Caribbean

Ulysease Roca Terry was a gay Belizean fashion designer living with HIV. He had recently lost his mother and was coping with depression. Even without a new pandemic, it was a difficult time.

He was arrested for breaching COVID-19 curfew laws in April. While in custody he suffered homophobic slurs and bullying by a police officer. A video of the abuse was posted to social media. He also claimed that he was physically attacked while detained. Days later he died.

This month in the Bahamas, a video circulated on social media of a gender non-conforming woman being beaten by three men hurling homophobic slurs. One man smashed a piece of wood onto her head. Others slapped and punched her. As the video circulated online, some made fun of the victim.

While countries in the Caribbean focus on combatting COVID-19, community organizations have been raising their voices against the casual verbal, physical and emotional abuse that is a feature of life in the region for far too many lesbian, gay, bisexual, transgender and intersex (LGBTI) people. And they are sounding an alarm that this cruelty is increasingly playing out online.

Caleb Orozco of the United Belize Advocacy Movement (UNIBAM) spoke about Mr Roca Terry’s case with a mix of sorrow and defiance. Mr Orozco is used to tough battles. He was the litigant who successfully challenged Belize’s law banning consensual sex between same-sex partners in 2016.  

“The police cannot erode public confidence in its law enforcement role by showing disregard for the dignity and rights of individuals who are members of the most vulnerable groups: those with mental health challenges, those living with HIV and those with different sexual orientation,” Mr Orozco said. “It is the responsibility of the police department to enforce the curfew in a manner that is reasonable. Mocking people does not help to build public confidence that the police are there to protect ordinary citizens.”

UNIBAM is calling for a transparent investigation, a review of the autopsy report and action to improve how the police treat members of vulnerable and marginalized communities, particularly in the context of the COVID-19 restrictions.

In Belize, a national dialogue is under way around a proposed Equal Opportunities Bill. A UNAIDS public opinion survey conducted in 2013 found that Belize was among the more tolerant Caribbean countries, with 75% of respondents agreeing that people should not be treated differently based on their sexual orientation. But this incident is a reminder that notwithstanding strides made in social attitudes and the law, pervasive challenges remain around prejudice and the abuse of power.

The Bahamas Organization of LGBTI Affairs has called the attack circulated on social media a hate crime and demanded that the perpetrators be prosecuted.

“Around the world, this kind of hate crime—the targeting of a person with extreme violence because of who they are—is denounced as among the most reprehensible modes of human conduct imaginable,” Rights Bahamas said.

Alexus D’Marco, Executive Director of the Bahamas Organization of LGBTI Affairs, insisted that there must be a broader dialogue and action to address social attitudes.

“What does it say about us as a people that so many consider this a source of humour and entertainment? What are we to think when so many of the culprits are fellow women, who should be standing together in solidarity to oppose the many injustices faced in common as members of an oppressed gender in this society?” Ms D’Marco demanded.

The Bahamas is the only Caribbean country to have decriminalized sex between consenting adults of the same sex by an act of parliament. Still, lots more work needs to be done to bring social attitudes in line with the law. Advocates insist that hate crime legislation must urgently be enacted and enforced.

In both the Bahamas and Belize, state entities have joined civil society to denounce the attacks. The National AIDS Commission, the Office of the Special Envoy for Women and Children and the Ministry of Human Development, Social Transformation and Poverty Alleviation have called for Mr Roca Terry’s case to be thoroughly investigated. In the Bahamas, the Ministry of Social Services and Urban Development called for a swift prosecution to signal zero tolerance by the government and society for gender-based violence.

“Alongside legislative reform and key population programmes, we must continue the social dialogue and law enforcement to create more peaceful and inclusive Caribbean societies for all,” said James Guwani, UNAIDS Director for the Caribbean.  

Delores Robinson’s days are usually busy. She heads GROOTS Trinidad and Tobago, a civil society organization that provides psychosocial care for people living with HIV. It also manages a transition house that provides shelter and services for displaced members of key populations.

