HIV/AIDS in Jamaica has a 1.5 percent prevalence of the adult population estimated to be HIV-positive. There has been no significant change over the last five years and therefore Jamaica appears to have stabilized its HIV/AIDS epidemic.
Prevalence
Recent data from high-risk groups suggest that at least 9 percent of commercial sex workers and 20 to 30 percent of men who have sex with men (MSM) are estimated to be HIV-positive. Men and women aged 20 to 39 account for 54 percent of reported AIDS cases in Jamaica. First detected in 1982, HIV is present in all of Jamaica’s parishes, but Kingston, St. Andrew, and St. James – the three most urbanized parishes – have the majority of cases, but St James being the highest overall. UNAIDS estimates that 25,000 people in Jamaica are HIV-infected.
The primary contributors to the epidemic are sociocultural, behavioral, and economic factors that result in risky behaviors such as multiple sex partners, older men having sex with younger women, and early sexual debut. A 2004 Behavioral Surveillance Survey demonstrated that 89 percent of males and 78 percent of females aged 15 to 24 had sex with a nonmarital or noncohabitating partner in the preceding 12 months (2006). Fifty-six percent of males and 16 percent of females had multiple sex partners in the preceding 12 months. Among patients attending sexually transmitted infection (STI) clinics in Kingston, St. Andrew, and St. James, HIV infection rates reached 5 percent.
In the general population, overall AIDS case rates among men continue to exceed the rates among women. However, surveillance data, as presented by Dr. Peter Figueroa of Jamaica’s Ministry of Health (MOH) at the U.S. Government-sponsored sixth annual Caribbean U.S. Chiefs of Mission Conference on HIV/AIDS held in Jamaica in October 2007, indicate that adolescent females (10 to 19 years old) are 2.7 times more likely to be infected than same-age males.
Young women are particularly at risk because they find it difficult to negotiate whether and when to have sex and how to protect themselves from pregnancy and disease. For example, the “sugar daddy” phenomenon, in which young women and girls exchange sex with older men for material or financial gain, is common. Gender inequality, high levels of unemployment, persistent poverty, rising crime and violence, population mobility, and the growing commercial sex trade – including sex tourism – compound the country’s vulnerability to the HIV/AIDS epidemic.
Although Jamaica has a well-established national surveillance system, collecting accurate data about at-risk groups is challenging. Despite some progress in reducing stigma and discrimination (S&D), homosexual behavior continues to be illegal in Jamaica, and many MSM hide their sexual orientation and behavior, impeding accurate health surveys. Recent program estimates indicate that 20 to 30 percent of MSM are HIV-positive.
Jamaica also has a large number of mobile sex workers, both Jamaican and from outside Jamaica, who are difficult to monitor. HIV infection rates among sex workers are much higher than they are in the general population. A 2006 study of female sex workers, reported by UNAIDS, showed an HIV prevalence of 9 percent in this group. However, according to Jamaica’s 2006 UNGASS report, an earlier study found a 20 percent prevalence rate among sex workers in the tourist areas of Montego Bay. The actual prevalence of HIV may be higher in these groups as data collection remains difficult and is limited by sampling methods.
Sex workers who were older, less educated, and used crack cocaine were more likely to be HIV-infected. According to UNICEF/Jamaica, in 2003, there were 5,125 children in Jamaica who had lost one or both parents to HIV/AIDS, and thousands more were estimated to have been made vulnerable by the disease. Poverty and neglect have led to a growing number of street and working children. There were 5,143 children in institutional care in 2003, including those in foster care.
Controlling new tuberculosis (TB) infections in Jamaica remains a challenge; the incidence rate is 3 per 100,000 people. However, according to the World Health Organization (WHO), the prevalence of HIV among Jamaican TB patients is 26 percent. This figure is similar to other developing countries. However, Jamaica has a higher mortality rate among those who are co-infected, so prompt diagnosis of HIV infection and early institution of active antiretroviral treatment (ART) are imperative.