MONTEGO Bay, St James – As the number of HIV/ AIDS cases continue to soar, health sector and social workers are now watching what they describe as a ‘worrying trend’ of deliberate infections. Persons who know they have HIV are knowingly passing on the virus to the unsuspecting sex partners, with health workers, just as worried that legally such cases are hard to prosecute and that perpetrators can easily escape legal sanction.

Donnamarie Ross who chairs the St James Parish Action committee – a group actively involved in the anti-AIDS drive – told the Sunday Observer on Thursday that she is aware of at least 10 cases where HIV/ AIDS positive persons have deliberately transmitted the deadly disease.

Health minister John Junor said he too has heard about such cases, but stressed that he knew of no “specific case.”

One of his chief technocrats, Dr Peter Figueroa, head of the ministry’s epidemiology unit, says from time to time the unit gets reports of persons who are HIV-infected, but are not making the disclosure to their sexual partners.

“The business of someone purposely going out there seeking to infect other individuals in our experience is very unusual but it does occur and it is a matter of tremendous concern,” Figueroa said.

Among the 10 cases, Ross cited two individuals said to be actively involved in the HIV/AIDS support sector.

“There is one that is in Kingston and … he likes boys that are young,” said Ross, adding that the man prefers not to use condoms during sexual intercourse. She declined, however, to name the organisation he works for.

The other person, she added, is a female who operates out of St James.

“This young lady goes out to speak (about AIDS),” said Ross. “However, her boyfriend does not know that she is HIV positive, and other people are saying that they have gotten it (the virus) from her,” Ross alleges.

“What bothers me about her is that she goes out to speak all over the place about how she got (HIV) and what it is like, but she is not using any kind of protection nor having any kind of control where her (sexual) activities are concerned.”

Ross has also pointed to another case in St James. In this case, she said, a HIV-positive woman in her 30s has had three children since she was diagnosed with the disease. “She has had HIV for seven years now and she has had three children since then for different fathers,” said Ross.

“These things need to be addressed and I have made numerous contact with social workers and attorneys to see how the matter can be addressed,” added the concerned social worker.

She is recommending that tubal ligation be offered to HIV-positive females in an effort to prevent them from reproducing. At the same time she argues, that men who knowingly pass on the virus should be criminally charged.

Public Defender Howard Hamilton, QC, who is also chairman of the National AIDS Committee (NAC), said that if persons with the disease knowingly pass on the virus to other persons, it does amount to a legally punishable offence, akin to assault.

“If it can be established, it is a criminal offence,” the AIDS committee chairman stressed, saying however he knows of no arrests ever being made for such a crime.

“First of all, it is an assault, but it must be proven that the infected person is aware that he or she is diagnosed with the disease, and then we need to have evidence that he or she has gone on to indulge (in sexual intercourse).”

Hamilton is arguing that the crime could also result in a charge of attempted murder or manslaughter. But while he too acknowledged hearing of cases of deliberate infection, such cases were difficult to prove, he said.

Government is not contemplating a legislation to address the matter, with Junor saying the existing laws are sufficient to deal with the situation.

“Right now, it is an offence. They can be charged with causing grievous bodily harm,” the health minister said.

Under the current laws, if it can be established that the person knew that he has the virus and then infects another person, the police can take action, said Hamilton, at the same time urging persons who have proof of such deliberate acts to pass it on to him.

“Report it to me, and I will get the police on to it,” he said.

Not only can persons be charged criminally, they can also be sued for damages in civil court.

“The person who is infected can sue the person who knows that he has the virus and infect the other,” said Hamilton.

Figueroa has fallen back on message and is encouraging persons who are sexually active to use a condom as protection at all times during intercourse.

“Persons must use a condom consistently, especially with new partners, casual partners and sex partners in which money is exchanged,” said the disease expert.

Figueroa believes that some of the transmittals stem from the psychology of stigma, noting that some persons are unwilling to disclose that they are HIV-positive because they are concerned about the possible reaction of others, including possible abuse.

An estimated 22,000 persons live with HIV/AIDS in Jamaica.

The health ministry has reported 244 new cases for the first three months of this year – 139 males and 105 females.

During the same period, there were 170 AIDS deaths compared to 109 for the corresponding first quarter of 2004.

All the numbers suggest a rise in infections.

The parishes of St James and Kingston and St Andrew continue to record the highest cases of HIV/AIDS in Jamaica, officials say.

It is estimated that 38 million people worldwide live with the disease, the largest number, 5.3 million, of whom live in South Africa.

Over the last decade or so, there have been numerous efforts worldwide to raise awareness of the AIDS pandemic.

An Associated Press news bulletin several weeks ago reported that the US government, in a major policy shift, had recommended for the first time that Americans exposed to AIDS virus from rapes, accidents or occasional drug use or unsafe sex, may receive drug cocktails to counter infection.

Previously, federal officials recommended emergency drug treatment only for health care workers stuck with a needle, splashed in the eye with blood, or exposed in some other way on the job. That recommendation was first made in 1996.

Jamaica too, as it grapples with the AIDS epidemic, has implemented a similar policy, as part of its efforts to deal with the chronic and fatal disease.

“We use anti-retroviral drugs as a preventive measure; we call it post- exposure prophylaxis,” said Figueroa.

“It is accepted that people who get, for example, a needle stick injury in a lab and they were handling a positive sample (HIV), then there is an established procedure where that person is provided with anti-retroviral drugs for a month,” he explained.

He added that studies have shown that the drug reduces the likelihood of the person becoming infected.

In the case of rape, Dr Figueroa explained, some practitioners do recommend that for the victims at risk of HIV exposure, the same drug could be used in a similar fashion to reduce the likelihood of infection.

It is recommended that treatment should start no more than 72 hours after a person has been exposed to the virus and the drug should be taken on a daily basis for about 30 days.

The drugs, Dr Figueroa said, are made available under grant from the Global Fund.

cummingsm@jamaicaobserver.com