But since the first COVID-19 case in the country was confirmed, on 12 March, Ms Robinson’s workdays have become a whirlwind. The government’s containment measures—a stay-at-home order and a shutdown of all non-essential business—have thrust the most vulnerable people further into the margins.

GROOTS Trinidad and Tobago is an example of how civil society organizations can move quickly to identify and respond to the needs of the voiceless. Ms Robinson, a Jamaican, has lived in Trinidad and Tobago for the past 34 years. During conversation she alternates between wide, open smiles and a furrowed brow. These days there’s lots to worry about.

Every day she prepares meals for 30 families. She then personally delivers them. There is no structured funding for this effort—just money and other contributions from HIV response stakeholders.

There’s a unique story at each drop-off point. Today she manoeuvres through the narrow roads of Sea Lots, a low-income community in the shadow of the capital city, Port of Spain. The men on the block recognize her car. One offers to deliver her parcel. She laughs. Ms Robinson has come to visit the seven children of a single mother living with HIV who is currently hospitalized.

The Government of Trinidad and Tobago has provided a range of COVID-19 relief options. These include salary relief, rental assistance grants and nutrition support. Sometimes, Ms Robinson’s role is to help clients navigate government systems. For example, one illiterate mother living with HIV lost her food card and needs help getting it replaced.

“The forms are complicated for many people, plus they don’t have an Internet service,” Ms Robinson explained. “Now that we are all being encouraged to conduct business online, many have no access.”

Since the stay-at-home orders went into effect, she’s been asked by the police to accommodate women and children at the transitional home. The combination of income loss and constant contact has exacerbated abusive situations, leading to a spike in reports of domestic violence.

Ms Robinson reports that her clients living with HIV have so far had no problem accessing their treatment. Before COVID-19, it was standard practice for Trinidad and Tobago clinics to dispense two- to three-month supplies of HIV medicines at a time. HIV treatment facilities and sexually transmitted infection clinics remain open, although they have altered hours.

“They have their meds,” she said. “What they need most now is nutritional support to be able to stay healthy and take their treatment.” And they need masks.

UNAIDS Caribbean is advocating for governments in the region to ensure that community organizations like GROOTS are included in decision-making and planning around meeting the needs of vulnerable populations during the COVID-19 crisis. They are an essential service, ensuring that people’s most basic needs are met. These organizations should be included in contingency plans for connecting people living with HIV to services. And they should be resourced.

“We think we’re all in this together, but there are many people who don’t have the things we take for granted—a safe home, healthy food and the ability to speak out. It’s tiring work but it’s needed now more than ever,” Ms Robinson said.

Some Jamaicans have responded to the COVID-19 outbreak in extreme ways. Family members of one of the first confirmed cases received death threats, and nurses have reported being barred from public transport. Some people have given the health authorities wrong addresses to avoid the stigma that a home visit would attract.

UNAIDS Jamaica and civil society organizations serving people living with HIV have joined the national discourse to share a key lesson learned from HIV: that stigma and discrimination are barriers to an effective response.

Two-thirds of Jamaicans would not purchase vegetables from someone they knew to be living with HIV, according to the 2017 Knowledge Attitude and Behaviour Study. The effect of such widespread prejudice is seen in the island’s treatment outcomes. According to government estimates, while an estimated 84% of people living with HIV were aware of their status in 2018, less than half (47%) were on treatment

For Jumoke Patrick, Executive Director of the Jamaica Network of Seropositives, there are clear parallels between people’s reactions to the novel coronavirus and HIV.

“People living with HIV feel they need to stay away from people and from accessing services. They feel they need to reduce and limit their lives because of how people treat them. We have some of the same treatment meted out to people positive with, or suspected of having, coronavirus. When there’s fear we respond in a defensive way,” Mr Patrick explained in a webinar hosted by UNAIDS Jamaica.

