Discrimination in health services can be fatal

In the fifth paper of The Lancet, - an online publication series, published on July 20 of this year, 2011 results show that the prevalence of HIV/AIDS among men who have sex with men (MSM) in Jamaica is 31 per cent and constitutes 1.7 per cent of the population.

It reported that data on black MSM in the Caribbean are sparse, even though it is the second most affected region by the global HIV epidemic. According to The Lancet, a total of 10 Caribbean countries criminalise same sex behaviour, and there have been several accounts of intimidation of, and violence against, gay men in Jamaica.

Spreads HIV/AIDS

In an issue of the Human Rights Watch (HRW), it was highlighted that discrimination spreads HIV/AIDS in Jamaica, "by discouraging at-risk individuals from seeking HIV-related information or health care. Men who have sex with men reported that health workers had refused to treat them at all, made abusive comments to them, and disclosed their sexual orientation, putting them at risk of homophobic violence by others".

As a result, the HRW reported, "many men who have sex with men delayed or avoided seeking health care altogether, especially for health problems that might mark them as homosexual". Because the presence of other sexually transmitted diseases heightens the risk of HIV transmission, such discrimination can have fatal consequences.

Older male partners

The Lancet reports a study of Jamaican MSM aged 15-24 years showing that 75 per cent had male partners who were five or more years older than themselves, with 57 per cent reporting unprotected anal intercourse with older partners. These findings are important because age-discordant sex is associated with HIV seropositivity in young black MSM, the paper states. Even more frightening, research has shown that a significant number of these men reported having at least one female partner and multiple male partners.

When a client needs help, there should be no discrimination within the health provider's space. The fact is, without their help, the infections will permeate the country. Therefore, it is critical that health providers create an environment that groups like these feel comfortable and safe to visit and get the help they need. This help will not just be for their benefit, but also for the benefit of the society in general.

The Lancet reports that pooled estimates from across the African diaspora show that black MSM are 15 times more likely to be HIV-positive compared with general populations and 5-8 times more likely compared with black populations. Since we cannot stop men from having sex with men, as some Jamaicans may wish, health providers should do all they can to modify risky sexual behaviours and influence positive sexual and reproductive health choices and outcomes.

Source: Racquel Reece, National Family Planning Board