One of the driving forces of the HIV/AIDS epidemic is male promiscuity. The epidemic is unrelenting because of the culture of Jamaican men to have multiple partners. These men boast among themselves about their sexual exploits with women outside of their usual intimate partners. They feel powerful when they can demonstrate multiple sexual encounters irrespective of the health dangers to themselves and their partners. This practice drives the spread of infection because less than half of these men use condoms consistently.
Having sex in exchange for money or gifts, also called transactional sex, is another worrying feature of the HIV/AIDS epidemic. The 2008 Knowledge, Attitude, Beliefs and Practice survey revealed that 27 per cent of the 15-49 age group engaged in transactional sex. The high incidence of this type of sex represents a disparity in power between the sexual parties as is demonstrated by adolescent males and females who have sex with older men. This kind of transactional sex often does not facilitate the use of condoms since the person paying controls the conditions of the sexual act.
Sexual abuse of young men
The survey found that one in 10 males in the 15-19 age group had sex in the last year with a non-marital partner who was more than 10 years their senior. These young males often had sex without a condom because they didn't plan to have sex nor did they have a condom. These young males are at high risk for sexual abuse as well as transactional sex. It is estimated that 30 per cent of men who have sex with other men are likely to be infected with HIV.
Deaths from AIDS
AIDS is the second leading cause of death for young people ages 15-24. More males (595 in 2007) die each year from AIDS than females (509 in 2007). However, deaths from AIDS have decreased because of the introduction of anti-retroviral drugs. The epidemic continues because many people do not know that they have the disease. It is estimated that half of the 27,000 people with the disease have not been tested. These people are at greatest risk of spreading the HIV infection to others.
HIV/AIDS is now recognised as a chronic infection. In Jamaica, it is spread by sexual contact with an infected person. The epidemic can be controlled or even eradicated. This can be achieved by urging young people to defer sex until they are able to make safe, adult decisions. Young people should be taught how to use a condom and trained to insist that a condom must be used all the time. All men engaging in sex should aim to have one steady partner who they believe is faithful to them. It is recommended that even partners in steady relationships use the condom because of the high level of promiscuity among men.
Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians. Email: yourhealth@gleanerjm.com.