Community organizations have reported that some COVID-19 stigma has even been directed to people living with HIV. UNAIDS Jamaica has been working to raise awareness among policymakers and through the news media about the importance of building trust with affected people while combatting stigma and discrimination among the wider population.

“Just as with HIV, success in combatting COVID-19 absolutely depends on people’s willingness to get tested and access care. Verbal abuse, violence and intimidation will only chase people away from services,” said Manoela Manova, UNAIDS Country Director for Jamaica.

The Jamaica Ministry of Health has launched an antidiscrimination campaign that includes stories of harassed COVID-19 patients in virtual press conferences.

“None of us are immune to the virus,” Christopher Tufton, the Jamaican Minister of Health, said at a recent press conference. “None of us must claim or think that we will exclusively escape and it is somebody else’s fault. We must treat each other in a way that almost assumes that tomorrow we are going to need the support from those who are so infected and impacted today. We really need to cut the hate and work together as a country and as communities, to overcome.”

In 2017, a Jamaican actress starred in an educational video about HIV treatment adherence. It was an upbeat, innocuous reminder to people living with the virus to eat healthily, exercise and take their medicine every day.

After she made the film, the young woman faced some strong reactions—bookings dried up, strangers in the street pointed at her and her daughter faced teasing at school. Although she herself is HIV-negative, it was a sharp reminder concerning the stigma and discrimination faced by people living with HIV.

Earlier in 2019, Jamaica’s Minister of Health, Christopher Tufton, appeared in a public service announcement with the young actress to tell people that a person’s HIV status was no reason to discriminate against them. “There is still a lot of work to be done and while I was disappointed by the reactions to the video, I have seen and heard enough to understand that HIV-related stigma and discrimination is still a big challenge in the community and something we have to work on,” he said.

Jamaica’s 2017 HIV/AIDS Knowledge, Attitudes, Behavior and Practice survey found that just 12% of respondents were accepting of people living with HIV. Over the years, Mr Tufton has had his own journey from fear to acceptance.

He was a teenager in Manchester, United Kingdom, when the first HIV cases were diagnosed in Jamaica during the early 1980s. During the decade that followed, as a post-graduate student in the United States of America and the United Kingdom, he heard how advances in the scientific and social response to HIV were creating new pathways toward prevention and stigma reduction. He describes his current spell as Minister of Health as “peak awareness.”

“Over time, I have evolved from fear to actively advocating for greater levels of tolerance. I’ve been more interactive with people affected by HIV and with vulnerable groups. I have become an advocate both for anti-discrimination and for prevention. HIV does not have to be a death sentence. It can be treated. It can be controlled. If you take your medicines you can live a long and fruitful life,” says Mr Tufton.

Thousands of Jamaicans living with HIV are still not accessing treatment. As it updates its National Strategic Plan, the Ministry of Health and its partners are focused on addressing the challenges around connecting people to care and keeping them on treatment. For example, they are working to increase testing and outreach to men. Men are far more likely than women to be diagnosed late and to die from AIDS-related illnesses.

Having drawn the connection between relatively low levels of treatment coverage and discriminatory public attitudes, the government has boosted efforts to change hearts, minds and behaviours. Health-care discrimination is monitored through the Client Complaint Mechanism, as well as the Jamaica Anti-Discrimination System managed by the Jamaica Network of Seropostives. The Ministry of Health is also deploying strategies to reduce stigma and discrimination by training health-care workers, engaging with the faith community and running additional campaigns aimed at the general public.

These efforts come as the country prepares to transition away from a substantial degree of international funding for the AIDS response to greater national ownership. Along with its

commitment to provide free HIV treatment for all who need it in 40 facilities across the country, the government will also ensure that vulnerable communities currently served by donor programmes are included in domestic budgetary planning.

Partnering with civil society is a critical strategy for ensuring that the most stigmatized groups—people living with HIV, transgender people, gay men and other men who have sex with men and sex workers—are able to successfully access treatment.

