Providing health care with dignity

The results are in undetectable = untransmissible; it had been for sometime.  Promotion seems necessary, we are still trying to sell PrEP (Pre-exposure prophylaxis)  that is when people at very high risk for HIV take HIV medicines daily to lower their chances of getting infected… And now we have even better outcomes to share; people with undetectable viral loads cannot pass on HIV to their sex partners.

Lots of people living with HIV have injected  “I’m undetectable“… in their peer conversations.  Imagine how relieve they are to add … “uninfectious which means I will not pass on HIV to  you when disclosing to sex partners.

For the  people who make it their business to inject fear into sexuality and sexual relationships for people living with HIV it will be difficult to embrace the results undetectable = untransmissible .    Many continue to harbor (believe) outdated information on HIV.  The ones who continue to spread unhealthy fear from their places of influence; such as health care workers at HIV treatment sites.  Some are so set in their judgmental behavior  which can breed shame in the clients they serve, and shame is a known enemy of health and recovery…defeating the purpose they are engaged to fill.

Undetectable = untransmissible …mmm.  What does this really mean for women living with HIV?   Will this be motivation to tolerate the side effects of ARVs?

Will access to treatment and care become more accessible?  Health care providers that respect clients/patients and provide dignified treatment and care.  Schedule blood test with the results available in a timely manner and discussed with clients.  Pharmacist that respect your privacy and confidentiality enough to resist making snide remarks to your love ones picking up your prescription.

JCW+ will be having Test , Start and Stay conversations for women living with HIV because it is important that we are in an informed position to take responsibility for our health….and demand a quality standard of care.

In January 2017, the Ministry of Health’s National HIV Programme adopted the 2015 (World Health Organization) WHO guidelines, which recommend that anyone who is diagnosed HIV positive be offered treatment (Test and Start).  Treatment as a method of prevention is another benefit of the WHO new guidelines as more PLHIV are virally suppressed and consequently the risk of transmission is decreased.

According to the announcement made last year at the National HIV Programme annual review and planning retreat, the ‘Test & Start’ initiative anticipates that an additional 1200 new patients will be eligible for treatment.

Current estimates are that over twenty nine thousand persons are living with HIV in Jamaica; but approximately 19% are unaware of their status.

HIV is very much on the priority is the approaches to interventions that MUST be adjusted.



We rural women account for a fourth of the world’s total population.

We are leaders, with continuous advocacy efforts for equity and equality.

We are producers of not just children, but we weed and plough the farm lands and work it effortlessly yielding in the crops and taking home the bread just as any man would. The decline in the contributions of women to agriculture, as a result of their own illness or that of family members, can create a substantial drop in agricultural productivity and in some developing countries, women account for as much as 70 percent of the agricultural labour force and an even higher percentage of food production.

We are entrepreneurs. Innovative thinkers and although we sometimes procrastinate, we also make it happen. We are service providers to everyone that comes in contact with us; and it’s not merely because are women but because we rural women face an awful lot of challenges and are more likely to negotiate our demanded result from a situation with whatever resources we have.

With all our attributes and traits though we face many socio-economic needs and sometimes end up in abusive relationships when we seek to have a man in the house to assist us financially. This sometimes lead to us contracting HIV in our endeavors to be all woman, independent and survivors. HIV/AIDS is still highly stigmatized and many women are ostracized. The effects of HIV/AIDS are not only felt at the household level but have wider repercussions, as well. Thus, help from the extended family and the community, their main safety nets, is often severed.

More households are headed by HIV/AIDS widows than widowers, left with the children to care for as men generally have a ‘don’t care’ attitude in regards to their health, refusing to see the doctor and refusing clinical treatment and care. Often times this leads to poverty as family assets and savings may be completely spent, leaving the surviving family members without means of support.

Access to land and support services that could see these women through the hard times are denied them because of their inferior social and legal status in traditionally patriarchal rural societies.

Our contributions are quite vital to the well-being of families; we are most likely to be the ones with the responsibility of caring for the children, the sick, the elderly and the grown ass men in our lives.

Today as we celebrate rural women internationally, we remind them of their importance to their families by extent communities and country’s economy as this depends on us and assertion of the Sustainable Development Goals is impossible without us.

Increase the availability of treatment and care provision in rural areas. Improve educational and social productivity. Help in preventing the spread of HIV and HIV mortality.


#International Day Of Rural Women- October 15



Mental health as defined by World Health Organization, is a level of psychological well-being, or an absence of mental illness. It is the “psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment”. 1

Often times we misunderstand the importance of having our mental health needs addressed. You are called mad or crazy and thus many of us suffer because of the taboo on mental health.

