Pregnant, HIV positive and scorned
Although Jamaica has almost eradicated mother-to-child HIV transmission, there are concerns that women living with the virus are still being criticised by some medical personnel when they get pregnant.
Kandasi Levermore, executive director of Jamaica AIDS Support for Life (JAS), says this is a form of discrimination which infringes on the reproductive health rights of women who want to have children despite their status.
According to Levermore, she has heard several pregnant women complain about the situation; with some saying that they have been advised to 'tie off' (tubal ligation) to avoid getting pregnant.
"If they are HIV-positive and they are known, they explain that they get almost like a feeling like 'you shouldn't be here', because you shouldn't be pregnant because you are HIV-positive," said Levermore.
"They feel less than welcome when they go to access (some medical) services," added Levermore.
Case worker at JAS, Christina Gordon, alleged that she has witnessed this form of discrimination at first hand.
RIGHT TO REPRODUCE
"One of the biggest things I have seen is that people don't believe that they have the right to reproduce as a HIV-positive person, so automatically, once you are HIV-positive it's like, 'You are wicked eeh, you have HIV and you go and get pregnant again'.
"I have heard that and I have actually witnessed where a doctor said, 'If you have another baby again, I am not going to treat you'," said Gordon.
Levermore believes that such attitude by medical workers is not in keeping with the country's thrust towards providing access to universal health care for all citizens, and wants the treatment style for HIV-positive patients to be given more consideration.
"I have had clients who tell me that, 'Listen, before I go so and so place, I would rather dead, Ms Levermore'. I have heard that over and over because of the fear that when they go there, they are going to be set apart (and) people are going to know their business," she said.
One HIV-positive mother told The Sunday Gleaner that she is still living with the regret of aborting her son eight years ago because a doctor informed her that the child would automatically have HIV.
Levermore said that while pregnant women are stigmatised mostly in the public-health care system, doctors in the private sector sometimes avoid treating pregnant HIV-positive women.
She charged that doctors most often refer the pregnant HIV-positive women to the public-health facilities for prenatal care and treatment.
"They will use the excuse to say that they are not HIV specialist as a means to refer the client, and I tell you, the Comprehensive Clinic in Kingston is the number one reference point," she said.
REORGANISE SERVICE DELIVERY
Levermore said she has expressed her concerns in the past about the stigmatisation of HIV-positive individuals, and while there have been minimal improvements, this is only in some urban health facilities where health-care providers are educated about the issues.
"We have been asking, please let us look in a real way at how we can reorganise the service delivery so that it doesn't alienate anyone or set apart any particular group. People will feel that they are treated fairly and there is equity, whether I come in with pink eye or I come in because I have tested positive for HIV," she said.
"They (health professionals) are justifying everything. I can tell you that. And so because they feel that they are justified in how they are answering, they are ignoring the real implications on the individuals and those things make people not want to access services. They are not getting the bigger picture," she said.
Jamaica's mother-to-child HIV transmission rate was at just two per cent last year. It is estimated that about 32,000 persons are living with HIV in the country.
"Worldwide, it is known that you can put measures in place so that the virus is not transmitted to the child; neither in the womb nor at birth. It is the one area in Jamaica that we have done exceptionally well in. We are now going through the processes to get certified that we have eliminated mother-to-child transmission. That is how good the programme has been here," said Levermore.