“Civil society organizations are key partners. As part of the process we will identify which groups are best suited to deliver services. There are government systems in place for engaging with service providers,” says Mr Tufton.

The UNAIDS Country Director, Manoela Manova, welcomes this commitment to working with civil society to address prejudice and increase access to services.

“Jamaica has done a good job at HIV testing,” says Ms Manova. “Now new strategies are needed to reach those who are not aware of their status and to connect people diagnosed with HIV with treatment. The more we do to ensure that people feel safe and respected, the closer the country will come to ending AIDS.”

Charlot Jeudy, the President of Haiti’s lesbian, gay, bisexual and transgender (LGBT) community organization Kouraj, was found dead at his home in November. Investigations into the circumstances of his death are ongoing. UNAIDS remembers Mr Jeudy as a fearless campaigner for human rights.

In the aftermath of the devastating earthquake in 2010, the people of Haiti worked to overcome the loss of homes, businesses, public services and more than 100 000 lives. But amid the shared trauma and determination, a harmful narrative emerged.

Some people began to blame the masisi—a derogatory Haitian Creole term for gay men. They thought that the disaster was a divine punishment for the sins of the LGBT community. Members of sexual and gender minorities found themselves subject to intensified exclusion and abuse. Human rights organizations documented cases of LGBT people being denied access to emergency housing, food, health care and work. There were also reports of physical assaults and homophobic rape.

Rather than accept the situation, Charlot Jeudy decided to act. He created Kouraj, which means courage in Haitian Creole. In the struggle for equal rights, Kouraj emphasized the importance of community empowerment and aimed to inspire pride and confidence among LGBT people.

“We wish to put forward an alternative discourse on homosexuality in Haiti because for too long only homophobes have discussed our reality and proposed their own interpretation,” Mr Jeudy said in 2011.

Over the next eight years, Kouraj evolved to offer community training, legal and psychosocial services and sexual health education. It became one of Haiti’s leading advocates for ending discrimination against LGBT people and has played a key role in resisting the introduction of discriminatory laws.

The organization was aptly named. Its members have contended with verbal abuse and death threats. Three years ago, it had to cancel a festival to celebrate the Afro-Caribbean LGBT community after numerous threats of violence. According to friends, Mr Jeudy resisted their pleas to leave the country at the time. In response to a spike in reports of anti-LGBT street violence last year, he worked with the United Nations on a project to promote tolerance and equal rights.

John Waters, Programme Manager of the Caribbean Vulnerable Communities Coalition, paid tribute to Mr Jeudy’s leadership.

"I have watched Charlot Jeudy grow from a young, impatient and impassioned activist into a thoughtful, strategic leader, capable of using human rights not as a sword, but as a shield,” said Mr Waters. “He won over the hearts and minds of others to create allies. Mr Jeudy has left a huge gap in human rights work in the Caribbean. He raised the bar for those who must now follow in his footsteps.”

Mr Jeudy was also an active civil society representative on the body that oversees the management of Haiti’s response to HIV, tuberculosis and malaria.

“Under Charlot Jeudy’s leadership, Kouraj was a model partner,” said Fritz Moise, Executive Director of the Foundation for Reproductive Health and Family Education. “His death is a big loss for the response to HIV in Haiti.”

UNAIDS has added its voice to the expressions of grief and also paid tribute to the leadership of Mr Jeudy.

“Charlot Jeudy exemplified the power of communities to be the voice for the voiceless and to make meaningful change in people’s lives,” said UNAIDS Country Director for Haiti, Mame Awa Faye. “This World AIDS Day we celebrated the power of communities to make a difference. Mr Jeudy did just that.”

Erva-Jean Stephens works as a Strategic Information Adviser in the UNAIDS Country Office in Jamaica. She describes her role as using evidence-informed data to shape programmes and policies that contribute to the country’s development.

Ms Stephen’s professional career is entwined with an activist’s desire to see better health outcomes for ordinary Jamaicans.

