V. Findings of Human Rights Watch’s Investigation

In Jamaica, state-sponsored homophobia and discrimination against homosexual men and women, sex workers, and people living with HIV/AIDS, the conflation of HIV/AIDS with homosexuality and sex work, and the misguided fear that HIV is transmitted by air or by casual contact are undermining an effective response to HIV/AIDS. Police not only harass and persecute people suspected of homosexual conduct, sex workers, and people living with HIV/AIDS. They also interfere with HIV/AIDS outreach to them. Men who have sex with men and people living with HIV/AIDS face serious violence and are often forced to abandon their homes and communities. Many are denied health care; some cannot even seek health services because they are denied public and private transportation services. And past experiences of discrimination, coupled with the fear that HIV status or sexual orientation will be disclosed and publicized, keep many people from seeking health care in the first instance.

Police abuse

Police abuse based on sexual orientation and gender identity

Verbal and physical abuse and inciting others to violence

On the afternoon of June 18, 2004, a mob chased and reportedly “chopped, stabbed and stoned to death” a man perceived to be gay in Montego Bay.³⁷ Several witnesses reported to Human Rights Watch that police participated in the abuse that ultimately led to this mob killing, first beating the man with batons and then urging others to beat him because he was homosexual.

Fred L., thirty, described the incident as follows:

Me and another guy were sitting on the beach . . .While we were there, some little teenager was on the beach swimming, and Victor, the guy that was killed, was standing looking at the boy. The boy said, "Why are you looking me like that? You a battyman." Two rastamen³⁸ said, "Every day they come on the beach to look at men, battyboy them." Two policemen and a female police officer were there. The two male officers started to beat the man with batons. I turned to the female officer and asked, “What has he done wrong?” She turned to me and said, "Everyday me have to warn people about this guy coming on the beach. I'm going to lock him up.” I said, “For what?” She didn't say. I said to her, “If he did something wrong, lock him up, don't beat him.” [Victor] started to run from the two male officers toward the Old Fort Craft Market. The two policemen said, "Beat him because him a battyman."³⁹

The crowd followed the police officers’ lead, beating the victim and throwing bottles and stones at him.⁴⁰ Joseph W., twenty-six, told Human Rights Watch that he saw police hitting the victim with a baton and with their fists, and that once persons from the crowd started beating the victim:

the police officers walked off. The crowd got thicker and more persons started hitting the guy. Then I saw the guy run out of the road into the town. . . . Then I woke up the next morning to hear that Victor was killed about a mile and a half from the beach.⁴¹

Police abuse is a fact of life for many men who have sex with men and women who have sex with women in all of the communities that Human Rights Watch visited in Jamaica. As in the incident described above, homophobic police violence can be a catalyst for violence and abuse by others. It is sometimes lethal. Police abuse is also profoundly destructive because it creates an atmosphere of fear sending a message to other lesbian, gay, bisexual, and transgender people that they are without any protection from violence.

Dennis M., twenty, lived in Montego Bay. He told Human Rights Watch:

Police always harass me. . . . They stop you and hear you talk a bit feminine [and ] they ask you personal questions like are you top or bottom and like that. . . . The last time this happened . . . two police came over and said “Battymen mus’ dead. You should be under the ground. You should not be living in Jamaica.” Not every police officer does that. Some police officers say it is not legal so you should curtail your behavior. But most of them, once they hear you talk feminish they begin to bitch [verbally abuse] you and a crowd comes around.⁴²

Nicholas C., twenty-nine, was stopped by the police while walking down the street one evening in April 2004. The police asked him if he was a battyman and searched him. After finding condoms, lubricant, and gel, they became violent. “They said, ‘You a battyman. Battyman mus’ dead. Run before I shoot you.’” The police beat Nicholas C., hit him with batons, kicked him, and scattered his things on the ground.⁴³

Several gay men reported that police abuse accelerated violence by others. Albert B., thirty-three, and his friends had been attacked by Kingston police a few days before Human Rights Watch met with him in June 2004. The police beat Albert B. and his friends, threw stones at them, called them “battymen,” “faggot,” and “nasty men” and drew their guns at them. The police actions drew the attention of other men, who came and beat them with boards, crying out “battymen.”⁴⁴

Peter T., nineteen, was walking on the street with friends late in the evening of December 25, 2003. A police car drove by, and the policemen inside yelled, “Battymen, go home.” When Peter T.’s friend told the police to leave them alone, the police stopped their car, beat the men, then put them in the police car and drove them to another part of town. As they let the men out of the car, the police yelled, “Battymen, battymen, beat them,” and fired their guns in the air. This attracted the attention of a crowd of men armed with machetes, who followed the police instruction and beat them.⁴⁵

Harold B., thirty-four, reported several incidents of police abuse in 2004, including an attack by police a few hours before his interview with Human Rights Watch. For Harold B., the public humiliation by police that incited others to violence was worse than physical attacks. “The worst thing is when police embarrass you whenever they see you in a crowd. When I’m walking on the street, the police yell, ‘battyboy, you catch men.’ When they do that, people start to look at you and some want to attack you.”⁴⁶

Many of the men who have sex with men interviewed by Human Rights Watch reported having to flee their homes and communities because of homophobic violence by their neighbors or other residents of their towns. In some cases, police abuse of men suspected of homosexual conduct prompted violence by private actors, whose violence effectively evicted them from their homes.

