OVER the past six months, an in-depth qualitative research has revealed how unmet health care needs of HIV-positive Jamaican women undermine the quality of the national HIV/AIDS response. Individual and focus group discussions with 12 HIV-positive young mothers in Kingston reveal that more than 80 per cent have unmet reproductive health needs due to stigma and discrimination by health care workers, and lack of resources to access crucial health services and treatment.

Ten out of the 12 participants experience stigma and discrimination at clinics, treatment sites and hospitals by health care staff and workers, such as doctors, nurses, community health aids, and contact investigators. Six of these women described experiences where staff workers shared their status through visits to the workplaces and homes of their parents, spouses and other relatives.

Most of the women also recounted experiences of mistreatment by medical practitioners before giving birth. One of the HIV-positive women, a 19-year-old mother of two, recalled a conversation a nurse at a local clinic had with her as she was in a labour.

“The nurse looked over at me and said, ‘Yuh gone guh breed again? Why? Yuh have HIV and yuh guh guh get pregnant? Yah guh infect odda people’.”

Another participant, a 21-year-old mother of one, described a near-death experience after being neglected by nurses while she was in labour.

She stated: “The nurse burst my head water without letting me know. She sent me back to the room. I was bleeding the whole night and vomiting as my baby was defecating inside me. The baby was breathing on and off. After seeing my condition the next day during a routine check, a nurse immediately changed and stringed me up for surgery.”

Both participants’ experiences revealed some of the horrifying treatment meted out to HIV-positive women, particularly young mothers. Administrative shortfalls coupled with negative sentiments of people living with HIV/AIDS create unfavourable environments to reaffirm the dignity and human rights of HIV-positive young mothers.

Three-fourths of the participants who reported mistreatment by staff at public health facilities also reported feelings of shame and isolation. While some women responded by seeking services at different health care sites, others responded by retreating, which involved non-adherence and the avoidance of appointments and interactions with people.

Various obstacles hindered the women’s access to health care and medication. At the time of the interviews, only three of the 12 participants were employed. While those employed had a source of steady income, they stated it was not enough to support their basic needs and those of their children.

Like the other nine women in the study, the employed mothers reported financial instability as the primary factor preventing them from securing the resources they need to attend doctor’s visits and pay for medication. Eight of the 12 women attributed their issues with adherence to the lack of money to purchase food and pay for transportation to medical visits.

Amidst increasing diagnoses of HIV and AIDS among young women, it is crucial that nations make a concerted effort to address not only the reproductive health needs of HIV-positive women, but also their socio-economic concerns.

The current cohort of adolescents and young adults are among the first to be able to imagine living a “full” life after acquiring HIV. Ultimately, HIV interventions, policies, laws, and programmes must take into account both their clinical demands of managing a chronic and infectious disease, as well as the unique challenges they face as they navigate the transition to adulthood.

Over the next few weeks, I will discuss other aspects of this qualitative study by exploring the particular obstacles faced by young mothers who are HIV-positive.

Jallicia Jolly is a PhD student at the University of Michigan. She is a Fullbright scholar with the United States Embassy and has, since March 2015, been working with HIV-positive young mothers in Kingston and St Andrew.