But that’s not sex, that’s artificial sex, let’s have real sex, skin to skin.” And girls will believe this and they will have sex with them. They’ll have unprotected sex with them simply because they fear losing them.
After a while I began to wonder, what does it take to change sexual behavior in a highly sexualized country like Jamaica? And I also wondered, who was taking on this mission?
Claude McKay High School, Kingston, Jamaica
GLENDON ASPHALL [Jamaica AIDS Support]
I remember when I just found out I was HIV positive. The doctor came into the office and said, within five years a person with HIV will be fully blown, that means I’ll start to get sick, get skinny and all of that. I’m with somebody and my girlfriend is HIV positive, and that does not mean that we are going to have unprotected sex, because I’m on medication and my girlfriend is not on medication. And so, my HIV is more advanced than hers. If I have unprotected sex with her, she can surpass me in terms of stages. If I have many viruses in my stage, she can pick up my viruses. But this is my fate and what I have to do now is accept it and move on. Not that my dreams have been shattered, because we are working on our house, and we plan to get married next year.
Community Health Care Clinic, Greater Portmore, Jamaica
WINSOME KEANE-DAWES [St. Catherine HIV/STIs Prevention and Control Program]
The greatest challenge I have is individual persons acknowledging their risk. Not just for HIV, for any STI, to get them to acknowledge the risk, take responsibility. It must be human nature to keep blaming other people for our problems.
So do you have any idea how you contracted the disease?
Not really, but I know -- I’m not saying it’s my fault and I’m not saying it’s the other person’s fault, because I’m supposed to take responsibility for myself, so it’s both of us. Because if I was protecting myself I wouldn’t have ended up with AIDS, so I can’t put all the blame on him.
It started with about two people, then three, and we built on that. Just by having them in a room where they can exhale and be themselves, they don’t have to hide and be fearful. Just by having them come twice a month and meeting, sharing their experiences, and realize that, “Hey, I’m not alone in this thing, there are so many of us.”
Can I just add that I find that persons who have family support do much, much better? Sometimes the HIV positive persons tend to underestimate their relatives.
When I first found out, I had strokes on my right side. At one time I could not walk, not talk. But since coming here, I can walk and talk.
I’ve been coming to Jamaica very regularly ever since I left. You engage the country, you engage people. I’ve met many people who I remained convinced are courageous. I’ve also met people who have reminded me about the resilience of Jamaicans to survive and to struggle to survive in difficult times. I’ve met people who have used what is their sickness to create something useful for themselves. So I’m left with a sense of hope and possibility.