Until early 2003, Peter T. lived with a group of gay men in a house in Kingston. He said that the police visited the house frequently, making derogatory comments about homosexuality and beating the residents. The police presence would attract others, who would join in the abuse. He told Human Rights Watch:

Police visit there a whole heap of time. . . . Every time the police come to the house, others would always show up. The police come there and start searching and then the next neighbor would come over and start in. Police would search in the closet, under the bed. If they see condoms, they say that we were fucking, we carry AIDS, battymen have AIDS, man on man fi dead. [gay men should be dead].⁴⁷

By February 2003, the violence had escalated sufficiently to drive Peter T. and his housemates away. One afternoon, “people come and say we can’t sleep there tonight because we’re going to bomb it down.” Peter T. and his housemates fled, leaving without their belongings.⁴⁸

Police abuse of gay men extends to men living with HIV/AIDS, whom they assume must be gay. Paul M., forty, told Human Rights Watch that in 2003, he was with a friend who had AIDS when the police approached and asked:

“Eh boy, how you look so, w’happen to you?” The person say, “I have AIDS and I want to take my medication.’ Police say, “you must be battyman. Eh boy, eh boy, move your AIDS self from here. Mind me turn mi gun pon yuh and kill you. [Watch out because I might turn my gun on you and kill you.]”⁴⁹

Arrests, detention, and prosecution

Gay and bisexual men and AIDS service providers told Human Rights Watch that men who are or perceived to be gay are routinely threatened with arrest, arrested, detained, and sometimes prosecuted because of their actual or perceived homosexuality or homosexual conduct. Human Rights Watch also documented cases of police arrest of women because of homosexual conduct.

Jamaica’s sodomy laws criminalize consensual homosexual conduct between adult men, prohibiting the “abominable crime of buggery, committed either with mankind or with any animal” and “gross indecency.”⁵⁰ “Buggery,” which generally refers to all acts of anal intercourse and bestiality, is a felony punishable by imprisonment with hard labor for up to ten years.⁵¹ “Gross indecency,” generally interpreted to mean any sexual intimacy between men short of anal intercourse, is a misdemeanor punishable by up to two years with hard labor.⁵²

Jamaican law provides broad latitude for police to detain individuals on ill-defined charges, including suspicion of buggery or gross indecency. The Offences against the Person Act permits a police officer to arrest without warrant any person found “loitering in any highway, yard, or other place” between 7 p.m. and 6 a.m. the following morning whom the constable has “good cause to suspect of having committed, or being about to commit any felony” proscribed by the Act.⁵³ Jamaican police are also empowered to arrest without warrant and based on charges made by any “credible person” any person loitering in a public place to solicit another for prostitution.⁵⁴

It is impossible to say how frequently sodomy laws are enforced against men engaged in consensual same sex contact in Jamaica, but by some accounts, they are in active use.⁵⁵ Lawson Williams, a Kingston attorney who has represented men charged under these statutes, told Human Rights Watch:

I always seem to have a case of a practicing gay man who is in court on account of his homosexuality. It's either that he and another have been busted and are jointly charged for [consensual] buggery, he's been charged in circumstances where someone has alleged forcible or unwarranted homosexual advances against him, or there is an allegation that he has had sex with a minor. . . . Too many of the charges of sex with a minor are motivated by the prejudice that gay men are naturally inclined to have sex with underage boys, and they fail because of a lack of physical or credible evidence.

Usually, the police indict gay men for buggery. This is very difficult to prove in the context of consensual anal sex and there is seldom a successful prosecution for buggery. The damage is in the terror of the charge itself. Oftentimes, the defendant pleads guilty to the lesser offence of gross indecency, to abbreviate the embarrassment. Or if the defendant is adamant that he will not compromise, very often the charge is dismissed for lack of evidence. But the damage is in the charge. It is standing in the dock in the face of judge, police and sometimes other litigants, where it is known that you are charged as a battyman.⁵⁶

High-level police officials claimed that sodomy laws seldom were enforced. Clarence Taylor, assistant commissioner of police in charge of administration, said that sodomy cases among adults were rare.⁵⁷ A St. Ann’s Bay constable told Human Rights Watch, “We occasionally arrest homosexuals. If they’re caught in the act, we charge them with buggery.”⁵⁸ A high-level police officer at a Kingston divisional police headquarters told Human Rights Watch in June 2004 that it had been “many moons since we have had an arrest for solicitation, buggery, or gross indecency.”⁵⁹ A high-level police officer at a second Kingston divisional police headquarters said that he could not recall a case of buggery, and that the last one may have been three or four years before.⁶⁰

Regardless of how often buggery and gross indecency laws are actually enforced, the arrests themselves send a message.⁶¹ The Jamaican press publishes the names of men charged with “consensual” buggery and gross indecency, shaming them and putting them at risk of physical injury.⁶² And the threat of criminal sanctions for homosexual conduct is itself powerful. Buggery and gross indecency laws provide a means to harass, arrest, and in some cases imprison individuals. They also perpetuate social prejudices.

Allen C., twenty-two, said that he was arrested and charged with buggery after someone reported to the police having observed him having sex with another man. He was taken to the police station, where police officers urged him to confess to a charge of buggery while beating him with a stick and chanting “buggery fi dead” [people who commit buggery should be killed]. The police told him that he would be examined by a doctor in the rape unit to see if he was the receiving partner in anal intercourse. He was placed in a jail cell, where he was cursed out as a “battyman” by other inmates. When he was released to the custody of his mother, the police ensured that the abuse would continue: when Allen C. left the station, they announced the charges to people outside.

Although the incident took place in 1999 (five years prior to his interview with Human Rights Watch), Allen C. was still suffering its consequences. He told Human Rights Watch that since this arrest, “The whole community find out [that I’m homosexual.] People put up a hand like a gun to their head and say, ‘battyman fi dead,’ and throw stones at me. I can’t complain to police, because they know I am a homosexual and will turn on me. Most of the time, I just keep to myself and my friends who are homosexual.” He remained worried about being charged again with buggery and imprisoned. ⁶³

A number of witnesses said that they thought that some element of their outward behavior, dress, or appearance was the motivation for police to arrest or detain them. Ryan N., twenty-three, was interrupted by police while talking with friends. “Police started saying I’m gay because how me talks. Police took me to the station and threatened to charge me with gross indecency. I asked him, ‘What is gross indecency? Can you define gross indecency?’ Police say, ‘When two men start to play with their penis.’ I say, ‘Was I doing that?’ When they realized that I’m not stupid about the law and started to quote the law to them, the police started threatening to lock me up and then men could screw me up in prison.” Ryan N. was charged with obstructing police on duty and resisting arrest.⁶⁴

