By Johnny Coomansingh
Christmas and the welcome of the New Year 2025 have moved off the stage. Next on the docket for celebration in the Caribbean is the Trinidad Carnival. The pre-Lenten bacchanal is the ultimate ribald celebration for ‘freedom of the flesh.’ Nevertheless, celebrants must be reminded that there is a pernicious disease called the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS). Although the disease is very much alive in the Caribbean region, it would seem that in many quarters it is not being publicized as much these days.
In 2023 an estimated 5,100 people died from AIDS-related illnesses in the Caribbean; a decrease from 12,000 in 2010. Despite this drop in cases, in 2023, an estimated 330,000 people were living with HIV in the Caribbean. There are reasons why HIV/AIDS is still a problem in developing countries, especially those heavily involved in the tourist industry.
In the Caribbean, HIV/AIDS has penetrated the populations of tourism-dependent islands. In 2001, Dr. Peggy McEnvoy, the Caribbean team leader for the Joint United Nations Program on HIV/AIDS described HIV/AIDS as “The Mobile Epidemic.” She affirmed:
“From culture to culture and island to island, HIV/AIDS is enveloped in a dark shroud of irrationality. Professionals working on the issue must wend their way through a labyrinth of stigma, taboo, denial, discrimination and secrecy. HIV/AIDS is a condition related to sex, blood, death, disease, and forbidden or illegal behaviour—men having sex with men, the sex trade (both male and female), drug abuse, and the sexual abuse of children. The fear associated with the disease thwarts efforts to address its causes and find solutions…”
In the wake of failing oil prices on the world market in the 1980s, Trinidad and Tobago (T&T) fell ‘victim’ to the tourist industry. In light of this, Wesley Gibbings, a prominent Caribbean journalist in 1997 declared:
“Tobago…is fast realizing that sex—the fourth dimension of the tourism industry that sells sun, sea and sand—bears a terribly high price tag. Tourism and promiscuity are being blamed by health experts for the fast-rising incidence of the dreaded AIDS in Tobago…an island that has begun to establish itself as an alternative to traditional tourist destinations in the Caribbean.”
It is clear that social and cultural taboos often cause a hindrance to any aggressive move to deal with the HIV/AIDS situation in the Caribbean. Citing Jamaica as a prime example, Zadie Neufville in the article Health-Jamaica: Women twice as vulnerable, published in the Interpress Service news agency (2003) indicated that because of the decline of condom use in Jamaica HIV/AIDS cases would continue to rise. In 1996, condom use in women in Jamaica was 96 percent. It has dropped to 67 percent in the first six months of 2003, and condom use with regular partners fell to 38 percent from a level of 41 percent.
Also it is a common thing for women to engage in sexual intercourse without a condom even while they suspect that their significant other is having sexual relations with others. Many women are willing to do without the condom “as long as the man is using one with his outside partner.” Neufville adds:
“The north coast, and West Kingston section of the capital are of particular concern as infections here continue to increase… poverty, ignorance, and poor socialization have robbed women of the ability to negotiate condom use. AIDS is the second cause of death among the young and part of the problem is unplanned sex between older men and young girls…social factors include the belief that having sex with a virgin will cure sexually transmitted diseases as well as a ‘breakdown’ in moral values that causes many to exchange sex for material gain. In many countries of the Caribbean the hidden story is rape, incest, domestic violence and ‘sugar daddies.’ Sugar daddies are older men on whom younger women come to rely…and who extract sex in return for financial support.”
Stigmatization with regard to HIV/AIDS in the Caribbean is rife. The literature showed that as the AIDS rate soar, those infected are shunned by society thus continuing the vicious circle of ignorance. Certain Christian churches in the Caribbean, in this case the Pentecostal Church in the village of Yabucoa, Puerto Rico, associated the spread of HIV/AIDS as punishment from God for sins committed. However, infected children were cleared from such judgment.
Karen De Young in her 2001 article: A deadly stigma in the Caribbean published in the Washington Post reported about a woman named Claudia infected with HIV/AIDS in Jamaica. Claudia literally became an alien in her own hometown. Her mother, son, and siblings broke communication with her, threw her out of the family house…the costly treatment for HIV/AIDS was beyond her reach. Poor and dejected, she died within two years. In the article, C. James Hospedales, director of the Caribbean Epidemiology Center (CAREC) said: “AIDS is already the leading cause of death in the Caribbean for those aged 15 to 45.” Fighting AIDS is terribly difficult for people steeped in the “poverty trap.”
In terms of homophobic violence, homosexuals in Jamaica have been given a rough ordeal. They have been victims of violence even to the point of death because of the presence of discriminatory laws in the country. According to Neufville, since 1980, 38 homosexuals were killed, and hundreds viciously beaten, driven from their abodes, and their jobs. In Jamaica, protection from abuse because of gender or sexual orientation is not present in the constitution.
Adding to the continuance of homophobia, Buju Banton in the song titled Boom Bye Bye, stated: “…aal bati-man fi ded.” This was interpreted as a death sentence for homosexuals. Look at what Noelle Andrego wrote in his 2024 article Continued Persecution of Jamaican Homosexuals Leads to Strong Claims for Asylum: “Jamaica is one of the most unpleasant countries for homosexuals, as this group continues to be targets of discrimination and persecution…The illegality of homosexuality in Jamaica ‘mobilizes the authority of the state’ and reinforce[s] prejudice and negative social attitudes.”
