TEN-year-old children, many of them victims of incest and rape, are among the 1.7 per cent (32,000) of the Jamaican population that has tested positive for Human Immunodeficiency Virus (HIV).

The figure represents an increase in the number of cases identified up to 2008 with women and young girls numbered prominently in the spike.

“We are able to track viral transmission separately from mother to child,” Dr Sharlene Jarrett from the National Family Planning Board said. “That has been our most successful programme. So what we are seeing are the sexually transmitted infections, from the incest cases, rape, and need-base cases.”

Dr Jarrett made this revelation at the weekly Jamaica Observer Monday Exchange yesterday.

Melissa McNeil-Barrett, assistant representative from the United Nations Population Fund (UNFPA), said the increase in the prevalence rate of HIV showed that women and young girls are the dominant victims.

“It is being regarded in the Caribbean as the feminisation of the epidemic as women and girls are becoming more and more infected and are experiencing more prevalence rate,” McNeil-Barrett said. “We are particularly concerned about the adolescents, and particularly what we are seeing among young girls because the data will show from the HIV programme that girls ages 15 to 19 are three times more likely to be infected than their counterparts of the same age.”

One of the main reasons cited for this increase among females is gender inequality because girls, for example, may not be in a position to negotiate condom usage for their own protection.

“That has to do with the gender norms and stereotypes that we have become accustomed to,” McNeil-Barrett, who was among the guests at the Monday Exchange, said. “Physiologically as well, it is easier for women to become more infected with HIV than a man just because of how the female reproductive system is made up. Again, some of these cultural realities make women more vulnerable and girls in particular.”

She said violence also facilitates greater transmission of HIV among girls and women. “So certainly, there is an increase that is being observed and it will require greater focus, greater intervention on HIV prevention efforts, particularly among women and girls,” McNeil-Barrett said.

In fact, Dr Jarrett said while initial reports were that the epidemic started with men back in the 1980s and is seen among a number of gay men, over time it has been found that an increasing number of women were becoming infected to the point where there is a 50/50 split between both genders.

“So back then, more men were diagnosed with HIV in Jamaica, but now the majority of recent cases are women. We are seeing at this point where it is almost 50/50, so there is a drastic shift from where it was a long time ago,” Dr Jarrett said. “As we see with the younger age group of girls (16-19), we are seeing where the HIV prevalence is three times that of boys their same age.

“For the men, when you look at the ages from 24 to 30, you see an increase prevalence where they will meet and then exceed the rate among women. So it’s based on that kind of dynamic that we have to assume that younger girls are having sex with older men because the prevalence rate just isn’t there with boys in their age group for them to infect them that way,” Dr Jarrett said.

She said there are also key groups that are at higher risk and who factor in the lack of access to services. Some of the key population include young people who do not have access to health-care services, young people who are not as informed, the homeless, women engaged in sex work, men who have sex with men (MSM) and drug users.

“We have to make sure we have programmes that acknowledge their sexual reproductive health needs,” Dr Jarrett said. “That is the way we actually have to contain the epidemic — by paying attention to all these various sub-groups because where infection occurs in one person there are sexual relations with many other persons and so the population has to attend to every member in society in order to contain the epidemic.”

Dr Jarrett explained that while it was difficult to track the prevalence rate leading up to 2008, the estimate was based on what was seen in antinatal clinics since that group of women is representative of sexually active people in the country.

Since 2008, however, officials were able to conduct surveys and access the sexually active population in terms of testing the homeless, prisoners, MSMs, and other vulnerable groups while collecting data from a number of sources in a full epidemiological profile, thus being able to calculate and get better figures.

However, stigma and discrimination attached to HIV continue to aid in people shying away from testing, while men are simply refusing to get tested.

Also present at the Monday Exchange were St Rachel Ustanny, CEO of the Jamaica Family Planning Association; Angela Clarke from Woman Inc; and Ruth Chisholm, country programme manager, Population Services International/Caribbean.

The groups are pushing for voluntary testing by Jamaicans who do not yet know their HIV status as they said this will make a critical difference in moving forward.