Several gay men told Human Rights Watch that they had been stopped by police while in a car with male friends. Harold B. recalled being stopped by police twice in the first half of 2004, once the week before his interview with Human Rights Watch. “If you’re driving with a friend, police stop you and say, ‘battyman, what are you doing in the car—fucking?’ Try to argue with them and they’ll take you to the station.”⁶⁵ Vincent G. was present in early 2004 when police approached a car in which two male friends of his were sitting, arrested them and threatened to charge them with buggery. His friends were taken to the police station and then released.⁶⁶ Ryan N. was parked in a car, eating burgers with several friends when police approached them, told them they had observed them kissing, and made them get out of the car and show their documents.⁶⁷

Police also use other laws as a pretext to stop men based on nonconforming gender identity. Patrick D., twenty-five, told Human Rights Watch about a 2004 incident: “I was going to a costume party and wearing a dress. The police stop me and tell me to hold up my head. I do and they see I am a man. I tell them I am entering a costume party competition. They radio other cars and accuse me of wanting to rob someone. They let me go, but they come and look and talk and call me ‘battyman.’”⁶⁸

Women who have sex with women are also targeted for arrest because of homosexual conduct. Lillie P., thirty-six, told Human Rights Watch that she was arrested while parked in a car with her girlfriend on December 31, 2002. “On New Year’s Eve, myself and my girlfriend went to a lovers’ spot after a party. There were a lot of other cars there, but the police approached us.” The police called Lillie P. and her girlfriend “dirty lesbians,” threatened to charge the women with indecent and lewd exposure and asked them for money. When the women refused to offer a bribe, the police arrested them and took them to the Portmore police station. At the station, the police superintendent told the women that they were not going be charged, but that their names would be recorded in a register. “It was scary at first because at this point I was not out to my parents and I was going to start a job soon and I was afraid that it was going to jeopardize it. I was concerned for my girlfriend . . . She works for [a government ministry] and could suffer problems if they find out she is gay.”⁶⁹

Extortion and theft

Men who have sex with men are easy targets for extortion by both police and private actors. Discriminatory police practices, fear that their homosexuality might be publicized, the paucity of available legal assistance, and the possibility of being prosecuted themselves combine to keep men who have sex with men from filing complaints or seeking redress when they are victims of extortion.

Several gay men told Human Rights Watch that police demanded money from them and arrested or beat them when they refused to pay. Harold B. recalled being stopped twice by police in 2004 and accused of having sex with another man. On one occasion, Harold B. and a friend were arrested and threatened with a charge of buggery after they refused to pay money to police. They were taken to the police station, where, after being questioned by the arresting officers’ superior, they were ultimately released.⁷⁰

Two days before his interview with Human Rights Watch, police stopped Lawrence O. and two friends outside a shopping center in New Kingston. According to Lawrence O., the police yelled “battymen” and told them that they could avoid arrest by paying a bribe. When no one produced any money, the police started to shout and to beat Lawrence O. and his friends, attracting the attention of shopping center security guards, who, hearing the commotion, joined the police in beating the men.⁷¹ A Jamaica AIDS Support outreach worker reported another case in which a gay man who complained to police that he was being blackmailed had to pay police to keep them from disclosing his sexual orientation.⁷²

Lawson Williams, a Kingston attorney, represented several men who had been blackmailed with accusations of buggery or gross indecency by men who had committed crimes against them. He said that fear of prosecution under buggery laws and the dire implications of charges of buggery prevented blackmail victims from even contemplating seeking the protection of the state.

The sodomy laws are used to silence MSM, to keep them in check. They allow criminal acts to be committed against MSM with impunity. People know—thieves, crooks, layabouts—that if they commit a crime against you, they can play the “battyman card” to silence you. I’ve seen this in my cases. And this builds on the perception that gay men are saps, not only because they’re effeminate, but because their vulnerability is supported by state institutions—police, courts—that don’t protect them.

In a 2004 case, for example, a man charged with car theft claimed that he had taken the car from its owner after having been forced to have anal sex with him. In his statement to the police, he admitted driving the car away without permission, stating that he had meant to drive to the police station to report having been buggered but had been too ashamed to do so. The car owner was subsequently charged with buggery. His accuser never appeared in court to prosecute his complaints, and the buggery charges against the car owner ultimately were dropped. As of this writing, the car has not been recovered.⁷³

Police failure to provide protection from violence and abuse

We haven’t had any reports about violence against homosexuals. Most of the violence against homosexuals is internal. We never have any cases of gay men being beaten up. I know that there is a sort of revulsion against homosexuals, lesbians, but evidence does not substantiate that there is any level of violence perpetrated against them.
— K.K. Knight, senior superintendent of police, Kingston, June 18, 2004

If you make a police report, they start by making you instead of the victim the person that is wrong. The police ask, ‘Why all of a sudden they calling you a battyman? How do they know you a battyman?’ These kinds of questions trivialize the problem.
— Adrian S., thirty, Kingston, June 13, 2004

Men who have sex with men and women who have sex with women repeatedly told Human Rights Watch that they did not bother to report homophobic violence because they did not believe that police would take any action to address it, especially in cases where police were the perpetrators. In some cases, attempts to make complaints were ignored altogether; in others, police investigation efforts inspired little confidence, fueling concerns that police cared little for the lives and wellbeing of homosexual men and women.

