CHIEF Medical Officer of Health Dr. Peter Figueroa is batting on a sticky wicket when he proposes a change in the country's laws to decriminalise homosexual acts to allow for the distribution of condoms in prisons to stem the spread of HIV/AIDS. Perhaps less potentially contentious but no less important is his suggestion that prostitutes be allowed freely to ply their trade without the stigma of illegality.
His proposal made at last week's PAHO/WHO conference will probably provoke a storm of protests as has happened in the past with much heat and not much light.
Given the staggering statistics showing significant and continuing growth in the number of HIV/AIDS cases across the island over the past decade, few persons will doubt that something needs to be done and quickly.
The question, however, is what should the new public health policy be and how should it be implemented. There are no easy answers.
While there is general public acceptance of the public education programmes that speak to behaviour change and lifestyle adjustments, amendments to the laws relating to buggery and prostitution might be seen as running contrary to the goals of the "safe sex campaign" and responsible behaviour.
We note that some categories of prisoners are allowed to leave their cells for weekend visits. Presumably some will make use of the opportunity for conjugal relations. The possibility and risks of either contracting or further spreading the disease are thereby increased.
Dr. Figueroa's proposal will not only have to get past the fears of politicians, it will have to hurdle the wider society's concerns about morality and concepts of normative behaviour.
When the then-Commissioner of Corrections, Lt. Col. John Prescod proposed the distribution of condoms in prisons two years ago to address the same problem, scores of inmates were slaughtered in a backlash against those labelled homosexual. Prison warders made clear their aversion to participating in any policy which would seem to be condoning homosexual acts.
Several countries have gone the route suggested by Dr. Figueroa. According to the World Health Organization, 23 of 52 prison systems surveyed allowed condom distribution from as early as late 1991. No system that has adopted a policy of making condoms available in prisons has reversed the policy, and the number of systems that make condoms available has continued to grow every year. In a number of surveys undertaken in Europe, the proportion of prison systems that declared having made condoms available rose from 53 per cent in 1989 to 75 per cent in 1992 and 81 per cent in 1997.
Supporters of condom distribution contend that with this policy, the incidence of HIV is significantly reduced.
We suggest that public health authorities examine all aspects of the proposal and its implications carefully before deciding either to accept or discard it. We suspect, however, that this proposal will not get anywhere fast in this homophobic society.
