Adolescent MSM in Jamaica: HIV Risk, Homophobia, and Gender Stereotypes in Relationships

1
Adolescent MSM in Jamaica- HIV Risk
Homophobia and Gender Stereotypes in
Relationships
Nesha Z. Haniff Jamaica Aids Support for Life
Senior Program Advisor Kingston Jamaica
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Background

• This project with young MSM (14-21 yrs. Old) came
  about because there was a great concern in JASL
  for several years that the HIV infection rate for
  this group was alarmingly high.
• I then in discussion with Dr. Robert Carr the
  executive Director of JASL at the time develop a
  pilot project based on discussions with young MSM
  who admitted to having unsafe sex before they
  were tested.
• After they received their test results they
  dramatically changed their behavior holding on to
  their negative status as though it was a shield.
• The idea then was to see if this was replicable
  on a small scale and then to hone it into a
  larger intervention.

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Background continued

• It was decided along with the young men that they
  would begin a peer HIV testing project in which a
  selected four would get at least two of their
  peers who they knew were having unprotected sex
  to get an HIV test.
• The worry here was the potential positive results
  and so a series of discussion sessions was
  launched to prepare the potential peer initiators
  about the problems and risks of this intervention
  and to have frank and open dialogue about the
  groups own risks for HIV and the realities of
  being young and gay in Jamaica.
• This project was conducted with the targeted
  intervention department of the Jamaica Aids
  Support for Life

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Program Design and Outcomes

• There were 12 young men in all who Participated
  in this project over a period of two months.
• The 4 selected peer initiators got at least 5
  people tested of which one was positive.
• They had asked at least 20 persons to be tested
  but only five actually did it.
• This presentation is about the social
  construction of this small group and the world in
  which they live and how the reality of their
  lives is really the driver that makes HIV
  infection inevitable for at least half of them.
• It would not be far fetched to extrapolate from
  this small group experience important hypotheses
  about the larger young MSM population in Jamaica.

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HIV in Jamaica

• UNAIDS report that the prevalence rate for
  Jamaica in the 15-49 age group is 1.5 0.8 2.4
  .
• From 1994-1996 the HIV prevalence in major urban
  areas for men who have sex with men (MSM) ranged
  from 30 to 67.
• The Ministry of Health surmises that the MSM rate
  is 25-50.
• In my own experience with this group I would
  guess that the rate would be around 50 but not
  as high as 67.
• There is no baseline study of this group and so
  the amounts vary. Suffice it to say that the
  lowest percentage being 25 is cause for alarm.

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Portrait of Jamaica

• The Human Development Report 2002 (www.undp.org)
  ranks Jamaica 86th of 173 countries on the human
  development index (HDI).
• More importantly the Report indicates that
  Jamaica is one of only two countries with a real
  per capita income that was lower in 2000 (PPP
  US3639) than it was in 1975 (PPP US3981).
• The debt to GDP ratio in 2001 was 136 and with
  debt servicing obligations consuming in excess of
  60 of the national budget very few resources
  are available for the social sector including
  the health sector. (Haniff HIV in Jamaica The
  Current State with Special Attention to
  Marginalized Groups LACASSO 2005).

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Reflections on Jamaica

• Let me say that the poverty and violence which
  wracks Jamaica represent one dimension of this
  remarkable country.
• Its powerful culture makes its music universal
  and is a force in creating new ideas in music and
  dance. To live in Jamaica is to live in a culture
  every moment of every day.
• It is a culture of rebellion and confrontation
  like a volcano whose ashes and magma become
  fertile ground for rebirth.

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Homophobia in Jamaica

• Jamaica is a homophobic society and it expresses
  itself in violence and murder.
• The climate is fanned by a passive bourgeoisie
  which is latently homophobic and a music industry
  that has been used as a vehicle for supporting
  the death of gay men.
• As in this chorus by Buju Banton
• Boom bye bye inna battybwoy head
• Ruud bwoy no promote no nasty man
• Dem hafi dead
• Boom bye bye inna battybwoy head
• Ruud bwoy no promote no nasty man
• Dem Hafi dead

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Homophobia in Jamaica continued

• My friend Steve Harvey who worked with targeted
  intervention and who was gay was taken to a hill
  top and killed shot in his head (boom bye bye in
  a battybwoy head) in November last year.
• The homophobia and violence towards gay people in
  Jamaica are well documented in the Human rights
  Watch report on Jamaica Hated to Death (V.166
  November 2004)
• It is also in Robert Carrs excellent piece On
  Judgments in the Caribbean Journal of Social
  Work V.2 July 2003)

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Young MSM HIV and Violence

• It is in this context of violence about their
  sexual orientation that these young men grow into
  adulthood.
• The entire group with which I worked came from
  very poor backgrounds. They were often products
  of child shifting a process in which children
  in poor families get passed around from parent to
  granny to aunt to uncle as the financial vagaries
  of the family change. Already these young people
  have no secure base.
• Their realization of their sexuality must remain
  a secret and those who reveal it are often the
  victims of violence. Indeed several of these
  young men were thrown out by their parents and
  the mother of one asked a gun man in the area to
  take care of her son (kill him) because he was a
  batty bwoy.