Joseph W., twenty-six, lived with two male friends in the Kingston area. In December 2002, a policeman came to their house and told them that he had received a report that they were gay. The policeman forced his way past the security gate and onto the veranda and threatened to kill Joseph and his roommates if they did not leave. Joseph attempted to lodge a complaint with the police later that day. When he told police that he lived with two other men, they laughed and said that there was nothing that they could do to assist him. The following day, Joseph went to the Police Public Complaints Authority, the independent state authority charged with investigating allegations of police abuse, which likewise refused to investigate the case or otherwise provide assistance. After the initial incident, a crowd gathered around the house hurling antigay insults, and the men were forced to move—both because they feared for their safety and because their landlord was concerned about possible damage to his property.⁷⁴

The night before Lawrence O.’s interview with Human Rights Watch, a friend of his was robbed and stabbed in front of him. The police came to the scene, retrieved the knife, and left without investigating the incident or assisting the injured man in obtaining medical care. “The guy [the assailant] told the police that we were battymen. So the police just left. The police should have done something. [My friend] was cut and he was bleeding. . . . They looked at us and said, ‘you are all battymen.’ Then they took the knife [from the assailant] and told him to go.”⁷⁵

In Ocho Rios, several gay men said that there was a man in town who frequently harassed them and other gay men, threatening to kill them, extorting money from them, and inciting others to commit violent acts against them. Leroy J., thirty-three, said that in May 2004, when he tried to report this harassment to the police, the police chased him out of the station and threatened to attack him. “I went to the police to report these threats. They wouldn’t come. They said that we don’t have a right to live in our own country and that they would chop us up and kill us.”⁷⁶

When he met with Human Rights Watch in June 2004, Allen C. said that people often threw stones and bottles at him when he walked down the street. He had not complained about this to the police, however, believing that a prior buggery charge had effectively stripped him of police protection. “Because of the [buggery charge], police think I’m homosexual. I can’t complain about stone throwing, because then they’ll turn on me.”⁷⁷

Edward P., twenty-two, said that: “Sometimes I can’t walk in peace. People shout battyman and all this stuff. They keep saying that I’m a battyman and men will fuck me and that I can’t walk in this neighborhood. And sometimes if I turn they will try to attack me.” He has not registered a complaint with police, however. “To be honest, I feel scared because police themselves will try to bitch you and even tell you to leave the police station.”⁷⁸

Nicholas C. testified that people in the town where he had lived were constantly threatening to kill him because he was gay, forcing him to move from the town. He also testified that he had been beaten by police on more than one occasion. When asked about lodging a complaint about his neighbors or the police, Nicholas replied, “Complain? No, because I don’t know who to complain to. Police [and homophobic people in town] are the same thing.”⁷⁹

Albert B. said, “It doesn’t make sense to complain because you will not get anything from them. One time, a guy accused me of being gay and wanted to beat me. The policemen drove around and asked me if I did it.”⁸⁰ In May 2004, Paul M. and his housemates were driven out of his house by a group of men armed with machetes. “I did not complain to the police. When it comes to homosexuals, we have no rights.”⁸¹

Some police denied that homophobic violence was a problem in Jamaica. K.K. Knight, senior superintendent at the Kingston police station charged with investigating Brian Williamson’s murder, told Human Rights Watch: “Most of the violence against homosexuals is internal. We never have any cases of gay men being beaten up.”⁸² According to Knight, gay men inflict injury on each other in crimes of passion: “Usually in homosexual cases, you can see some kind of passion by the amount of injury inflicted and the scars on the body, and the sort of information you get from witnesses.”⁸³ Newton Ames, police superintendent at St. Andrew parish south divisional headquarters, testified that “we have never had any report of community violence against homosexuals. [Police involvement] is not a thing that people want in these areas. People stay away from accusing someone of homosexuality or getting involved in it.”⁸⁴

An individual with close links to law enforcement agencies who had experience working at murder scenes said that:

abuse of gay men is by gay men. From my experience, all gays are killed the same way. If you go to a crime scene, you can tell if a person is gay or straight by how they are killed. Gay men, they are more brutally slain—by a knife, strip them up.⁸⁵

There is evidence that supports the claim that in many countries, gay, lesbian, bisexual and transgender people are victims of serious violence, including murder, because of their sexual orientation and that these murder victims often undergo exceptional brutality, sometimes called “overkill” (extreme harm beyond that necessary to cause death).⁸⁶ But this evidence does not support any conclusion that gay men commit such savage acts of violence against other gay men. The “overkill” stems from hate. The misperception that gay men kill each other in brutal crimes of passion is a common barrier to investigating “gay murders” not only in Jamaica but in many parts of the world.⁸⁷

Percival Buddan, the officer in charge of HIV/AIDS training for the Jamaican police force, acknowledged that members of the police force shared homophobic attitudes common in the general community. According to Buddan, “The police force has a culture. If they know you’re homosexual, you’ll definitely be discriminated against and stigmatized.”⁸⁸ However, in some cases, police had helped protect against assault. A St. Ann’s Bay police officer said that he knew of an incident where police had intervened to stop people from stoning gay men.⁸⁹ A few gay men also testified that police had assisted them in leaving dangerous situations, such as escorting them from their homes when armed men were threatening them with serious violence.

On June 9, 2004, Brian Williamson, a prominent gay rights activist and one of the very few people in Jamaica to appear openly in the media as a gay man, was murdered in his home, his body mutilated by multiple knife wounds. Because of his international prominence as a gay rights advocate, his middle-class status, and his dual Canadian/Jamaican nationality, members of the lesbian, gay, bisexual, and transgender community initially were hopeful that police would take special care in the investigation of his murder. But police actions from the start raised cause for concern.

Williamson’s body was discovered on the floor of his apartment, reportedly with stab wounds to his neck and body. After the police left the crime scene, Ernest N., thirty-six, a friend of Williamson’s, went to the apartment to clean up. He told Human Rights Watch that the apartment was unlocked and the door open. A few feet from where the body had lain, Ernest N. found a ratchet knife and an ice pick, both of which had blood on them.⁹⁰

A witness told police that he had seen two men at the apartment the morning of the murder. The police detained one of the men, nicknamed ‘Wingee,’ and called the witness to identify the suspect in a lineup. As the witness passed the lockup on his way to the lineup, inmates called out, “See the battyboy who has come for Wingee. Him fi dead. [He should be dead.]” At the lineup, nine individuals were presented with towels on their heads and white cream (apparently toothpaste) on their faces, making them virtually unrecognizable. According to the witness, “I never saw that guy with anything on his head or face so I couldn’t identify him.” The witness also stated that even one of the police officers at the station told him that he had never seen participants in a lineup disguised in this way.⁹¹

Police abuse of sex workers

Male and female sex workers interviewed by Human Rights Watch reported being harassed by police, who apparently regarded them as a source of both money and sex. Because soliciting sex is illegal, police face little risk of censure for these actions. Male sex workers face the double condemnation of homosexual conduct and prostitution. These abuses may increase HIV risk for sex workers by driving them further underground and away from potentially lifesaving information on HIV prevention and other health services.

