DESPITE previous evidence that more adolescent girls than boys were living with human immunodeficiency virus (HIV) in Jamaica, statistics now show that the opposite obtains.
This was revealed by Marion Scott, chief co-ordinator for the All In initiative in the Ministry of Health, while speaking at the HIV forum ‘Health for All’, at Knutsford Court Hotel in St Andrew, recently.
She said that within the 15-19 age group, 815 boys are living with HIV, compared to 685 girls. The numbers, she said, are based on the 2013 census which showed that Jamaica has just over 513,000 adolescents, that is, boys and girls ages 10 to 19.
“Originally, we used mostly our antenatal clinic attendee data, which we used as a proxy for estimating HIV prevalence in Jamaica. But with ‘All In’, we were able to use multiple sources and we used our wider surveillance, and that surveillance system would take in all the HIV tests that are done — both at facilities as well as in the field (through) outreach — so we are able to now compare and that’s when we are seeing more boys being affected than girls,” Scott told the Jamaica Observer after her presentation.
She noted that girls tend to be able to access heath care based on health-seeking behaviours as well as, in the event that they become pregnant, they visit health facilities and will benefit from tests to know their status. She explained that this is not the case for boys, therefore, many of them go undiagnosed and, as such, are not accessing treatment.
The ‘All In’ initiative, a partnership between UNAIDS (Joint UN Programme on HIV/AIDS) and United Nations Children’s Fund, aims to reach adolescents, with HIV services designed for their specific needs, and to fast-track progress to advance global efforts to end the AIDS epidemic.
Scott explained that the ‘All In’ initiative was implemented a year ago after it was noticed that globally, according to the United Nations, all other age groups were seeing declines in AIDS deaths except among the 10-19 age group.
Scott said the ministry was very interested in finding out if what obtained globally was also the case in Jamaica. She said that Jamaica had to identify its key populations and, though the country adopted things from its global partners, the All In initiative was tailored to the country’s reality.
She explained that the initiative has four pillars: to change the social context and work with adolescents as agents of change; to sharpen adolescent components of national programmes; to promote innovative approaches for scale up; and advocacy, communication and resource mobilisation.
“For us in Jamaica, it is a major opportunity to strengthen our data systems. We had a long history of very good data collection and analysis, but there have been some gaps and we have to acknowledge this, particularly with the adolescents and the younger age groups,” she said.
The priority populations identified were young sex workers, young men who have sex with men, young transgenders, adolescents and young people living with HIV, teenaged parents — because of Jamaica’s high rate of teenage pregnancy, which is the fourth highest in the Caribbean — and children in State care.
Besides noticing that more adolescent boys than girls are living with the virus, the chief co-ordinator for All In said they also identified the sizes of the key populations.
She said the estimated number of transgender females in the 15-19 age group is 1,310, while the estimated number of young men who have sex with men for the same age group is 6,250. She also disclosed that the estimated number of girls in State care in the 10-19 age group is 298 and that there is an estimated 3,358 girls, ages 15-19, who sell sex.
She emphasised that All In gave the ministry a “clearer grasp” of the situation, because previously, though empirical data was available from working in the field, it was not as clear.
She said beyond establishing the population sizes, All In looked at coverage in relation to HIV intervention, which includes HIV testing, antiretroviral therapy coverage, prevention of mother-to-child transmission coverage, condom use, comprehensive knowledge, and media access. She added that All In also looked at the social safety nets that exist and cross-sectional interventions, such as sexually transmitted infection, adolescent pregnancy, maternal health, mental health, alcohol use, sexual violence, and general education.
Based on the numbers, Scott said the key populations identified have a significant portion of the burden.
“Our transgenders 15-19 have an HIV prevalence of 27 per cent; young men that have sex with men in the same age group, 14 per cent,” Scott said.
She said the information was not available for adolescents in State care, but there is an estimated 2.9-per cent HIV prevalence for young females who sell sex.
But does the Jamaican picture look like the global picture?
Scott said no, Jamaica is not mirroring the global picture of declines in AIDS deaths in all other age groups except among the 10-19 year olds.
“We have shown significant improvements in reducing deaths among our adolescents. We are still projecting a downward trend,” she told those gathered at the forum. “The challenge, however, is unless we get the support and do something about those policies and legislations that may be inhibiting access, then we may run into difficulty in terms of maintaining that downward trend.
“We have also seen reduction in support for adolescent programmes, so that also has implications,” she added.
The forum, which was held under the theme ‘Health for All: Putting Youth and Adolescents at the Heart of the HIV Response’, sought to raise awareness about adolescent and youth-specific issues in response to HIV and AIDS.