Thus riveted in the cultural makeup is the intolerance towards homosexuals and lesbians, and this state of affairs drive homosexuals underground who dare not reveal their sexual orientation or ask to be tested for HIV/AIDS less they be endangered.
As mentioned earlier, many Small Island Developing States (SIDS) in the Caribbean are in the “poverty trap” with no immediate hope of escape. In the Dominican Republic (DR) according to John Kreniske, in the text: AIDS in Africa and the Caribbean (1997) a crisis situation exists. The downward slide in the economy began in the mid-1980s, and the trend is continuing. Many basic food items such milk, cheese, eggs, and even the sugar produced on the island, if ever in supply, are priced well beyond the reach of the masses.
Unemployment is about 42 percent. “It is too hard. It is just too hard,” is the cry on every lip. In light of these conditions which render HIV/AIDS interventions more complex, Kreniske said: “If people cannot buy food or secure water that is clean enough to wash—let alone drink—they are not likely to be receptive to messages concerning condom use or the threat of a disease which might kill years from now.” With respect to the sex worker, tourism, and poverty in the Dominican Republic, Kreniske observed:
“On the darkened streets there are boys of varying aggressiveness, pregnant women and grandmothers, all hoping to interest or coerce someone, anyone, into paying something for some sort of sexual act. The issue for the sex-minded tourist is not whether sex is available; rather, it is what sort and how much one wishes. The issue for the sex worker is, simply, survival.”
Coupled with poverty are the dynamics of migration in the Caribbean region, Haiti and the Dominican Republic’s intra-regional migration patterns will serve as classic examples to show how migration ‘promotes’ the transmission of HIV/AIDS. It must be taken into consideration that when people migrate they often carry some of their culture with them.
There is a migratory process occurring between the DR and Puerto Rico, and between Haiti, and the DR. To escape the poverty, and unemployment that faces them, citizens of the DR ‘face the rigors of migration’ to the United States. According to Kreniske, as a result of the strict measures applied by the United States of America (USA) with regard to legal migration, many Dominicans attempt to cross the Mona Straight by ‘yola’ (small open boats) to Puerto Rico in search of a better life. Every year between one, and two thousand people from the DR perish in the waters in their bid to make it to Puerto Rico.
Arriving on the shores of Puerto Rico is also not a pretty picture for many of the women who survive the trip. Women are frequently sexually assaulted, and pressed into sex work by private bands of Puerto Ricans, and even the local police. These people use the threat of deportation to control these ill-fated victims. Such circumstances provide fertile ground for the transmission of HIV/AIDS.
On the other hand, the situation with Haiti is a little different. Haitians migrate to the DR in search of jobs usually during the sugar cane harvest. Haiti is so steeped in poverty that much of their forests were cut down to provide cooking fuel. Owing to this, many Haitians cross the border to seek jobs in the ‘bateyes’ (sugarcane worker’s camps) of the sugar plantations. Bateyes have been referred to in the literature as the most brutal, and enslaving work situation (esclavizante) in the world, the base in the ‘pyramid of poverty’ in the DR. In such localities, living conditions are filthy, malnutrition is the rule, and physical abuse the order of the day. In short, people living especially ‘an-bas-fil’ (illegal Haitians) in the extremely impoverished conditions of these camps, may be part of the problem involving the transmission of HIV/AIDS.
Kreniske speculates that in the bateyes sex work is common, and sexual activity commences at around 12 years old. In yet another twist to the problem, Kreniske explained sexuality and the ‘Haitian Mystique:’
“In Dominican folk belief, there is a certain mystique surrounding Haitians…Haitians are often seen as having a connection with the past and primitive…Connected to this belief is the belief that Haitian men harbor great potency and many Haitian women possess the ‘cocomordan’ (biting vagina capable of exerting great pressure). Dominican men deliberately seek out sexual contacts with Haitian women in search of cocomordan. For those who believe in cocomordan, the attraction may override fears of AIDS.”
Then there are other factors that add their fair share to the imperceptible transmission of HIV/AIDS. The Caribbean region is now considered to be a cultural hearth because of its festive atmosphere, where over 40 musical art forms have emerged and developed among which are Reggae, Zouk, Calypso, Soca, Chutney, Chutney-Soca, and Steelpan music.
These musical art forms have been employed in the celebration of various festivals in the Caribbean among which are: Crop Over (Barbados), Reggae SunSplash, and Pocomania (Jamaica), Rara (Haiti), Junkanoo (Bahamas), Heritage Festival (Tobago), and several summer carnivals staged, for example, Grenada, Saint Lucia, St Vincent, St Kitts and Nevis, Antigua and Barbuda, Jamaica, Anguilla, and Saint Maarten.
Such festivals evoke certain kinds of sexual behaviours and sensual dances especially when participants are inebriated with alcohol or other kinds of mind-numbing potions, and drugs. Presently, preparations for the pre-Lenten Trinidad Carnival is moving at full speed ahead. Mark Fraser’s headline on the Trinidad Express published on February 06, 2013 read: Enjoy yourself but don’t be reckless.
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