Male and female sex workers told Human Rights Watch that police extorted sex and money in exchange for not arresting them. Vincent G.’s experience was typical of the accounts we heard. “Police ask for sex and they don’t pay. Last time I was with a policeman was about a month ago. Police said I had to give him a blow job. I had to do this because I didn’t want to get charged.”⁹²

An outreach worker with Jamaica AIDS Support told Human Rights Watch: “Sex workers are arrested, but not as often as gay men. Very naughty police will try to get sex off of the ladies so they won’t get locked up. The ladies say it happens often. . . . Gay men selling sex [are treated] worse than females. They [police] beat them up bad. This happens often.”⁹³

A number of sex workers said that they could not report violence or abuse, in part because they risked abuse by the police if they did so. Jennifer S. told Human Rights Watch that police beat her and asked her for money and sex, and clients stole money from her. When asked whether she had ever reported such abuse to the police, she said, “Complain? I can’t do that because they will not listen to us. . . ‘Come out of the station. You’re nothing but a whoring girl.’ This is what police say when we try to complain.”⁹⁴ Vincent G. said that when one of his clients stole money from him, “I couldn’t complain to the police about it because I am homosexual.”⁹⁵

Police interference with access to HIV/AIDS information and health services

Jamaican government policy recognizes that the most effective and indeed in some cases the only possible AIDS educators for members of marginalized groups, such as men who have sex with men and sex workers, are their peers.⁹⁶ But peer educators and others who reach out to marginalized groups are often held in the same contempt as the individuals with whom they work and subjected to discrimination and violence at the hands of the government. Human Rights Watch documented numerous cases of police harassment of HIV/AIDS workers providing services to men who have sex with men and to male and female sex workers. In some cases, the very possession of condoms—a key tool in the work of HIV prevention—triggered police harassment of HIV/AIDS educators and of sex workers.

Men who have sex with men

The Ministry of Health relies on the NGO Jamaica AIDS Support (JAS) to provide HIV/AIDS information and services to men who have sex with men.⁹⁷ Dr. Yitades Gebre, executive director of Jamaica’s Program Coordination Unit at the Ministry of Health, acknowledged that the ministry had “identified MSM as a target population, but we’re not reaching them.” He explained “because the laws impeded the Ministry of Health from working with MSM, we give the work to JAS. To date, we don’t promote direct programs or services to MSM as a group because the existing laws impede this work [and] because [of] the high level of stigma and discrimination, they’re not open to getting services through the public sector.”⁹⁸ The police however, are actively impeding JAS’ government-supported efforts.

A JAS outreach worker told Human Rights Watch that: “police always try to get in the way of handing out condoms. . . . Police say, ‘how can you be handing out condoms to battymen. . . . We do not encourage you to do this work because battymen fi dead. [gay men should be dead].’”

He recounted two arrests for handing out condoms to MSM:

In May 2003, I was in an area known to be frequented by gay men . . . I was there handing out condoms on the main road. It was me alone, at about 9:30 in the evening. I was issuing condoms and about five guys were there and a police car drove up. There were four police in the car. They asked, “What are you doing here? You must be battymen.” I say that I am on my job, issuing condoms. They turned to me and said, “How come you issuing condoms to battymen?” I say it’s a part of my job. . . . He turned to me and said he was going to lock me up because I am not supposed to be issuing condoms to battymen. . . . Then his friend said “come and charge the boy for loitering.” And then they said for me to get in the car and they took me to the police station.

When I was in the police station, I was placed in a holding area and I asked them to call [my supervisor] at my workplace. They didn’t give me the call right away. I was there for about three hours. And every police comes into the station, the policemen that arrested me would say to their friends, the other policemen, “the boy handing out condoms to battymen.” Some will talk some abusive things, like “boy, are you gay? You a battyman too? Battyman fi dead!” Then I asked them again for the call because I wanted to know if I am going to be charged because I am here for over three hours now. After a long deliberation, they let me go. When I was released, they told me, “Go home and stop helping the battymen. And we hope we don’t catch you handing out condoms to battymen.”⁹⁹

In October 2003, this outreach worker was again arrested and charged with loitering for handing out condoms to men:

I was out on the main road handing out condoms in an area known to be a gay area and the police came down and the men began to run. I stood my ground and I had a condom in my hand and the policemen asked me what I was doing there and the police asked me if I were a battyman. I had three boxes of about 100 condoms in my hand. . . . They said that they were going to charge me with loitering, but if they see me in the act they would kill me. And they said that they were going to charge me for loitering because they knew that I was a battyman because only a battyman would be handing out condoms to men. . . . I was accused of buying sex and being a battyman and charged with loitering.¹⁰⁰

The outreach worker was called to appear in court twice, but the charges ultimately were dropped.^{^¹⁰¹}

Sex workers

Jamaica AIDS Support also provided condoms and HIV/AIDS education to male and female sex workers who operated in the Kingston, Montego Bay, and Ocho Rios areas, including street sex workers, go-go dancers, and massage parlor workers. A Kingston-based JAS outreach worker explained: “We have educational sessions with ladies and men two nights of the week on the road. We hand out condoms and pamphlets and talk a little about safe sex and what we can do to help them. We also invite them to JAS to do free HIV testing, have a place to chat.”¹⁰² He told Human Rights Watch that he had been stopped by police several times while handing out condoms on the road to sex workers. Once he was once accused of being a sex worker and detained overnight in jail.¹⁰³

Steve Harvey, JAS’ coordinator of targeted interventions in Kingston, said that he had been stopped by police while doing outreach to sex workers several times in 2003 and 2004. On one occasion, the police accused him of illegal soliciting; other times, police stopped and searched him, his colleagues, and their car.¹⁰⁴

Police crackdowns on sex work—of which there were at least two in Kingston in the first five months of 2004—hampered HIV/AIDS prevention work by undermining outreach workers’ ability to distribute condoms and to discuss HIV/AIDS and other health services with sex workers. Harvey told Human Rights Watch:

Sometimes the police decide that they are going to crack down on sex work, and they do it for two weeks. During that time, the girls are afraid. Some of them won’t come onto the streets, some of them will go to other places, and some of them are in hiding so when you go down the streets, you can’t see them. It hampers HIV/AIDS prevention work. We really don’t have the time then to talk to the girls.¹⁰⁵

Police also threatened sex workers that possession of condoms could be used as evidence of their illegal activity. Joyce D., forty-one, had been selling sex on the street since she was a young girl. She told Human Rights Watch that police regularly took condoms from her, threatening to use them as evidence against her if she refused to provide them with sex. “Police say, ‘hey girl, if you don’t give me some pussy, condom is there for evidence that you’re fucking in the street.’ . . . Now they have the handle. I have the blade. There is nothing that I can do about it. I give them my body.”¹⁰⁶

Abuses in the health care system

People living with HIV/AIDS and men who have sex with men face numerous human rights abuses that constitute barriers to obtaining necessary medical care. Among these are discrimination by health workers who forced them to wait extended periods of time to be seen, treated them in an abusive or degrading manner, provided inadequate care, or denied them treatment altogether. Health workers also routinely violated their privacy by disclosing confidential information about HIV status and sexual orientation.

Human Rights Watch found that the threat of serious violence and discrimination, compounded by the deep stigma associated with homosexuality, was keeping men who engaged in homosexual conduct from seeking medical treatment and from existing prevention services and driving them to engage in unsafe and unprotected sex. Discrimination and stigma also was driving people living with HIV/AIDS away from health care and other HIV/AIDS services.

Several people told Human Rights Watch that health care provision to people living with HIV/AIDS had improved in the last few years, crediting the Ministry of Health and the efforts of AIDS service organizations like Jamaica AIDS Support (JAS) and the Center for HIV/AIDS Research, Education and Services (CHARES) for these changes. “Things have changed a lot,” said Orchid Gowe-Hunter, a nurse with Jamaica AIDS Support, “but people still have some bad experiences.”¹⁰⁷

Discrimination by health care providers

Heath care delayed or denied

Human Rights Watch interviewed several nurses and AIDS service workers who said that public hospitals and clinics provided inadequate care to people living with HIV/AIDS, sometimes refusing to treat them. Some acknowledged that the situation had improved since the start of the epidemic but stressed that the abuses had not abated altogether.

Human Rights Watch learned that some doctors who treated people living with HIV/AIDS failed to conduct adequate medical exams or even to touch them, and that clinic staff had refused to register people living with HIV/AIDS for admission. Men who have sex with men also told Human Rights Watch that they had been denied health care treatment.

Tonya Clark, a nurse with Jamaica AIDS Support in Kingston, said that a JAS client who had suffered a head injury had been denied services twice in the week prior to her interview with Human Rights Watch. In June 2004, Gary T. was beaten and suffered a head injury. He first went to the police, who referred him to the hospital with a form to be completed with details of his injury. After Gary T. told the nurse that he had HIV, she tore the form up and told him to leave. A JAS social worker returned to the hospital with Gary T., where they again refused to treat him.¹⁰⁸

A health worker with years of experience working in the health sector in northern Jamaica who assisted people living with HIV/AIDS in obtaining medical care said that based on her experience, physicians at the regional hospital treated HIV-positive patients differently from other patients and had provided inadequate care to two of her clients in April and May 2004. In one case, she brought a client to the regional hospital because he had lesions on his penis and difficulty urinating. The examining physician stated that the man had HIV, donned gloves, and ignored the health worker’s request to examine the client’s genital area, instead focusing on his chest and abdomen and sending him home without examining the lesions on the penis. The health worker told Human Rights Watch:

The doctor that came to see him knows me and my work [with people living with HIV/AIDS] and said at once, “this is a positive person.” . . . I said we found him on the road, I think he has some sores on his penis. The doctor put on gloves, did a chest exam, peeled off that set [of gloves], did an abdomen exam, peeled off that set . . . and I was saying, there is something wrong with his penis. You need to look at him. [The patient] said he has sores on it and hasn’t urinated in a while. And he has this smell coming from his genitals. The doctor wouldn’t look at it. . . .

The man received no treatment for the lesions on his penis that day. The health worker ultimately secured the assistance of a nurse who worked with an AIDS service organization to examine him and provide appropriate medication to treat his lesions.¹⁰⁹

Men who have sex with men and health workers reported that public and private health care providers refused to treat men whom they knew or perceived to be gay and made abusive comments to them, at times instigating abusive treatment by others. Curtis M., twenty-four, told Human Rights Watch that when a friend accompanied him to St. Ann’s Bay Hospital, a nurse made homophobic remarks, and he left without receiving treatment. “[The nurse] said, ‘I wonder which one is the woman and which one is the man. . . . We had to leave because the crowd started looking at us and then on the road they were hurling words at us, ‘battymen fi dead.’ I felt threatened.”¹¹⁰ He did not receive treatment that day.

When Leroy J., thirty-three, went to a private doctor, he was told “we don’t work with gay people here.”¹¹¹ Craig F., a health worker in northeast Jamaica, said that public health centers in the region have refused to treat men whom they believed to be homosexual and that he had heard health workers making abusive comments to gay and bisexual men. For example, one health worker told a gay man with gonorrhea that he was “nasty” and asked why he had sex with other men.¹¹²

Several people told Human Rights Watch that health workers routinely mistreated people living with HIV/AIDS, delaying care or impeding access to treatment. When Eric B., a thirty-year-old man living with HIV/AIDS, sought treatment for a foot injury, he had to wait until all other patients had been seen, including people who arrived after him and people with lesser injuries, before he was examined.¹¹³ Craig F. told Human Rights Watch that in May 2004, a health clinic clerk had refused to register a person living with HIV/AIDS for treatment, stating that she would not look after anyone who was HIV-positive.¹¹⁴

