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VII. Regional Efforts to Address HIV/AIDS

Regional efforts to address HIV/AIDS-related discrimination and abuses have the potential to promote domestic policy reform in Jamaica.  Regional organizations providing assistance in drafting rights-respecting laws and policies can provide guidance to Jamaica and use their influence to lobby Jamaica to enact such legislation on an urgent basis.  Regional organizations also can lobby for policy changes that national organizations lack the political or economic resources to support (such as repeal of the sodomy laws).  These efforts may be constrained by the United States, a major donor, through its imposition of policies that limit the capacity to advocate for the rights of sex workers.213

The Pan Caribbean Partnership on HIV/AIDS (PANCAP), a coalition of public and private national, regional, and international organizations, was established in 2001 by the Caribbean Community (CARICOM) to scale up national and regional responses to HIV/AIDS among twenty-one Caribbean states and territories.  PANCAP’s priority areas of action include ensuring that national legislation and policies incorporate international human rights protections; providing treatment, care, and support for people living with HIV/AIDS; and preventing HIV among vulnerable populations, including men who have sex with men and sex workers.

Since 2002, PANCAP has worked with the Canadian HIV/AIDS Legal Network to assist national governments in the region in developing law, policy, and ethical guidelines.214  PANCAP is currently working with seven Caribbean countries to draft legislation to protect people living with HIV/AIDS against discrimination at work and in the health care system, and to ensure universal access to treatment for people living with HIV/AIDS.  According to St. Kitts and Nevis Prime Minister Denzil Douglas, who represents CARICOM on HIV issues, PANCAP also has been discussing condom distribution in prisons and laws criminalizing sex between men.215

In October 2003, the Global Fund approved eight CARICOM proposals, including regional proposals by PANCAP and the Organization of Eastern Caribbean States (OECS).216  PANCAP’s proposal aims to bolster its current law reform efforts by establishing a regional mechanism to ensure human rights protections for people living with HIV/AIDS; to coordinate regional and sub-regional HIV/AIDS prevention efforts; and to address inequities in care, treatment, and support among Caribbean countries.217  PANCAP regional efforts to ensure human rights protections have the potential to complement Jamaica’s national law and policy reforms.

There have been important regional efforts to establish and coordinate networks of people living with HIV/AIDS, men who have sex with men, and sex workers.  The Caribbean Regional Network of People living with HIV/AIDS (CRN+) provides training and technical assistance to people living with HIV/AIDS in twenty-seven territories and seven national networks in the Caribbean region.  CRN+’s position on the PANCAP steering committee has made it a key partner in regional initiatives, including with the World Bank and the Caribbean Health Research Council.  In July 2004, CRN+ got approval of its own Global Fund proposal, which aims to enhance the capacity of people living with HIV/AIDS in the region to obtain treatment, care, and support services, to adhere to new treatment regimes, and to participate in advocacy and policymaking on the national and regional level.218  This initiative targets people living with HIV/AIDS and their networks in twelve Caribbean countries, including Jamaica.219  In Jamaica, the United Nations Theme Group on HIV/AIDS is also providing support and technical assistance for the Jamaican Network of Seropositives (JN+).220

Since 2003, the NGO International HIV/AIDS Alliance has been working in several Caribbean countries to mobilize support and HIV/AIDS prevention education for men who have sex with men.221  In 2003, Jamaica AIDS Support collaborated with the Alliance to establish and support community organizations of men who have sex with men in the eastern Caribbean, and to form a regional network of groups working with men who have sex with men to provide support to national groups.222  The Latin American Association for Comprehensive Health and Citizenship, a network of lesbian, gay, bisexual, and transgender groups in Central and South America, has been working with groups working with men who have sex with men in the region to develop and support strategies to force governments to address the needs of men who have sex with men in national HIV/AIDS programs.223

In some Caribbean countries since the mid-1990s, sex worker organizations have been providing HIV/AIDS and other health services, and advocating for the protection of sex workers’ rights.224  The Movimiento de Mujeres Unidas, MODEMU (The Movement of  United Women) and the Maxi Linder Association in Suriname have been internationally recognized for such work and looked to as models for other organizations in the region. 

The U.S. government provides significant funding to support HIV/AIDS-related work in the region, including work targeting sex workers.  U.S. law and policy bars the use of these funds by organizations that do not have a policy explicitly opposing prostitution and limits the legal advocacy that can be done with these funds.  These funding restrictions limit the extent to which other organizations might emulate the exemplary work of organizations like MODEMU and the Maxi Linder Association.  A health worker working with sex workers in Jamaica told Human Rights Watch that the restrictions have impeded the organization’s work with sex workers by undermining its ability to support efforts for sex workers to organize on their own behalf and to join with regional and international calls for advocacy on behalf of the rights of sex workers.225  Other NGOs that receive U.S. government funding to work with sex workers in the region may face similar obstacles.



