by Steph Quena

Created on: March 28, 2010   Last Updated: March 29, 2010

At a dinner table, we are told, never discuss politics, religion, or sex. Raise HIV/AIDS as a topic of conversation and we have a full house: politicking, morality and sexual behavior.  Out of these topics, we are sure to find stigma and discrimination.  While stigma and discrimination have been shown to be important drivers of HIV/AIDS, we do not always understand where they come from, how they operate, or what we can do about them. 

Jamaica has a well documented history of stigma and discrimination.  HIV/AIDS is yet another example of the many forms of stigma and discrimination that its interesting and diverse inhabitants have experienced in its oppressive and colorful history.

In order to understand HIV/AIDS stigma and discrimination, it is useful to first appreciate the pre-existing stigma and discrimination associated with sexuality, gender, race and class.  This pre-existing stigma and discrimination caused specific popular misconceptions about HIV/AIDS.

For example, that ‘HIV is a gay plague’ (sexuality); ‘HIV is a women’s disease’ (gender), ‘HIV is an African disease’ (race), and ‘HIV is a disease of the poor’ (class).  In 1987, the late Jonathan Mann, the HIV/AIDS advocate, described three phases of the HIV/AIDS epidemic: the epidemic of HIV, the epidemic of AIDS, and the epidemic of denial, stigma and discrimination. Twenty three years later these phases are still relevant, and while the first two phases had made major advancements in the areas of prevention, treatment and management, stigma and discrimination remain one of the major and continuing challenges in managing the epidemic.

Stigma and discrimination are closely linked to the issues of power and control in a community.  Governments and policy makers (those with power and knowledge) often make decisions for the so-called victims (those without power and knowledge).  HIV/AIDS research in Africa has highlighted the problems of health policies and programs that are imposed from above without respect for the voices of patients and other users of the health care system. 

This has resulted in policies and programs that face more resistance and are less successful.  Power is situated in a complex set of social institutions, practices and situations, yet many decisions are made for patients and communities that add to the stigma and discrimination of persons living with HIV/AIDS.

In Jamaica, there is an alarming amount of violence against HIV/AIDS persons because of their supposed gay lifestyle.  In the early months of 2008, Bruce Golding, the Prime Minister of Jamaica, sent four letters to non-governmental organizations in which he condemned the violence against gay persons.  What he and his government have not been able to address are the legal issues securing equality for gay persons in Jamaica.  As shown above, the underlying stigma and discrimination associated with sexuality, gender, race, and class are important in the HIV/AIDS debate and in Jamaica sexuality and class are of particular importance. 

Jamaica’s stigma and discrimination are not only located in the government, they are located in the communities. Its roots are firmly located in its history, and thus in individuals, communities, social, legal and political structures.  Jamaica as a country needs to address this complex and historical stigma and discrimination, not only the government.  And, this complexity is why sex, religion and politics are so interesting at a dinner table.

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