Discrimination in health care provision

My neighbor, she was ill, she was HIV-positive. [At the hospital], they screened her off. Her food was taken to her in a styrofoam box, and everyone else on the ward was treated differently. Everybody else had regular plates, and hers was just in a box. . . . I went to her because I knew her. Nobody cleaned her, looked after her. The nurse said, ‘You know what she have?’ I said yes. The nurse said, ‘Then you have gloves?’ I looked after her, gave her a bath. Her mother came and asked, ‘Why are they treating her like this, like a dog?’ No one cared for her. I went every day with her mum and cleaned her, taught her mother how to care for her.
— Tonya Clark, nurse with Jamaica AIDS Support, Kingston, June 14, 2004

Among those encountered by Human Rights Watch, people living with HIV/AIDS who did receive medical care were separated from other patients and placed at the back of a ward or behind a screen with their basic needs left unattended. Health workers also engaged in discriminatory practices that called attention to their HIV status, such as placing their clothes and linens in conspicuously marked bags, and making sure that medical equipment did not touch their skin.¹¹⁵

Orchid Gowe-Hunter, a nurse with Jamaica AIDS Support, had worked with people living with HIV/AIDS in the Kingston, St. Andrews, and St. James parishes for several years. She told Human Rights Watch that both Kingston Public Hospital (KPH) and Cornwall Regional hospitals continued to isolate people living with HIV/AIDS in the ward. At KPH, for example:

they always isolate them in the ward. They have a little corner way to the back. One day, we went to visit this guy and he was just lying in the bed alone. He had no sheets on the bed, no proper clothes. . . He was unable to feed himself or take his medication. All of the food, all of the medication was just left by the bed.¹¹⁶

Gowe-Hunter’s account is typical of those documented by Human Rights Watch.

HIV-positive men who have sex with men faced additional barriers. “They perceive, and rightfully so, that if they divulge who they are and what they do, they may be shunned,” said Deborah Manning, program manager of the Center for HIV/AIDS Research, Education and Services. In one case, for example, when an HIV-positive patient’s boyfriend came to visit him, a nurse ran him out of the hospital, telling him that she did not want any of their “nastiness” there.¹¹⁷ Joseph W., twenty-six, told Human Rights Watch that when he visited a friend at Kingston Public Hospital in December 2003:

the nurses and the ancillary workers were laughing and saying, “which one of them is the man, which is the woman?” Partly because of his sexuality and because he was [HIV] positive he was not given the kind of treatment he should have gotten. He wasn’t able to help himself. They wouldn’t change his sheets . . . They would leave his food there. Myself and all my friends had to go help him eat.¹¹⁸

Patrick D., twenty-five, found his HIV-positive friend lying in soiled diapers, and changed them while a nurse called out, “Battyman, you shit up yourself. You shitty shitty.”¹¹⁹

Health care workers at public and private hospitals in Kingston parish told Human Rights Watch that patients at their institutions were treated the same as others, but noted that their clothes and linens were placed in specially marked bags and laundered separately; doctors and nurses used gloves when attending to them; and that when taking the blood pressure of a person living with HIV/AIDS, they put a “precautionary barrier” between the person’s arm and the cuff. One health worker explained that “if a patient knows another person is HIV-positive, he won’t use the same blood pressure cuff.”¹²⁰

Several health workers said that HIV-positive patients posed a danger to health care workers because they had a tendency to be angry and aggressive and would try to intentionally infect others with HIV.¹²¹ A health worker at a private facility offered this example of such dangerous behavior: “I had a patient who said he contracted HIV and it’s not his fault, he’s not going down with it. He threatened to spit on a nurse.”¹²² A nurse at a Kingston public hospital acknowledged that she and her coworkers treated patients differently from other patients. She said that they were concerned about contracting the virus from patients who were often “deliberately demanding,” in part because they “really hopelessly wanted you to get HIV too.”¹²³

In the view of some health workers, the fear that HIV-positive patients would spread the disease to health care workers and others—whether intentionally or otherwise—justified segregating patients living with HIV in the hospital as well as in the larger community. At a workshop to discuss quality of care for patients with HIV, one health worker, summarizing the views of a small group discussion, said that people living with HIV “should be isolated to prevent this epidemic from being spread to the rest of society.”¹²⁴ A spokesperson for a second small group added that “some persons [with HIV] are isolated for their own protection,” while others because they “are more aggressive. They want to bite you, spit on other patients.”¹²⁵

Inadequate protection of confidential information

That word, confidentiality. I’m so afraid of that word because in most instances it don’t mean anything.
— Lena B., twenty-nine, Montego Bay, June 22, 2004

Human Rights Watch found that some health workers failed to preserve the confidentiality of patients’ HIV status. By singling HIV-positive patients out for disparate treatment absent medical justification, they risked divulging confidential information about their HIV status. In some cases, health care workers disclosed confidential information about HIV status without patient authorization. Some health care workers also disclosed private information about sexual orientation.

The failure to preserve confidential information about HIV status and sexual orientation violates the right to privacy protected by the ICCPR and the American Convention on Human Rights.¹²⁶ Such actions also threaten other rights. As described above, people living with HIV/AIDS and men who have sex with men may be denied health care or subjected to violence and stigma when state and private actors discover their sexual orientation or that they are HIV-positive.

Lena B., twenty-nine, was hospitalized for the last four months of her pregnancy at the regional medical center. Doctors and nurses there repeatedly chastised her in front of other staff and patients about having continued to have sex while living with HIV. A doctor who knew that she had worked as an HIV/AIDS educator told her that she “should have known better” not to have sex when she had HIV and chided her for proving a poor example for others. One of the nurses instructed the ward assistant not to serve Lena on plates that other patients might use; when that nurse was on duty, Lena had to use disposable dishware.

At the end of Lena’s pregnancy, two doctors discussed the decision to give her an emergency caesarean section in the middle of the ward, “in front of a lot of people.” The first doctor explained, “I’m going to do the C-section [caesarean section] because you want to push the child out of your vagina, and you know you have the disease running around in the vagina and you want to put the child more at risk than he is already at.”¹²⁷ A second doctor added, “I want to take you on a tour up to the top where all the AIDS babies and children are and show the misery that you people cause to come on the land. Because I agree that you should not be having sex, much less getting pregnant.”¹²⁸

Hospital staff signaled Lena B.’s HIV status to her mother-in-law through their treatment of her newborn son and comments they made. When Lena B.’s mother-in-law came to see her new grandchild, she found the baby by the nurse’s station, still unwashed, and asked to help clean it.