I asked myself if there are mental illnesses that affect men only and any that affect women only. Well I did not get a straight answer on that one but based on my research I was made aware that mental health does have some aptitude of gender biases and although men tend to suffer more from suicide, women are generally more affected by the more common mental disorders. I shall continue my research but this year as the focus of mental health week is on the prevention of suicide it is critical for me to dispel the myths of mental health and shed light on some facts with you just to get us all to understand the dire need for seeking to help persons and ourselves with our mental health issues.

FACT: “Over 800,000 people die due to suicide every year and there are many more who attempt suicide. Hence, many millions of people are affected or experience suicide bereavement every year. Suicide occurs throughout the lifespan and was the second leading cause of death among 15-29 year old globally in 2012.” 2

With that being said can you actually tell me a mental health myth and a mental health fact?

Mental health problems does not affect everyone. Can that one be considered a myth of a fact? Truth is mental health is pretty much like HIV or any other STI, although you may not be infected, it does affects us all. Take for instance depression. This is one of if not the most common mental disorder affecting at least 350 million people globally with majority of those being women and young people. It enables disability and has the ability to fuel suicide. We are therefore left footing the bills for treatment of any other expense that may occur and sometimes left feeling hopeless as our friends and families suffer. Thus we are all affected.

Children do not experience mental problems. Actually it is the second leading cost of death among young people between the ages of 15-29 years old. Half of these affected person start showing signs before or by the age of 14.

 People with mental health disorders find it stressful holding down a job. If we invest in our health and treatment this too can be shunned as with effective treatment person with mental disorders are just as productive as anyone else. Encouraging this will be equivalent to lower medical cost and social burden costs through increased productivity.

Persons diagnosed with a medical disorder can be due to:

  • Biological factors, such as genes, physical illness, injury, or brain chemistry
  • Life experiences, such as trauma or a history of abuse
  • Family history of mental health problems

Self-care and therapy however can aid in their process of recovery.

One of the major barrier in receiving effective treatment, as only half of these affected persons receive treatment, is the social stigma that is associated with mental health. 3 It will be a long shot for us to say we will eradicate this social taboo on mental health but family and friend support is an important factor in getting us the treatment and services we need for our mental health issues. Merely reaching out to someone and providing moral support helps a lot. Learning and sharing the facts and refraining from labeling persons by their mental health disorder also helps. But most importantly treating them with respects as you would anyone else.

This mental health week I vow to promote the social and emotional well-being of young people via shared knowledge. I strongly believe that this will increase productivity, enhance educational outcomes, strengthen our economy, lower crime rate and health care expenses and most importantly improve our quality of life and family life.

Therefore it is imperative for us to focus on the mental health needs of women and have them met in an effort to end suicide and increase our longevity because suicide is committed by people just like you and I.






MY NARRATIVE: Amanda/27. Barbados

So, are you open about your status?

Yes and no.

Could you please explain a bit?

Depends on the circumstance. My policies is don’t ask don’t tell unless it’s necessary.

In that case what name would you like to use for its publication?

You can use my middle name Amanda.

What’s your age? And when did you got infected?

I’m 27, I was diagnosed at 15.

How did you find out, and what was your first reaction?

I cried then, I went crazy. I wanted to kill my boyfriend, then I got depressed and over eat because I thought I was going soon get skinny and die.

What things changed because of HIV?

Some things change for the better because I took my goal more seriously, because I thought I didn’t have much time left and there’s so much I wanted to do. But also I had a lot of setback in terms of finding work and studying because of doctor’s appointments and when meds I was getting sick all the time. And I often neglect myself because it’s hard enough trying to prove yourself as a woman. Much less a woman living with HIV. Even though everyone around doesn’t know, I often feel like I have to make up for having HIV.

Have you faced any stigma and/or discrimination? Can you share a specific experience?

Most of the stigma and discrimination I experienced I was a bystander when people were saying thing about those “aids people” or those “sick people” not knowing I’m one of them. Some people in the social services department view “us” as just sitting around waiting for handouts. The most hurtful is when you get close to someone and you tell them and they run from you, or stop speaking to you, or bathe in Clorox because you touched. Or even worse, you’re in a relationship and your significant other wants you to do things to them sexually (eg. oral sex) but they don’t want to because of “your condition”. I’ve had people saying, medical professionals included, “why would you want to punish yourself and an innocent child by having a baby”.  Then the family members who fuss too much, and then those who don’t care at all, and it seem they trying to kill you faster.

How would you describe yourself?

I’m hardworking person, a student, a business woman, a sister, a daughter, a mom, even though I’ve never given birth. I’m kind loving sharing but at times very guarded and withdrawn because life changes when people know.

How are you engage in the HIV response?