[213] U.S. law and policy bars the use of international HIV/AIDs and anti-trafficking funds by organizations that promote or advocate prostitution as an employment choice or the legalization of prostitution and that do not have a policy explicitly opposing prostitution.  See United States Leadership against HIV/AIDS, Tuberculosis and Malaria Act of 2003, P.L. 108-25 (2003) (commonly know as the President’s Emergency Plan for AIDS Relief or PEPFAR), section 104A(e); Office of the United States Global AIDS Coordinator, “The President’s Emergency Plan for AIDS Relief.  U.S. Five Year Global HIV/AIDS Strategy,” February 2004, p. 65; U.S. Agency for International Development, “Trafficking in Persons: USAID Strategy for Response,” February 2003, p. 4.  Peer education projects are often the most effective and only possible AIDS educators for sex workers and have been acknowledged for their success in providing HIV education and prevention services in many countries throughout the world.  See Kemala Kempadoo and Jo Doezema, Global Sex Workers: Rights, Resistance, Rebellion (London: Routledge, 1998); Human Rights Watch, “Epidemic of Abuse: Police Harassment of HIV/AIDS Outreach Workers in India,” A Human Rights Watch Report, vol. 14, no. 5(c), July 2002.  U.S. funding restrictions undermine support for this important work, and limit advocacy strategies to ensure safe sex during sex work.   

[214] Canadian HIV/AIDS Legal Network, PANCAP, CARICOM, “Action Plan and Workshop Reports: Programme on HIV/AIDS, Law, Ethics and Human Rights,” January 2004.

[215] Caribbean poised to pass HIV Laws,” BBC Caribbean, March 8, 2004.  This contradicts current CARICOM model legislation for sexual offences that endorses criminalization of adult homosexual conduct.  See CARICOM Model Legislation for Sexual Offences, section 15, http://www.caricom.org/archives/sexualoffences.htm (retrieved August 27, 2004).

[216] These proposals were from Guyana and Haiti (two each), Belize, Jamaica, the Organization of Eastern Caribbean States and PANCAP.  CARICOM, “Eight CARICOM Proposals Successful at Sixth Meeting of Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM),” October 15, 2003.

[217] PANCAP, Scaling Up the Regional Response to HIV/AIDS through the Pan Caribbean Partnership on HIV/AIDS.  The OECS proposal focuses on improving access to HIV/AIDS prevention and treatment services in the nine small island nations that comprise the OECS subregion (Anguilla, Antigua & Barbuda, the British Virgin Islands, Dominica, Grenada, Montserrat, St. Kitts & Nevis, St. Lucia, and St Vincent and the Grenadines), which share strong economic, social and cultural links.  Country Coordinating Mechanism, Scaling up prevention, care and treatment to combat the HIV/AIDS pandemic in the organization of Eastern Caribbean States (OECS) Sub-Region.

[218] CRN+, Strengthening the Community of PLWHA and those affected by HIV/AIDS in the Caribbean—a Community Based Initiative, http://www.theglobalfund.org/search/docs/4MANH_767_0_full.pdf (retrieved August 20, 2004). 

[219] Ibid.

[220] Human Rights Watch interview with Bernard Bainvil, Chair, U.N. Theme Group on HIV/AIDS, Jamaica, Kingston, June 10, 2004.

[221] International HIV/AIDS Alliance, Annual Review 2003, pp. 41-42.  The Alliance established its Caribbean program in 2003, and targets prevention and care activities for men who have sex with men, sex workers, and people living with HIV/AIDS. 

[222] Ibid.; Human Rights Watch e-mail communication with Robert Carr, director, Jamaica AIDS Support, August 19, 2004.

[223] Asociacion para la Salud Integral y Ciudadania de America Latina (ASICAL), “Quienes Somos,” http://www.sidalac.org.mx/asical/asical.html (retrieved August 21, 2004).  The International AIDS Alliance and the POLICY Project have been collaborating with ASICAL in this work.  See International AIDS Alliance, Annual Review 2003, p. 41; The Men’s Health in Latin America,” February 6, 2003, http://www.policyproject.com/page_whatsNew.cfm?read=30 (retrieved August 21, 2004); POLICY Project, “POLICY/ASICAL Training PromotesMen’s Health in Latin America,” February 6, 2003, http://www.policyproject.com/page_whatsNew.cfm?read=30 (retrieved August 21, 2004).

[224] See Kemala Kempadoo and Jo Doezema, Global Sex Workers: Rights, Resistance, Rebellion (London: Routledge, 1998).

[225] Human Rights Watch interview, Kingston, June 14, 2004.


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