Dispatch September 2009

How AIDS Became a Caribbean Crisis

Widespread homophobia has intensified the epidemic in Jamaica, where the HIV infection rate is an astounding 32 percent among gay men.
jamaica aids
Photo taken at a meeting of Jamaica's underground gay church, known as the Sunshine Cathedral, which holds clandestine meetings several times a month. (Photo by Gabrielle Weiss)

We may be accustomed to thinking of AIDS as most rampant in distant parts of the world like Africa, India, and South Asia. But these days the epidemic is flaring up a bit closer to home, in the Caribbean. Indeed, AIDS is now the leading cause of death among adults there, and the Caribbean’s rate of new infections is the second highest in the world, following just behind Sub-Saharan Africa.

A major factor in the region’s susceptibility to the epidemic is its pervasive atmosphere of homophobia, which makes education and outreach efforts nearly impossible. Jamaica, which lies near the middle of the Caribbean and, as of last year, was found to have an astounding 32 percent HIV infection rate among gay men, offers a case study in how anti-gay attitudes have helped spread and intensify the epidemic’s impact.

More on Jamaica's AIDS crisis:


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In Jamaica, homophobic attitudes are reflected in everything from laws that criminalize anal sex, to the lyrics of popular dancehall music that celebrates the murder of gay men, to widespread acts of anti-gay violence, and a gay culture of sexual secrecy and high-risk behavior.  Each of these factors is intensified by a religious context that defines homosexuality as a mortal sin and points to the Bible for moral justification in violently rejecting the concerns of the gay community. 

According to Dr. Robert Carr, widely recognized as one of the world’s leading researchers on cultural forces and the unfolding of the AIDS pandemic, local awareness of the disease was initially shaped by the international media:  “AIDS was seen as a disease of gay, White, North American men.  And people were really afraid of it.”

“There were no treatments available in the Caribbean at the time,” he says, “so AIDS really was a death sentence. You had people with Kaposi's sarcoma, people with violent diarrhea, who were just wasting away and then dying in really horrible and traumatic ways.”   The terror induced by these deaths, combined with an already intense local culture of homophobia to produce a violent backlash.  “To call what was going on here ‘stigma and discrimination’ was really an understatement,” he says. “In the ghettos they were putting tires around people who had AIDS and lighting the tires on fire. They were killing gay people because they thought AIDS was contagious.  It was a very extreme environment, and really horrible things were happening.”

Jamaican male sexual identity, and Caribbean male identity more broadly, has long been defined in opposition to homosexuality.  “A lot of Jamaican men, if you call them a homosexual, the term is “battyman,” will immediately get violent,” says Dr. Kingsley Ragashanti Stewart, a professor of anthropology at the University of the West Indies. “It’s the worst insult you could give to a Jamaican man.”  

Dr. Stewart, who works with young men from the ghettos and himself grew up in a poor inner-city community, says that homophobia influences almost every aspect of life.  It has even come to shape the everyday language of ghetto youth. “It’s like if you say, ‘Come back here,’ they will say, ‘No, no, no don’t say ‘come back’.’  You have to say ‘come forward,’ because come back is implying that you’re ‘coming in the back,’ which is how gay men have sex.” 

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