Abuse of Young Women Fuels the HIV Epidemic in Jamaica

Tishanna * – diagnosed as HIV positive at age 21 – never knew her father. What she does know is that her great need for love and the abuse meted out by relatives while she was still a small child, has derailed her dreams and changed her life forever.

Tishanna, now 25, was sexually, physically and mentally abused by more than one family member in Kingston, from age six until age 12, when she was sent to live with an aunt and uncle in the United States.

The young woman states that her mother was a busy and hard-working woman who was not always around, and was thus compelled to leave her in the care of relatives. Tishanna was constantly beaten by one uncle and raped by another relative, whom she refuses to name. She never told her mother about the abuse.

The young woman notes that the abuse she endured between ages six and 12 is something she has not forgotten, and that it has shaped the adult she has become.

“It [the abuse] let me grow up to hate men. It made me reckless — I would do anything. I didn’t care if I got hurt. It also pushed me to have sex from an early age. I just did not care who I was having sex with because nobody cared about me.”

Women Are Vulnerable

In Jamaica, violence against women, especially rape is a matter of grave concern. Sex crimes alone account for 827 of the more than 5,000 major crimes reported between January and September 2008. Rape accounted for more than half (536) of the sex crimes reported between January and September 2008. There were 485 incidents of rape between January and September 2007.

But, in addition to rape, a significant number of women experience other forms of gender-based violence, such as physical violence and sexual coercion.

Like Tishanna, some survivors of violent sexual acts are at directly increased risk of HIV infection, as traumatic abrasions and lack of lubrication increase the risk of transmission. Sexual violence can also lead to the increased likelihood of high risk behaviours.

The 2008 UNAIDS country report on Jamaica indicates that violence and abuse remains a serious problem for young people in Jamaica. According to the report, physical and sexual abuse affects roughly one in 10 Jamaican youth.

The report also noted that approximately 11 per cent of respondents reported having been threatened or harassed into having sex by friends (44 per cent), neighbours (17 per cent), relatives (16 per cent), and family friends (13 per cent).

The country report also quotes the most recent Jamaica Reproductive Health Survey (2002), which states that about 20.4 per cent of young women between the ages of 15 and 19 years report having been forced to have sexual intercourse at some point during their life. Overall, one-fifth of Jamaican women have experienced forced sexual intercourse.

Control Violence And Abuse To Fight HIV-AIDS

The issue of violence and abuse remains a critical one in the fight to reduce the spread of HIV, especially among women who may lose the ability and the inclination to negotiate for safer sex.

Kingston-based counselling psychologist with the Women’s Resource and Outreach Centre, Faith St. Catherine, says, “Abuse destroys self-esteem — of anybody. It creates unhealthy dependencies and the feeling that they [the victims] cannot do anything on their own. They do not feel strong enough to negotiate for safe sex and do not feel that they deserve anything good and so they ‘take what they get’. Women have been dis-empowered by years of abuse and feel that dependency is their lot in life.”

St. Catherine notes, “Some, when abused over and over again early in their life, learn that the way to get people to love you is to have sex with them. Some appear to be addicted. We find this syndrome in a lot of children who have been sexually abused. They can’t help themselves.”

The primary contributors to the HIV epidemic in Jamaica are said to be socio-cultural, behavioural and economic factors that result in risky behaviours such as multiple sex partners, older men having sex with younger women, and early sexual engagement.

An estimated 1.5 per cent of the adult population of Jamaica is  HIV-positive. Men and women between 20 and 39 years old account for 54 per cent of reported AIDS cases in Jamaica. UNAIDS estimates that 25,000 people in Jamaica are living with HIV.

Strong Link Between Abuse And Sexual Risk-Taking

Dr Glenda Simms, Kingston-based consultant on gender issues, says there is a whole body of research connecting abuse and risk-taking behaviour.

“Research shows a significant percentage of prostitutes were violated and sexually abused as children and this has influenced their behaviour as adults.  Child abuse distorts natural sexual development, which should have been allowed to proceed normally.”

Concern about economic conditions and cultural traditions, which reduce the power of women and girls to negotiate safe sex, was expressed by Dr Leith Dunn, head, Institute of Gender and Development, University of the West Indies (UWI) at Mona.

“Because you have unequal gender roles with women often in subordinate and dependent relationships, they [women] therefore have less power in negotiating safer sex. Safer sex is ensuring that you can use a condom every time.”

“If you are dependent on a man for your economic well-being, you are less likely to demand that he use a condom. Men are also at risk because of the idealised images of masculinity, which dictate that the man should have a lot of women, and can take risk without fear of the consequences. The woman says no, but the man says ‘I am a man and I am entitled’.”

Married Women Are Poor Negotiators

Dr Simms is also concerned that married women in Jamaica are one of the large risk groups for HIV because of cultural constraints.

“Marriage has a certain meaning in this society. The woman is seen as belonging to the man. The man is seen as the master of the woman. Because of that, marriage is seen as this precious institution designed for people to have children — they [women] are not capable of negotiating safe sex even when they suspect the man is playing around. The tragedy is that husbands cheat with women and with men as well.”

Dr Simms claims that married women of all classes in Jamaica are affected.

She is not satisfied that enough is being done for this group.

“We were focusing on the treatment of HIV-AIDS and we not doing enough for prevention. It is not just about condom use. We need to interface with and empower women at all levels about the right to say no. Men also need to be educated that women are not their property, even though this is difficult in our culture.”

In 2007, the Jamaican Ministry of Health and Environment secured 40 per cent of the funding needed to implement a $200 million, five-year strategy to fight the spread of HIV and AIDS.

Policy Helps

The Government of Jamaica recently began implementing its third National Strategic Plan on HIV/AIDS/STIs, for the years from 2007 to 2011. The Plan focuses on achieving universal access to prevention, treatment, care and support.

Marion Scott, Behaviour Change Communications Officer with the Jamaican Ministry of Health notes that there are several programmes that are intended to strengthen the ability of women to negotiate safer sex throughout the island. These include interventions for sex workers, and targeted community intervention and intervention at clinics.

“The issue of negotiating for safe sex remains a challenge because there are a lot of economic factors that sustain the vulnerability of women. But our programmes are continuing,” Scott says.

St.Catherine notes that women who believe that abuse and dependence is their lot in life come into her office everyday. Despite this, she says, the culture that facilitates violence and abuse, and strips women of negotiating power, is changing.

“It is changing because people are more aware. The laws now say that those who are aware of abuse and do not report it are liable, so people are more likely to intervene on behalf of affected women and children. I have noticed a greater willingness to report and to intervene. We still have a long way to go but the increase in awareness has helped.”

In the meantime, the evidence of what abuse can do manifests in the lives of women like Tishanna, who says that at age 21, when she discovered that she was HIV+, she wanted to kill herself.

“I wanted to die,” she says. “But, I found Jamaica AIDS Support, which gave me reason to what to live again.”

But, Tishanna believes her dreams of becoming a chef will never materialise. She blames her disappointments and misfortunes on her abusive relatives.

To those who are doing the same she says, “You see how nice children are? You need to protect them. What happens to them early can scar them for life.” (Panos)

Avia Ustanny Collinder is a Kingston-based freelance journalist who specialises in gender and social issues.

     

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