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ONE of the world's leading bioethics publications, Developing World Bioethics Journal, says Jamaicans are making it difficult for men who have sex with men (MSM) to be monogamous. The publication also suggested that Health Minister Rudyard Spencer is unhappy with the fact that his government "continues to support legislation that contributes significantly to the high prevalence of HIV/AIDS among MSM". Following are excerpts from the recently published article:
"It is tempting to feel sorry for Jamaica's Health Minister, the Hon Rudyard Spencer. There he is, trying his best to do his job, and, among other urgent health matters, reduce the incidence of HIV/AIDS in his nation.
Unfortunately, on his own account, this is proving to be next to impossible unless Jamaicans change their cultural attitudes to — you guessed it — sex. The Jamaican Ministry of Health's website quotes him with these eminently sensible concerns about specific attitudes:
"These include a widely held belief that sex with a virgin can cure HIV/AIDS, the high level of sexual relations between older men and young girls and a persistently hostile anti-gay environment which all contribute to the stigmatisation and discrimination of infected and affected persons. A strong religious culture also inhibits open discussion on matters of sexuality... We too need to begin the process of unlearning those beliefs that endanger the health lives of others and rethinking the tendency to be obscene and degrading in rejecting values that conflict with our own..."
Public health experts are very familiar with the long-standing conflict between a utilitarian approach to harm minimisation and harm reduction and a cultural context that prizes firmness in the 'fight against drugs' over demonstrably positive health outcomes for individual drug users. It seems as if this same culture war is being played out in the Caribbean where centuries old religious teachings on sex take precedent over the insights of 20th and 21st century sex research.
"A bit of pertinent background on HIV/AIDS in Jamaica: a 2008 study commissioned by the Ministry of Health concluded that about 31.8 per cent of men who have sex with other men (MSM) are HIV infected in the island state. There is a strong correlation between men being HIV infected and them belonging to lower socio-economic groups, and them having been victims of anti-gay violence. The number of AIDS deaths per year is decreasing because the country has begun the rollout of anti-retroviral medicines.
"Jamaica reports the second-highest HIV-prevalence rate among MSM in the world, right after another notorious violator of the human rights of gay people, Kenya.
Homosexual men in Jamaica rarely ever live in monogamous relationships because of the security risks involved in living with a member of the same sex over longer periods in the same household. This is partly a result of colonial legislation prohibiting same sexual activities among men... The flowery prose under the heading 'Unnatural Offences' is sufficiently antiquated:
"Whosoever shall be convicted of the abominable crime of buggery, committed either with mankind or with any animal, shall be liable to be imprisoned and kept to hard labour for a term not exceeding 10 years... Whosoever shall attempt to commit the said abominable crime, or shall be guilty of any assault with intent to commit the same, or of any indecent assault upon any male person, shall be guilty of a misdemeanour, and being convicted thereof, shall be liable to be imprisoned for a term not exceeding seven years, with or without hard labour.
"Up to 10 years at hard labour for a mature-age man who has voluntary sex with another consenting adult male is a fairly draconian penalty for a self-regarding act.
One justification for this law is hidden under that well-known Christian natural law moniker of 'unnatural'. There is no such a thing as unnatural conduct. If something is physically possible it is very much within the laws of nature, and therefore by necessity it is natural. The phraseology of the 'unnatural' explains or justifies nothing. However, normatively nothing follows from this trivial insight.
"Many natural things are not desirable, natural conduct can be unethical, even criminal. Furthermore, as is well known among legal philosophers, even if such behaviour were 'unnatural', and even if we declared it unethical, nothing would follow with regard to the question of whether or not it should be illegal. The Jamaican law is not making a case for why same sex sexual conduct between consenting male adults is problematic, and why it is legislated against.
"Declaring homosexual conduct unnatural is arguably unintelligible and it begs the question of why the law exists to begin with. For good measure 'abominable' has been added to this 'crime'. Merriam-Webster's Dictionary enlightens us that the 14th century originated adjective 'abominable' means that something is variously disagreeable or unpleasant or worthy of causing disgust or hatred. All of these are terrible foundations on which to build sound moral judgments. Finding something disagreeable or unpleasant is insufficient to make it illegal...
"No doubt, plenty of Jamaicans hate gay people, but how does that provide a justification in terms of outlawing same sex sexual conduct among consenting adults? One does not have to be an old-fashioned liberal in the tradition of John Stuart Mill to realise that the criminal law has no right to interfere with important self-regarding actions of consenting adults. Surely, by any stretch of imagination, our sexuality determines, to a significant extent, who we are.
"Jamaica today finds itself in a difficult situation. Sectarian religious mores have been enshrined in law by its former colonial master, and have since been duly maintained as the gospel by generations of Jamaican politicians. The US-based human rights organisation Human Rights Watch published a report a few years ago highlighting the pervasive nature of oftentimes violent homophobia in Jamaica. The price MSM are paying in Jamaica for this situation is very significant indeed, as can be demonstrated by the extraordinarily high prevalence of HIV/AIDS among this group of Jamaicans.
"Unsurprisingly, research has shown that gay Jamaicans are reluctant to present with health problems that could disclose their sexual orientation to health care providers out of fear of reprisals by health care professionals and others...
"...Many Jamaican MSM patients' reluctance to consult health care professionals is indicative of the climate in the country. It cannot surprise then that the country's health minister laments the harmful impact of existing legislation on reasonable public health objectives. In his government's report on HIV/AIDS to the United Nations General Assembly (2010) he (Spencer) explicitly acknowledges the problems this legislation is causing:
The political framework towards HIV has not changed. With outdated laws that present obstacles for adolescents, SW (sex workers), MSM and prison inmates, prevention and treatment efforts to these populations are not able to be fully maximised.
"The existing political framework has also been implicated in contributing to the stigma and discrimination faced by MSM. Several efforts have been made in this area, however, through the review of laws that stand as obstacles to prevention, but to date no major achievements are noted in this aspect of political support. Enlightened politicians such as Jamaica's Health Minister Spencer and his staff find themselves in an unenviable situation. They are representing or working for a government that continues to support legislation that contributes significantly to the high prevalence of HIV/AIDS among MSM.
"Unlike in South Africa where church leaders have come together to support efforts aimed at reducing the incidence of HIV/AIDS, in Jamaica, church leaders are busy trying to preserve the homophobic climate and legislative framework that helped bring about some of the public health problems the country faces today. It will be interesting to see how the situation will evolve in Jamaica..."
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