Inter Press Service - Friday, March 26, 1999
Eulalee Thompson

"...The current Health Minister ... is much more aware and I believe that it (the legislation) is high on his agenda," says Stephen Johnson, chairman of the NAC's legal and ethical sub- committee.

Now still without such legislation, Jamaica, the largest English-speaking Caribbean country is lagging behind many of its neighbours.

The issue of willful transmission of the virus that causes the Acquired Immune Deficiency Syndrome (AIDS), is one of the factors that motivated the Committee's proposal.

The proposal speaks to the fact that "the special attributes of HIV/AIDS (including) the involvement of pleasure-seeking human behaviour; the low status of and therefore compromised sexual autonomy of those frequently at risk - women and children - no treatment capable of cure... means that control and prevention can only be based on compliance of the infected not to spread the infection and the uninfected not to expose themselves to the infection."

Johnson says one of the issues highlighted in the proposal is that on the matter of partner notification the physician is placed in an extremely difficult position if patients refuse to inform their partners that they are HIV positive In this situation confidentiality is in conflict with the duty to warn others known to be at risk, the proposal indicates.

The NAC is therefore proposing that in the face of persistent refusal, it is considered that the duty to warn supersedes that of confidentiality provided that the physician has certain knowledge as to the existence of risk to a third party.

The NAC is also proposing that persons with AIDS should either be required to bring in their partners for testing or provide satisfactory proof that their partners have seen a health care provider within 30 days, failing which the health care provider will notify the partner if he or she reasonably believes that there is real risk to the third party.

Actions of insurance companies here have also been scrutinised by the legal and ethical sub-committee. This sub-committee would like the proposed legislation to require these companies to advise the prospective client should they require an HIV/AIDS test to be done and formally have the consent of the prospective client before such a test is done.

In its proposal the NAC comes out strongly against discrimination stating that the legislation specifically makes it illegal to deny persons with AIDS access to health care facilities and housing and also that HIV testing should not be a pre-condition for employment.

A survey commissioned by the NAC last year in which questionnaires were administered to 16 companies comprising a work force of 1,394 persons, found that four companies required compulsory testing as a precondition for employment with positive testing precluding employment.

The Jamaica Defence Force (JDF) is one company which requires testing for its recruits. Serving officers are also tested each year.

Last year two female recruits were refused entry into the JDF because they tested positive for HIV. However, officers who are serving the JDF and are found to be infected are not dismissed, but according to Captain Shirley Tomlinson, are offered counselling.

It was in the light of those findings and the decision by some employers to implement mandatory testing that the NAC prepared the proposal calling for legislation to protect the privacy of HIV infected persons and minimise discrimination against them.

The proposed legislation , the NAC says could either be introduced as a separate set of legislation or it could be introduced as an amendment to the existing Public Health Act which already addresses the matter of the way some diseases should be dealt with.

"We have not yet signed off on which way to go, but if the Committee thinks that by amending the Public Health Act the matter could be fast-tracked, then we would not disagree with that," Johnson says.

Since the first case of AIDS was diagnosed here in 1982, epidemiologists now have on record 3,304 reported cases of the disease.

"The trend has been one where HIV infection has been doubling among the 25 to 35 age group which represents the more productive group within the country's labour force. Indications therefore are that unemployment will double if persons are denied jobs because they test positive," said Ian McKnight of the Jamaica AIDS Support (JAS) at that time.

The JAS is a non-governmental organisation which provides shelter and counselling for HIV-infected persons.

Meanwhile, one of the areas of concern here is that the highest rates of AIDS cases are showing up in the western region of the island, well-known for its tourist trade. Though some officials make reference to a link between the high case rate there and the tourist trade, no study has made a conclusive link. (END/IPS/et/cb/99)
990326
IP990303

Always watch for outdated information. This article first appeared in 1999. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1999. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .