Another in a series of articles by Jallicia Jolly which discuss the findings of a qualitative study, exploring the obstacles faced by young Jamaican mothers who are HIV-positive.

A longitudinal qualitative study on the experiences of young HIV-positive Jamaican women reveals the role of sexual violence in strengthening HIV and STI vulnerability. Individual and focus group discussions with 12 HIV-positive young mothers in Kingston reveal that 50 per cent have experienced child sexual abuse and forced sexual intercourse before the age of 16. The perpetrator was usually a relative or family friend.

Of the six participants who reported being sexually assaulted, five described experiences of abuse by older men who were from their communities. Reports of attacks by men who were viewed as the “big men” in the community, such as taxi drivers and dons, suffused the accounts. One described a violent assault that took place after a fake photo shoot. In these instances of sexual violence, most of the attackers were relatives or family friends who occupied spaces frequented by the young women.

Most of the respondents recounted experiences of sexual coercion and forced sex. For instance, in describing her first experience of sexual violence by a designated caretaker after the death of her father, one participant recalls: “Di Sunday, mi fadda tell him fi tek care of mi — shelter, school, and stuff like that. Mi fadda died di Monday. Things change when mi fadda dead. Most times mi would call him and ask fi money for school fees and it reach a stage where him start ask mi fi sex. I was 15. [Closes eyes and cries]”

Another participant, who is a mother of two, described an experience where she was forced into having sex with a family friend.

“I believe it was di summer holiday. Mi madda went to work every day… Mi ask fi lunch money and him tell mi seh we would go for a ride. Then him stop at di corna and came inside of me. I could not pee comfortably for a week. When I went to the doctor, I found out I had gonorrhoea. Months later, I found out I was HIV-positive. I was 13,” she said.

An estimated 16 per cent of the young women reported that a boyfriend had perpetrated the first incident of sexual violence.

In recounting her experience of sharing her STI status with her boyfriend, another particpant, also a mother of two, states: “I visited the clinic and they tested me and told me I had herpes and HIV… Suh him beat me go, ah suh him beat me come! Mi go home and tell mi boyfriend seh mi have herpes, mi nuh tell di HIV part. Him scream and it was just ‘blap, blap, blap!’ [Raises hand] One time, him drag me pon di ground outside. Him just ah drag me…”

The experiences of the participants reveal some of the factors that influence health behaviours and sexual reproductive health practices and outcomes. Of the six women who reported ever having experiences of sexual violence, all became pregnant and were diagnosed with HIV before the age of 18.

A predominant pattern that also occurred was survivors who do not share their abuse with anyone and who were unlikely to seek or receive professional help. Only one of the five participants who reported ever having an experience with sexual violence shared her abuse after the first incident.

Given that sexual violence is among the most stigmatised forms of abuse with severe long-term impacts on child growth and adolescent development, more investigation needs to be done to account for underreported experiences.

While there is no panacea to the issue of sexual violence, a multi-dimensional, multi-sectoral, multi-regional, and multi-generational approach can provide more strategic, holistic approaches to effectively address violence and its relation to HIV vulnerability among young women.

Ultimately, the efficacy of the national HIV/AIDS response will depend on how well we can address acts of sexual violence in our homes and communities.

Jallicia Jolly is a PhD student at the University of Michigan. She is a Fullbright scholar with the United States Embassy and has, since March 2015, been working with HIV-positive young mothers in Kingston and St Andrew.