I’ve been in too many support group meetings. I’ve often volunteer at the food bank giving out hampers or hosting at the Christmas parties for people living with HIV. I did massage this year for women living with HIV, and there health care providers free of cost for Valentine’s Day. And visit other women whom I know they’re positive, if they become hospitalized and offer an encouraging word or just stay and keep them accompanied. When I’m working at the hospital I trying my best to get assigned to the patients who are like men make sure they have an extra special day and give them information on how best to talk with their doctors and who to take care of themselves when they come out.

What do you dream of?

I want to have my own preventative healthcare center where people living with HIV get special preference. I dream of one day getting married and having the kids I wanted before this happened. I also dream of the day when the fear associated with HIV is like diabetics it something you don’t want to have because of the end results, but if you do, so what. Deal with it, and move on. I believe that the HIV response should be more focused on living with it and the stigma and discrimination; suicides, violence depression, substance abuse and loneliness.

What would you say about your sexuality?

When I was first diagnosed it went away. For almost a year I felt dirty, like some had raped me again, but this time I gave them permission. But I came back stronger than ever, but I keep it under wraps because regular relationships get complicated after sex. Discontent relationships are even worse. And almost all of the guys I met who are positive, are either gay, bisexual, way older than me, or have serious issues (eg. unemployed, uneducated, no ambitions, crazy jealous and abusive).

How do you see HIV in your country?

I see it as a hustle. For some people some people try to get what they can get in the name of helping us poor people. But the bigger heads aren’t concerned about the individual, once condoms and medicine are selling. Who cares about the physical and emotional torment and ostracism we received because we were diagnosed with something. Funny enough in my country our population is very sexually active, but they pretend like there not, until there’s a problem.


Vertical” was originally published in spanish in january 26th 2016 on Roja Vida by L’Orangelis Thomas Negrón, member of ICW’s Chapter of Young Women, Adolescents and Girls, living in the Hispanic Caribbean, Puerto Rico.

This is the first time I write about The Cure for HIV in my blog. I never before had written on this subject and I had, and still have, some contradictory feelings and thoughts, but things have happened in recent months and I think it’s time.

As you may know, I grew up with HIV and no, I don’t know what  it is live without it, but not for its time in my body, but the time I’ve been aware of its existence in me (since I’m 8 years). HIV is part of the group of things that construct my identity as a human being on this earth and its societies, and has predisposed and put me in situations that, in other ways, possibly haven’t occurred. For better or worse, many of the most important and decisive things in my life, HIV has had an influence. From my closest friends, my most significant works and experiences, thought the way I see the world and understand it. All this and more is due to HIV, and having the thought that the HIV would no longer be part of me, scares me and gives me that loss feeling. It is a kind of Stockholm syndrome, HIV being my kidnapper.

The cure for this syndrome, in my case, I think it would be to realize that there are hundreds of young people who have no access to medication or who simply don’t take it, for any reasons, and they are dying. That doesn’t matter how I may feel when we talk about the lives of hundreds. Currently the only or main alternative we have to keep the virus low, is to take medication, but what do we do with those who no longer have more options? What do we do with those who are weary and tired? I have no answer, but what if we talk about a cure?

The vast majority of global and national strategies are based on the medicalization and condomization of people with HIV or who are “at risk” to reach the “end of AIDS“, not the End of VIH by the way. So, we have strategies that talk about “detect“, “treat” and “suppress“, but not necessarily speak of access to mental health, sexual pleasure, institutionalized and social stigma, free access to information and human rights. People talk about reducing viral load, but suddenly many people make it sounds as easy as lowering the volume of the music, when between the viral load and strategies, are human beings who carries the virus in our blood and medication by our mouths.

Treatment now is prevention, and no, I don’t speak of Truvada as PrEP. I speak that once you’re undetectable, the possibility of transmitting HIV decreases enough to not infect someone else, but God, Buddha, Allah, Pachamama, Krishna and Changó keeps you from having sex without a condom!! It sounds cute “Treatment as Prevention“, but if people will call us irresponsible when we are undetectable and have sex without a condom, so why we even use both words in the same sentence? And I don’t really think it’s because of other STI or pregnancy, because usually strategies are designed to make us less infectious.

Getting tired for a while is valid, and also getting tired indefinitely. For more wishing that people have on young people who grew with HIV, to be 100% adherent, at the end of the day, the ones who places in their mouths the pills and swallow them, are us. When we speak and say “My Body, My Territory” is not only to decide whether or not to abort, it also comes to taking medication or not, going to a protest or not, having sex or not. It’s the right to have alternatives, availability, accessibility and the power to decide on them although the decision is appropriate, correct or NOT.

