The following is an edited
version of an address by Bertrand Bainvel, chair of the United Nations Theme Group on HIV/AIDS in Jamaica (UNTG) at the Review of the National Strategic Plan on HIV/AIDS on December 2.
JAMAICA HAS made impressive progress in its national response, especially over the past two years on several fronts: prevention; reduction of stigma and discrimination; and access to care and counselling. The expansion of treatment with the utilisation of the U.N. global fund for tuberculosis, malaria and HIV/AIDS is bringing new hopes for people living with HIV/AIDS, their children, families and friends.
This year witnessed a significant strengthening and expansion in the breadth of the response, especially in the prevention field, as illustrated by the large Jamaica representation in the Bangkok Conference on access for all. This week, and all year long, we saw how the media helped increase public awareness on HIV/AIDS as well as reduce associated stigma and discrimination. Today we will certainly take stock of this while we review the National Strategic Plan on HIV/AIDS.
RAPIDLY EVOLVING
But as we know, the epidemic is rapidly evolving and its face is changing. This requires from us not only expansion of our activities but also change in focus. I will share three statistics with you. In Jamaica, close to 50 per cent of people living with HIV/AIDS in Jamaica are women, adolescents girls are three times as much as boys likely to get infected (and we do now have significant numbers of teenagers living with HIV/AIDS); and more than 20,000 children are estimated to be vulnerable or orphaned by HIV/AIDS.
The epidemic no longer contains itself to individuals marginalised and ostracised by their society because of their sexual orientation or work. This means that all our strategies, policies, services and advocacy, need now to encompass this new reality: HIV/AIDS is increasingly targeting and undermining families.
EMPOWERING INDIVIDUALS
Empowering individuals affected or infected by HIV/AIDS must be part of a comprehensive, family-centred approach dealing with basic support services, social safety nets, prevention, care and treatment. As much as possible, partners, children and friends must be included in our interventions, while giving individuals especially adolescents the possibility to use services without others' consent. If we adopt this inclusive, more family-oriented approach, we can further reduce stigma and discrimination against people living with or affected by HIV/AIDS.
We need now to put more emphasis on relations between both sexes, understand Jamaican men's and women's respective take on sexuality, and tailor interventions specifically for each sex while also promoting new ways of socialisation, including among young people. Promoting self-esteem, and tolerance and respect in handling relationships and conflicts should be part of life skills-based education for our pre-teens as well as teens.
REALISTIC GUIDANCE
But this won't be enough. Specific interventions need to target those who have the trust of our children and young people at the forefront of which are parents, teachers, counsellors, doctors/nurses and coaches. They must be empowered to deal with their own sexuality and provide realistic guidance to their children and young people.
As women are increasingly taking the brunt of the epidemic, we also need to expand our understanding and approach to the epidemic. Decreasing domestic and gender-based violence, providing economic opportunities and children's services for single and teen mothers, increasing the age of consent, expanding family planning services, and enforcing new legislation and policies promoting the involvement and responsibility of fathers all these strategies, while not part of the National Strategic Plan on HIV/AIDS, are essential if we want to reverse the current trends in the epidemic. The plan on HIV/AIDS itself is not enough. Complementary plans addressing factors influencing the epidemic need to be developed.
We know the agenda is broad and ambitious, but the successes witnessed in our sister Caribbean countries, such as the Bahamas and Barbados, show us that we too can slow down and reverse the epidemic.
THEME GROUP
The U.N. Theme Group is definitely willing to contribute to the national response. Recommendations from the post-Bangkok conference the recent forum on youth and HIV/AIDS, strengthening of the network of people living with HIV/AIDS and extending partnership with their supporters have been already acted upon and others are being operationalised.
Each U.N. agency in Jamaica has to frankly assess its support to the national response, take full advantage of its respective mandate and help further expand the breadth of the national response. It is our hope that the newly-established UNAIDS office in Jamaica will help put our family on stronger feet. We should stand ready to help remove key bottlenecks that hamper the acceleration and expansion of the response, namely:
Stigma and discrimination and the promotion of human rights of women, adolescents, young children and marginalised and vulnerable groups, including sex workers and men having sex with men.
Poverty, especially among women.
Weak capacity in prevention, especially at the grass roots level, as well as psychological and social support.
Inadequate access to services, including voluntary and confidential testing, especially among teenagers.
We need now to put more emphasis on relations between both sexes.