“I try to serve people first,” says Ms Stephens. “People reach out to me because I make myself accessible and I easily relate to their needs. I naturally build networks outside of the work environment that I think might be beneficial to the work we do.” 

She supports the nongovernmental organization Eve for Life because she believes that young women and girls living with or affected by HIV are being left behind with regard to international funding and programmatic focus. Beyond providing technical support to help Eve for Life increase its funding, Ms Stevens has mobilized private sector organizations and UN Cares, the United Nations system-wide workplace programme on HIV, to raise funds and create care packages for young women and their children.

Under her leadership, UN Cares Jamaica has trained United Nations staff members in the country on issues such as unconscious bias and the human rights of lesbian, gay, bisexual, transgender and intersex people and of people who use drugs. In 2016, the United Nations team in Jamaica received an award from the United Nations Secretary-General for its work on raising awareness about HIV and noncommunicable diseases.

In 2018, UN Cares Jamaica launched UN Moves. This is an offshoot of a project led by the Ministry of Health that aims to harness the power of the private and public sectors to help create a healthier, happier population through nutrition, exercise and education. But for Ms Stevens, the most critical area of UN Cares’ work remains addressing HIV-related stigma and discrimination.

“There needs to be ongoing training on cultivating and maintaining a model work environment where stigma and discrimination have no place. Sometimes we may not realize to what extent people are looking at us in the United Nations and how important it is for us to walk the talk,” said Ms Stevens. She thinks about her own journey and how through the UN Cares programme she has learned to identify and uproot her own biases.

Ms Stevens has a degree in environmental health and food safety and a master’s degree in public health with a specialization in medical epidemiology. She began her career with the Ministry of Health, using monitoring and evaluation techniques to ensure outbreaks of malaria and food-borne illnesses were quickly brought under control.

She hopes to be part of the team that sees the end of the AIDS epidemic.

“When you look at the history of the Caribbean in terms of eradicating diseases, political commitment and community involvement have always intersected,” she explains. “To meet our commitments on controlling the transmission of HIV, we need to see more meaningful community engagement and leadership, supported by political will. I am here to provide the strategic information necessary to help realize that goal.”

Rachel Allen (not her real name), who lives in Kingston, Jamaica, was coming to terms with testing positive for HIV and trying to get on with her life. When she decided to go to nursing school, she was horrified to discover that the school required her to take an HIV test as part of the application process.

Jane Williams and Paul Brown (not their real names) were in love and wanted to start a family. But when health-care workers learned that Ms Williams was living with HIV, they expressed their disapproval. One nurse told her she shouldn’t have a child because of her status. One doctor called her “wicked”.

These are experiences that are all too common among people living with HIV, according to Jumoke Patrick, Executive Director of the Jamaica Network of Seropositives. The organization was set up in 2005 as a mechanism for people living with HIV to report rights violations. Now, the Jamaican Anti-Discrimination System (JADS) provides a system for the formal reporting of incidents and as well as a system of redress.

It’s an essential service, says Mr Patrick. He says that providing a channel for people to identify stigma and discrimination is a first step to allowing people living with HIV to access services and live full and productive lives.

“The fact that people are not accessing services has to do with stigma and discrimination,” Mr Patrick said. “That is why we have a fall-off in access to services. Stigma and discrimination is the main reason we are not where we are supposed to be in terms of getting people onto treatment. I have to know that when I disclose my status, you will not use it against me.”

People who have experienced prejudice in the health-care, education and employment sectors can report it to a JADS Redress Officer. Clients are often referred through a community facilitator in their health region, other civil society organizations or the Ministry of Health’s client complaint mechanism. Complainants fill out a form and are interviewed by one of the four redress officers in their district. A panel reviews each case and makes recommendations regarding an investigation. Agency and confidentiality are key. Some people opt out of seeing their complaints through, but those willing to go the distance have the benefit of an advocate.

“If you want redress you have to make a complaint, and you don’t have to be alone,” said Nadine Lawrence, a JADS Redress Officer. “It makes a lot of difference when you become empowered. You are able to get back into society and live a positive life.”