Not every young person who doesn’t take the medication, do it on purpose or in a conscious manner. Not all the young people who don’t take medication, do so because they have surrendered or because they are irresponsible. The desire to live, to be healthy, to have goals and dreams, is NOT synonymous of adherence. If I think about this, with this co-dependent mindset, it makes me see ourselves as machines of taking medication, it’s makes me feel that we were born to take medication and that no matter what we want, HIV is what determines and decides what is possible for us and what’s not. This kind of view, also makes me feel like if I’m resting us humanity, and that we are nothing more than a diagnosis. And this does NOT mean that I am against medication.

Willing to live is human, just as willing to be healthy, to have goals and dreams, regardless of a diagnosis. Good and bad things will always happen, and there will always be barriers, and because of this reason, it is necessary to develop new strategies and ways to maintain good health and quality of life. Strategies that are based on dignity and participation; shifting the power “over“, for the power “of“, “for” and “with“. Inclusion, because integration is not enough. Empowerment to speak out, instead of lying every time we go to the doctor when we are not adherent, because we don’t want to hear the nagging again (I’ve been listening since he was 15 and has not changed doctor after doctor). Including medication, but also advocate for a cure.

Including medication, but understanding that we are whole beings, and that HIV does NOT have a Velcro that you can take out to treat without having to deal with the rest. Including a cure, which currently does not exist (but that doesn’t mean we won’t ask for one), but it would be a final solution to the deaths among young people. As someone who has grown up with HIV, I get tired and always has complications with adherence. However, I know my body and I stay aware of how I feel, and having this consciousness supports me. But consciousness is not all, I have to keep this present in my mind all the time and that is no simple task, even after all this time. If anything has supported me is to be honest with myself and my health care providers, recognizing which my barriers are, and from that honesty with myself, look for my true alternatives from my reality.

Even if we don’t like it, speaking of adherence it is no longer enough. Much less when we speak of vertical transmission, that although the incidence has declined, those of us who still here, sometimes are the ones having more difficulties, and no wonder. A lot is required, a lot of support, mind and heart, because sometimes it feels like we are in danger of extinction.

Real or Perceived Health Care Discrimination

Today I cried.

I am 28 weeks pregnant and still having a hard time coping with the situation, I did not want to become pregnant; NOT for this man and especially not the way in which it happened. It took me 28 weeks to admit that I am pregnant and 28 weeks to go for my first antenatal visit.

The nurse assessing was a very candid inquisitive woman. She celebrates her birthday a day after mine and with us sharing the Capricorn sign I thought we were getting along quite fine. After scanning through my document to fill out the information in my antenatal book, I suddenly realized that I was going to be the highest point of her day. She asked, how long I have been aware of my HIV status, I responded, since the same day you see it as been recorded in my docket. Continuing she asked, the child you had last year is this pregnancy for the same man? Becoming irritated I asked, you heard your partner having bastard babies? She ‘urged’ me to not be rude then bluntly asked “why is it that you are going around having sex and getting all these children with different men and what about those in between that you have slept with, do they know your status? You need prayer, let me sing and pray for you.” Before I could stop myself tears were rolling down my cheeks, my throat became hoarse and I was trembling I distinctively heard myself say “what the f**k? How dare you?!” She offered me paper towel but I shunned her. I somehow managed to pull myself together and asked her if she doesn’t believe that I deserve the happiness of being romantically involved with someone, placing her right hand on her right cheek, she asked “how do I respond to that?” I told her to do so honestly. She said I deserve the happiness of not being able to have any more children because of my positive HIV status.

Broken and ashamed, regardless of knowing the facts,  I retorted probably if you people were doing your damn jobs instead of being investigators many of ‘us’ wouldn’t be in this position! After realizing my anger and frustration she begged me to not report her as she did not mean to offend me, she was merely asking these questions because she knows of cases where individuals intentionally seek to infect others. She wrote her number in my book and said I can call and speak with her if I ever felt like talking. I smiled and she asked are we friends, I just kept smiling.

After I left the assessment room I went down the hall and retrieved the information for reporting misconduct within the health care facility. I went home and cried some more. Here I am struggling to accept an unwanted pregnancy, forcing myself to deal with this compromising situation and this ignorant foolish woman has the nerve to be saying B.S. not even caring how I feel. I was not going to allow her to make me feel powerless. I wrote a wordy, emotional mail but stopped before I sent it off. I asked myself, am I being vengeful or am I helping another woman? I still have not sent that email as yet, I still have not answered me.

So here I am, what to do? Is this what stigma and discrimination in the health care setting really feels like? This is what others have and will face? Did I hear her right? Did HIV cause my brain to distort the message? Did I truly interpret her differently than she meant me to? Am I now one of the many who have faced treatment related discrimination?