‘Before HIV you're a human being’ – PLWHA and reproduction in Jamaica

Abstract

HIV sensitisation campaigns often aim to empower people living with HIV or AIDS (PLWHA) to enable them to cope with their illness by getting on with normal life as best as they can. However, contained within these messages are implicit assumptions about the needs of PLWHA. This research found that in Jamaica PLWHA's reproductive health needs are considered to be met largely by condoms. However, PLWHA respondents in this study expressed desires to have children and felt that their right to this was being denied. As such, dominant HIV sensitisation messages fail to respond to Jamaican PLWHA's own perceptions of their needs. This information is of importance, as the focus of the international HIV response moves away from simply preventing new infections to supporting those who have already been infected through locally appropriate interventions. As part of this, local perceptions need to be acknowledged ‘up-stream’ in HIV programming.

Keywords:

• HIV/AIDS
• Jamaica
• reproductive rights
• sensitisation
• gender roles
• stigma

Acknowledgements

I'd like to thank Gill Gordon, Gary Fry, Jelke Boesten, Paul Dempster and HumUS for their help throughout the writing of this article. I also thank all my respondents for sharing their perspectives, opinions and stories. This research was part funded by a student scholarship from the Swedish International Development Cooperation Agency.

Notes

1. All interviews and FGDs were conducted in Standard English, although some respondents answered in Jamaican Patois.

2. This group consisted of four contact investigators, two adherence counsellors, a nutritionist and a pharmacist.

3. There is some discussion of the actual level of homophobia in Jamaican society, one respondent powerfully arguing that homophobia could not be separated from other forms of discrimination against ‘difference’ (NGOR 1). See Gutzmore (2004), Hope (2006), Pinnock (2007) and Lewis and Carr (2009) for discussions of the complex nature of homophobia and the role sexual violence plays in Jamaican gender identities.

4. This lack of public profile for PLWHA was commented on by one respondent (CA 3). The use of two public figures in the PTP campaign was part of an effort to change this (AcR 1). See Stone (2007) for one notable account of a Jamaican PLWHA public figure, who kept her HIV status a secret until after her husband's death (Stone 2007).

5. The fertility rate has fallen from 4.5 in 1975 to 2.8 in 1997 according to one report (McFarlane et al. 1998, p. 87).

6. This is the ‘C’ of the globally disseminated ‘ABC method’ (Egerö et al. 2001, p. 17).