The most common cases are about treatment in health-care settings, breach of confidentiality and workplace harassment. Ms Lawrence has supported clients whose work colleagues disclosed their HIV status to their bosses. Others have had health workers from their community disclose their status.

What would she say to someone who has suffered an injustice but is reluctant to make a report? “Our organization exists so people who are HIV-positive can be more empowered. We sign a code of confidentiality. Trust the system,” she said. “Because it works.”

It worked for Ms Allen. JADS redress officers contacted the Ministry of Health to challenge the practice of requiring an HIV test to enrol in nursing school. The Ministry’s Legal Department intervened, sending a letter to the school advising it that the policy was illegal. The school’s board ultimately removed the HIV test requirement from its intake form.  

The system also worked for Ms Williams and Mr Brown, who received a written apology. In addition, their complaint initiated a training programme for medical staff about the sexual and reproductive health rights of people living with HIV.

“Is it safe to do their work?” Renaè Green and Donique Givans go silent for several seconds. “I am still scared,” says Ms Green, the Associate Director for Policy and Advocacy at TransWave Jamaica. “I don’t like to go to certain spaces. If anyone wants to participate in one of our campaigns, we explain the risks. You don’t know what kind of backlash you might experience.”

Ms Givans, who is the organization’s community liaison officer, knows this all too well. She wasn’t up front about her gender identity with her father when she began becoming more visible in her advocacy work.

“He doesn’t want anything to do with me now,” she says, her voice shaking a little. “He told me to go and not to come back to his house. So, we do let people know they might have difficulties.”

TransWave was formed in 2015 following a lesbian, gay, bisexual and transgender health and gender-based violence training, conducted by WE-Change and supported by the Jamaica Forum for Lesbians, All-Sexuals and Gays and Jamaica AIDS Support for Life.

TransWave’s Executive Director, Neish McLean, is the only transgender man at the helm of a Caribbean transgender organization. Recently Mr McLean discussed his personal journey publicly, exploring issues ranging from the distinction between gender identity and sexuality to top surgery. This is largely unchartered territory in a Caribbean nation famed for its social conservatism.

“For a long time, people actually said that transgender people didn’t exist in Jamaica because people could not put a face to them or identify anyone who was transgender. Now we have so many people who identify. It has helped in terms of explaining who transgender people are,” explains Ms Green. 

In addition to increasing transgender visibility, TransWave advocates on a wide range of subjects that affect the community—the lack of access to transgender-oriented housing, education and employment, for example, as well as initiatives to reduce poverty and violence. HIV is a huge challenge. A 2018 Integrated Biological and Behavioral Surveillance Survey conducted by the University of San Francisco found that 51% of Jamaican transwomen tested were living with HIV.

TransWave advocates strongly for all members of the community to access health care.

“Many are aware that they are HIV-positive but don’t seek treatment. They are just waiting to die. People cannot stomach not being able to live their lives as their real selves and won’t put themselves through the distress of going to a clinic,” says Ms Green. “It becomes difficult because all eyes are on you and you are putting yourself at risk for people to attack or hurt you,” explains Ms Green.

In July, UNAIDS Jamaica supported TransWave’s Transgender Health and Wellness Conference. The event helped launch a toolkit on how health-care providers can provide holistic, non-discriminatory services, along with dialogue around the rights and inclusion of transgender people. The organization has also met some employers to gauge the degree of acceptance for the inclusion of transgender workers.

Ms Givens paints a mixed picture of what life is like for transgender people in Jamaica. 

“It is very difficult, but people try to align themselves with society’s gender norms. They might do a little makeup to feel comfortable, but they don’t go heavy. Some workplaces allow people to be themselves, but you don’t have transwomen wearing skirts,” she said.

Public transportation is often challenging. When TransWave books a taxi, for example, they are never sure if the driver will be tolerant. Renting an apartment can be a landmine. Lower-priced housing often means living in a less safe area. Landlords and neighbours can be judgemental.

