Sun | Mar 29, 2020

Jaevion Nelson | Time to get real about AIDS

Published:Monday | December 3, 2018 | 12:00 AM


Far too many Jamaicans do not seem to realise that HIV is still a big problem in Jamaica. Consequently, bareback sex remains as commonplace as beggars and cookshops.

It's unfathomable that despite the tremendous investment and work being undertaken, after three decades, so many people are unaware of the prevalence and still think they are either not at risk of transmission or that this is a thing of the past.

I have my own theories about why so many Jamaicans think they are invincible and the belief about love and trust as a reason why people do not use condoms consistently with their sexual partner is not the only reason or thing to worry about.

A couple weeks ago, I did a presentation to some professionals from a service, club and at the end of the session, someone said they thought the problem of HIV was a thing of this past. It might come as a surprise to many, but it is still a big problem. A nah jus man weh a have condomless sex with other man a contract the virus.

Jamaica continues to be one of the focus countries in the global response because of the vast number of people who are becoming newly infected each year. In 2017, there were 1,197 new HIV infections - a mere 5.5 per cent reduction from the 2013 data that was 1,226. Of course, prevalence among key populations and vulnerable groups such as inmates, gay, bisexual and other men who have sex with men (29.3 per cent), female sex workers (two per cent, transgender women (51 per cent) and homeless persons (13.8 per cent) continue to outstrip the prevalence in the general adult population, which is now 1.8 per cent. But the incidence (i.e., the actual number of persons becoming infected) among heterosexuals is higher than men who have sex with men, or sex workers, for example.

The data are especially concerning when you look at the age groups for those from key and vulnerable populations who are becoming newly infected. In addition, HIV-related deaths have increased significantly by 84.3 per cent from 159 in 2013 to 293 in 2017. The data show that we are diagnosing 38 per cent of people late - at the stage of death, AIDS or advanced HIV, and that the prevalence among key and vulnerable populations is disproportionately high when compared to the general adult population.

In November, more than 200 of us - doctors, nurses, policymakers, advocates, peer educators, communication specialists, statisticians, researchers, epidemiologists and others from across the island - gathered for the Annual National HIV Retreat.

The discussions were most illuminating but the new data that were presented were very worry. It showed that despite tremendous work done by hundreds of people, we still are unable to meet some of our national targets to:

- Reduce by half, the number of new HIV infections by 2019.

- Increase to 65 per cent,coverage of ARV treatment for PLHIV by 2019.

- Increase to 90% the proportion of PLHIV on ART one year after initiating therapy.

- Reduce the number of HIV-related deaths by 25 per cent by 2019.

- Eliminate vertical transmission of HIV by 2015.

There is a multiplicity of reasons why prevalence and the number of new infections remain so high, including and especially among adolescents and youth, transgender women, inmates, men who have sex with men, and others.

We need to stop telling people to be faithful but simply let them know any kind of condomless sex - vaginal or anal - can put them at risk of contracting the virus.

We have to help people understand that lubricant - not baby oil, spit or lotion - is important and critical for safe condom use. We need to make services for HIV and other STIs more accessible. People should be able to walk into any health facility and get a test done. And we need to stop this myopic focus of conducting outreach only among key populations.

The time for action, change and innovation is now!

- Jaevion Nelson is a human-rights, social and economic justice advocate. Email feedback to and, or tweet @jaevionn.