INDIVIDUALS from key populations affected by HIV and AIDS are still being denied basic human rights, despite efforts to combat HIV-related discrimination, according to a 2020 study.
The study – ‘HIV and access to justice: Situational analysis of access to justice among key population affected by HIV and AIDS’ – done by Jamaica Aids Support for Life (JASL) and funded by the European Union, reveals that despite Jamaica ratifying several international and regional treaties, which seek to protect the human rights of all individuals, including people living with HIV (PLHIV) and LGBT people, efforts to combat HIV-related discrimination continue to be weak as vulnerable populations are still denied basic human rights.
The research had nine focus groups with 45 participants, an online survey with 71 respondents, and 14 key informant interviews with institutions and organisations whose mandate include redress or handling of key population complaints relating to stigma and discrimination. It aims to understand the nature of the discrimination experiences, their knowledge and perception of the redress system and their experience, where appropriate, if they have interacted with the system at any point .
The research also seeks to understand the experience of duty bearers and service providers of redress, and is aimed at assisting to develop relevant strategies to address the entrenched discrimination, and redress adverse practices by vulnerable populations in Jamaica.
The findings reveal that perpetrators, in relation to accessing justice and seeking redress for various forms of discriminatory experiences, include private individuals, health care workers, employers, law enforcement and employees where PLHIV and LGBT affected by HIV/AIDS worked.
Rodje Malcolm, executive director of Jamaicans For Justice (JFJ), who presented the research findings specifically highlighting data reported to non-governmental organisations (NGOs), said institutional settings — some place official — accounted for 55 per cent of the complaints. The most prevalent setting is in health care, as when asked to provide a description of those who violated their rights, one in three was either a private individual or a health care worker.
“Health care accounted for the most prevalent environment in which persons reported to have faced stigma and discrimination; and health care facilities accounted [for] the greatest degree of stigma and discrimination, and one in three reported this incidence,” Malcolm said.
He was presenting the findings at a public forum held yesterday at Jamaica Pegasus hotel in New Kingston.
“The context provided from focus group participants was that no matter how much training is provided in health people need more training relating to HIV as they thought the knowledge was low, and low knowledge led to harmful practices,” he said.
Malcolm further highlighted statements made by focus group participants which painted a grim picture of the experience they faced when trying to access health care.
“Is lef wi shoulda lef yuh on the bed, mek yu lie down in the bloody bed. Is so you HIV people stay, when unnu come in here wid unnu sickness unnu just wah dash it weh everywhere,” Malcolm quoted one focus group participant living with HIV.
“Another was being treated at KPH (Kingston Public Hospital) and was told point blank by the doctor that they could not get therapy because of their status. [The person said] I was told that the instrument that was used for the therapy was not to be reused, but because they were expensive they could reuse them but they would not run the risk of using it on her and then another patient,” Malcolm said.
“In March, another person went to the clinic and the security was shouting out for the different departments, asking who and who was going to which department. When the person went and indicated they wanted to go to the social worker, they were told to stand to the side. Another person was allowed to go through and the security said, ‘You two stand over here because I know what you are here for,’ ” he added as he continued reading excerpts from the focus group discussions.
“Someone, when first diagnosed as HIV-positive, reports going to a health care facility where each time a patient came in they would point and say at the end of the clinic, ‘this is where all the HIV persons are’. [The person said] each time they come in my confidentiality is not being secured,” Malcolm said, while pointing out that the experiences indicate how interventions should be targeted.
He said there was also a significant proportion of unauthorised disclosures of PLHIV status between health facilities and communities, which made PLHIV and LGBT people feel unsafe and impacted how they accessed services.
Malcolm added that in addition to denial of medical access due to HIV status, research participants highlighted incidents of substandard treatment received in childbirth, which is also an issue affecting the PLHIV community.
“There’s the issue of women and health. Many women living with HIV express experience of unauthorised disclosure, denial of services and substandard treatment. Their male counterparts continue to experience more discrimination and verbal abuse in comparison to other violations,” he said.
Further, the JFJ executive director said reporting to NGOs also showed discrimination in government agencies — particularly police stations, courts, and in communities to include schools and churches.
Malcolm explained that with the police, there is an unwillingness to take complaints seriously, especially for the LGBT community, and in instances that involve gender-based violence. He said there were reports of denial of medication to PLHIV, even in police lock-ups, and abuse of power. Subsequently, vulnerable populations were more likely to report to NGOs than to the formal justice system.
He gave examples of NGO reports of women reporting instances of domestic violence and being chased from police stations, sex workers being pepper sprayed, females who express themselves as males being sexually harassed by police officers, noting that the LGBT community had more situations of physical and verbal abuse than PLHIV. He however added that JFJ has engaged the police in human rights sensitisation workshops, but work is still needed.
While the research recommends civil society actors develop redress referral systems and enactment of broad anti-discrimination law, to name a few, Malcolm said it is important to note that majority of those violated want redress and the system must be able to respond. However, the prevailing impediments must be addressed.
“Factors that impact access to justice include how confident people are in the system, the complexities of the system, the cost of justice and the threat of corruption. Majority of complainants want sensitisation with the accused/community, formal legal services and a smaller group want social assistance, counselling, conflict resolution, reports to the police and referral to medical care. People also want psychosocial and therapeutic service, but very few NGOs offer that. Most people are seeking behavioural changes as it pertains to their alleged perpetrator, but they are also afraid of the formal justice and are more likely to report to NGOs,” he said.
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