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Violence Continued

• These young men raise themselves in a society
  which is ready to inflict pain on them for any
  reason and so they live their maturing process in
  the margins without the guidance and support of
  those who could mentor them into healthy and
  whole adults. They suffer not only pressure from
  the larger society but great trials from within
  the gay subculture.
• These two forces exacerbate their HIV
  vulnerabilities. In their discussions these
  young men felt that rape and physical harassment
  were the major obstacles they faced every day not
  only from people who perceived them as gay but by
  other gay men who saw them as vulnerable if they
  were perceived to be physically weak..

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Violence continued

• At least half of the 12 young MSM I spoke with
  had sex against their will... If they were
  walking on the street by the bus stopolder men
  might accost them or might take away their phones
  or might rob them.
• Like the findings on girls and poverty and HIV
  many of these young men became involved sexually
  with older men as a transaction for school
  uniforms for lunch for a place to live for a
  cell phone for school books for school fees
  clothes etc.
• The statistics which show that in Jamaica girls
  10-19 are three times more likely to be infected
  than boys that age also hold true for young MSM
  as well. It is the power dynamic of age male
  dominance and the vulnerability and powerlessness
  of the young that increase the HIV infection
  rates in these groups.

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Gender Stereotyping.

• These MSM however develop an unchecked and
  undiscerning construct of gender that they
  appropriate in forming their relationships.
  Indeed there is a great deal of dual gender
  identities where being physiologically male is
  part of their reality but also identifying
  themselves as she as equally or more important.
  
• What is distressing about this is that they see
  being female in the most stereotyped and
  oppressed construct. For them to be female is to
  be a victim of violence to have no say in a
  relationship to be dependent and powerless.
  This further complicates the transactional sex
  dimension. The transaction is now a transaction
  in passivity as well.
• It should be made clear here that these young men
  in no way want to look like women want to be
  women. They wanted to be an oppressed she as a
  sign of their devotion and availability to be
  completely owned and possessed.

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She

• She cyan come out she hafi do house work
• Him box her down and take away her phone she
  a cry
• A same thing him do me me look down and a cry
  me say me sorry and then me mek up and him give
  me back me phone.
• Him do dat because him love me bad

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HIV Vulnerability

• They felt that their role was to be submissive
  partners a collection of all the stereotypical
  female submissiveness.
• They expected that their partner could hit them
  to establish control to punish them by taking
  away pleasures to do housework to stay at home
  and know their place. To have no agency over
  their bodies.
• This gender stereotyping or caricaturing
  increases the risk of sex without condoms and so
  becomes another driver of HIV infection in this
  group.

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To be submissive and entitled The duality of
male and female

• But this becomes more complicated because they
  were raised as males and the society treated them
  as males which gave them an entitlement that
  women did not have.
• Women from the moment they are born are groomed
  to be defensive to know that you cannot flaunt
  your sexuality without consequences and to live
  within a strong prescription of monogamy and good
  girlness. If you have more than one man you are a
  slut. If a man has more than one woman he is a
  man. The double standard.
• Even though passive in relationships the young
  men in this group would still have a fling with
  someone else and become caught up in
  relationships which put them at risk for
  potential violence and HIV risk.

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Submissive/Entitled Continued

• It is not because they are gay that they feel
  entitled to have more than one partner but it is
  because they are men. It is the inherent
  dominance which the culture bestows on men that
  allows them this right to have multiple partners.
• This does not mean that the conduct of the
  relationship has changed. The submissive conduct
  of the relationship still remains.
• We can see then from this small portrait that the
  HIV incidence would be high in these young MSM
  who were poor and struggling. Their risks
  multiply with the complexity of how they construe
  themselves as sexual beings and that a rate of
  over 50 does not seem so far fetched

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Interventions Conclusions

• The interventions begun in this project should
  continue. They have stopped.
• The small group work is very important as a place
  where these young people can clarify their roles
  and understand the consequences of their own
  behaviors.
• Perhaps the most significant intervention is a
  feminist orientation to the meaning of she and
  that to be she in a relationship is not to be
  submissive or accept violence. You can
  appropriate being a healthy woman rather than a
  dysfunctional one. This intervention alone is
  rife with contradictions. Where do they see such
  women If feminist women cannot be completely
  owned and possessed will they still be an example
  of absolute love
• Is me alone look after meself when me mother
  send gun man fi kill me me had to run away. Ah
  so me life a go.
• For these young gay men this unchecked and
  undiscerning construct of their gender identity
  needs a safe place a safe society and a place to
  feel loved and accepted. It is this most of all
  that will reduce their risk to HIV. It is
  Jamaicas homophobia that is on the table. Unless
  this is addressed. These young mens live will
  continue to drive

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Conclusion

• For these young gay men this unchecked and
  undiscerning construct of their gender identity
  needs a safe place a safe society and a place to
  feel loved and accepted. It is this most of all
  that will reduce their risk to HIV. It is
  Jamaicas homophobia that is on the table. Unless
  this is addressed these young mens lives will
  continue to drive towards HIV infection.