Analysing reproductive health stats in Jamaica
LIKE me, you are probably hearing the saying, ‘the older the bull the stiffer the horn’ for the first time. G Llewellyn Watson in the 1991 work Jamaican Sayings: With notes on folklore, aesthetics and social control, explains it. Watson says that with age, people become more assertive and are less likely to allow others to impose on them.
Perhaps working in sexual and reproductive health has wired my brain to draw parallels with many things I see and hear. When applied to the life cycle, transitioning from adolescence to adulthood, you see the naivete turn to enlightenment with time. As we await the findings in the latest Reproductive Health Survey, 2020, let’s reminisce on highlights in the last study. Four areas will be further examined that align with the saying I mentioned above. They are contraceptive awareness, knowledge of HIV/AIDS, intergenerational sex, and routine gynaecological visits.
Contraceptive awareness
Between survey years 2002 and 2008 there was an increase in contraceptive awareness among women 15 to 49 years for main methods such as condoms, the pill, injectables, female sterilisation, withdrawal, IUD and the implant.
Knowledge of HIV/AIDS
Among males and females (across age cohorts 15-19, 20-24 and 25-49 years) correct knowledge of protective factors and myths relating to HIV transmission increased with age, moving from a low of 28 per cent to a high of 50 per cent. The preventive measures identified were 100 per cent condom use, and one faithful partner. Prevailing misconceptions about transmission that were rejected were a healthy-looking person, mosquito bites, and sharing food as detailed in the 2017 HIV/AIDS Knowledge, Attitudes and Behaviour Survey, Jamaica.
Intergenerational sex
The Reproductive Health Survey, 2008 revealed that for young adult women who were under 13 years old and were sexually experienced, in 2002, 56.9 per cent had partners who were three to five years older. Said another way, these male partners were having sex with young women who were not able to consent to sex, which under Jamaica’s law is a punishable offence. Positive improvements were seen in the 2008 report, where it was reduced to 21.0 per cent. Sadly, the age group 13-14 showed the reverse by 2008 (46.0 per cent) as against 22.2 per cent in 2002, for partners three to five years older. Not to be downplayed is the probability that some of these incidences may have been because of sexual abuse by men older than the youngsters.
Transactional sex in youngsters is defined as “the exchange of sex for receipt of money or gifts among young women”. Data shows that people with the lowest educational level (under nine years of schooling) and from the lower/poorer income bracket were the ones most likely to engage in transactional sex.
Several realities cause young adult women to engage in sexual activity in exchange for money and goods. Chief among these is the need for financial resources. Many are faced with the decision that to obtain goods or money they must ‘let off’ or have sex with a person who has economic means. Their sad reality of poverty, and needing to find a way to survive so that they can eat or fund their education, drives many in this direction. Young girls in transactional liaisons often are not in a position to refuse sex or negotiate condom use for a safer sexual act.
Routine gynaecological checks
The proportion of women electing to have a routine exam increased with age, from 12 per cent among 15-19 year olds to more than 58 per cent among the women 40 and over. After all, the older the bull, the stiffer the horn.
It is hoped that news of further improvements in these and other areas will be highlighted when the newest Reproductive Health Survey is released.
Dianne Thomas is the director, communication and public relations at the National Family Planning Board.