At the extreme, homelessness remains a major problem, with some young transgender people being thrown out of their homes before they even become teenagers. This is often the starting point for a frightening array of vulnerabilities, including a lack of schooling, poor job prospects and bad health, with some turning to sex work.

Asked about their hopes for the future, Ms Givans and Ms Green list adequate funding for TransWave and being able to further their education. Ms Green adds that she would like to emigrate.

“But not everybody wants to leave Jamaica and not everybody should leave,” she says pointedly. “That’s why we are working so hard. So that we can get to a point where everybody is accepted.”

Monique McDonald is an HIV peer educator who tells the story of her childhood with unflinching courage. “I was sexually abused by my uncle at the age of 12 and contracted HIV.”

Ms McDonald has written about her experiences in a book called I am now free. It uses her old diary entries to describe the abuse she suffered as a child and her journey to recovery. Today, she supports young women living with HIV, helping them to come to terms with their status and advising them on adhering to treatment. She has also founded the Ashley Fund to help other sexual abuse survivors to continue their education.

She admits that it’s been a long road.

“I was so depressed, I didn’t know who to trust,” she remembers. “How could this happen, and everybody turned their eyes?”

Rushell Gray reflects on her past with a similar mix of sorrow and disbelief.  

“As a young girl everybody turned a blind eye and blamed me. I was the AIDS girl walking around in the community. Nobody said, “this man needs to go to jail.” At one point I almost gave up because the stress was too high,” she said.  

Ms Gray now works as a Mentor Mom. The Mentor Mom programme enlists young mothers living with HIV to share their experiences and help other young women coping with similar situations. Mentor Moms answer questions and offer reassurance, accompany young women and girls on their health visits and reinforce clinical guidance on the importance of taking medicines regularly.  

Both Ms McDonald and Ms Gray are employees and past clients of Eve for Life, a Jamaican nongovernmental organization that helps to prevent new HIV infections and improve the quality of life of women and children living with or affected by HIV. Clients benefit from peer support groups, psychological care and empowerment programmes.  

Joy Crawford and Patricia Watson founded Eve for Life 11 years ago. While supporting young women and girls affected by HIV, they quickly learned that there was a clear link between HIV infection, adolescent pregnancy and child sexual abuse. According to Situation analysis of Jamaican children, a 2018 report by the United Nations Children’s Fund (UNICEF), more than one in five (21%) adolescent girls in Jamaica said that they had survived sexual violence.  

As a long-standing provider of technical support and capacity-building around sustainability for Eve for Life, UNICEF is keen not only on supporting girls, but addressing the cultural norms that make them vulnerable.  

“There is this pervasive idea that adult men should have some level of access to a girl’s body if they are in their life, supporting the family or something like that,” explains Novia Condell, UNICEF Jamaica’s Adolescent Health and Empowerment Specialist. “Of course, the girl has no power to negotiate any protection in a situation where she has been abused or exploited.”

High on UNICEF’s agenda is supporting the community engagement necessary to shift attitudes around child sexual abuse. Eve for Life has spearheaded the “Nuh guh deh” (don’t go there) campaign, which aims to stop sexual abuse. They use complementary strategies—everything from community meetings to music videos—to get the message out.

The UNAIDS country office in Jamaica also provides technical support to Eve for Life and has helped the organization build partnerships for resource mobilization. The UNAIDS Caribbean subregional office is also working with Eve for Life to create safe spaces for young survivors and leaders to raise awareness about the link between gender-based violence and HIV.

There is also a focus on meeting young women’s basic needs, including food, clothes and health care. But beyond these services, work continues to provide teenage girls and young women living with HIV with a deeper level of emotional support and mentorship.   

“Jamaica’s Ministry of Health has found a strong partner in Eve for Life—one that is able to focus on resilience and life skills-building. They get the girls’ lives on track so they can improve their lot and the lot of their children,” says Ms Condell.