The nurse said, “you come in off the street with germs wanting to take care of the child and want to finish killing him off because he has everything going bad for him already?” . . . The nurse clean up the child and she still have him over behind the nurse’s station. . . . My mother-in-law says, “I’m going to take him over to the mother to breastfeed.” The nurse said, “Breastfeed what? Mothers like those not even supposed to have children much less to breastfeed with the type of sickness they have.”

At this point, Lena B.’s mother-in-law asked whether she had AIDS. Lena B. lived with her in-laws and extended family. She said that since returning home after her HIV status was disclosed, her family members have tried to kill her on at least three occasions. Lena had no money to pay for shelter elsewhere, and stayed with her children in a locked room at the house to protect them.¹²⁹

The hospital neglected to attend properly to Lena B.’s surgical wounds from her c-section and they became infected. Lena B. said that based on her experiences, she would no longer seek treatment for herself in the public health system. There was a comprehensive health clinic within walking distance of Lena’s home. Lena B. said that she would not take her children there, nor pick up infant formula and groceries provided to mothers who are living with HIV, because health workers there chastised her and other women for having gotten pregnant while living with HIV, and publicly disclosed their status to other patients and members of the public without their authorization. As a result, Lena B.’s children were also effectively denied health care and other benefits to which they are entitled.¹³⁰

Hospital staff providing ancillary services (such as porters, ward assistants, cooks) often knew patients’ HIV status and sometimes disclosed it to family and community members. A laundry attendant at a Kingston area private hospital said that the head nurse pointed out a person with HIV to her because his clothes had to be washed separately.¹³¹ A peer educator in St. Andrews and St. Catherine’s parishes told Human Rights Watch: “Sometime the ward assistant knows, sometime the cook know, and I don’t see why they should know. And they talk a lot. . . . They go back to their area and they say that Mary Jane is at the hospital, she’s HIV-positive. So all of that person’s confidentiality is out.” In one case, for example, a patient with HIV recognized a warder from her area.

She said she had a family member who did not know that she was sick in the hospital and she did not want the family member to know. The warder told her family member that this person was HIV-positive and was in the hospital. . . [The person] did not go back to her community because she was afraid that she would not be treated nice.¹³²

In some hospitals, porters may learn patients’ status because they have access to patient records. Glenn C., thirty-nine, a JAS volunteer, said that “When patients go into a ward, files are given to the porter and they discuss it and they say, ‘this is another C13 [the hospital code for HIV/AIDS]. This is a homosexual.”’ He remembered visiting a person living with HIV/AIDS at a Kingston-area hospital in 2003. ‘I asked the porter where he was. The porter said, ‘The battyman. The one with AIDS’ [and then] told me where he was.”¹³³

Men who have sex with men and AIDS service workers told Human Rights Watch that hospital staff also disclosed information about people’s sexual orientation. Craig F., a health worker who worked with men who have sex with men, said that after his client disclosed his sexual orientation to a contact investigator, “the same day, persons in the health center knew that he was gay. I heard them talking. ‘That man is a battyman.’ They mentioned his name. There was a lot of talk that he is gay and fire burn and him fi dead.”¹³⁴

Driving men who have sex with men and people living with HIV/AIDS from health care services

Abusive treatment in the health care system and state failure to protect men who have sex with men from homophobic violence keep people from seeking health services, especially for conditions that might mark them as homosexual. Several gay and bisexual men told us they delayed or avoided seeking treatment for sexually transmitted infections because they had received poor health care when they were known or perceived to be gay; feared mistreatment because they were gay; and were concerned that health workers would publicly disclose their sexual orientation, thus risking their safety. Since the presence of other sexually transmitted diseases heightens the risk of HIV transmission, the failure to seek care promptly in such cases may have fatal consequences.¹³⁵

Craig F., a health worker in northeast Jamaica, estimated that 90 percent of men who engage in homosexual conduct with whom he had worked had told him that they would not seek treatment for sexually transmitted diseases in the public health system because they feared that confidentiality was not maintained.¹³⁶ Harold B., thirty-four, told Human Rights Watch that health workers mistreated men who have sex with men: “When you go to a clinic and they know you are gay, they scorn you.”¹³⁷

A JAS health worker said that the stigma attached to being gay and fear of discrimination put gay and bisexual men at risk of HIV, both because they did not get relevant HIV prevention information in the first instance, and because they delayed seeking care for sexually transmitted diseases that they feared might mark them as gay. He said that many men who have sex with men “don’t know that safer sex goes beyond using a condom. . . . They don’t use a lubricant and the condom breaks.” And many were reluctant to get tested for sexually transmitted diseases and did not know that the presence of other sexually transmitted diseases could increase the risk of HIV transmission.¹³⁸

Using a water-soluble lubricant helps prevent condom breakage and is recommended for anal intercourse. Many men who have sex with men will not buy lubricant, however, because its purchase is equivalent to announcing one’s sexual orientation.¹³⁹ And, as in the case of Nicholas C. (described above), men who have sex with men who carry lubricant may be subject to police violence.¹⁴⁰

Adrian S., thirty, told Human Rights Watch that he did not feel safe asking his doctor about gay health issues, especially concerns related to anal or oral sex.

There was one concern I had with regards to feeling something different after anal sex with someone, and I just had to not talk about it and watch it and use my own way of approaching it. There was one instance when I had anal sex with someone that was very endowed. That meant that there was some stretching and some tissues torn. I wanted to find out if I was okay, but I couldn’t say anything to anyone and all I could do is pay extra attention to hygiene and use topical solutions that were safe.¹⁴¹

Edward P., twenty-two, testified:

One time, I caught gonorrhea. I was so scared of it, to go to the doctor. At first I said, this will go away. I started to see it getting yellow, and it started to run [from my penis], then it started to turn green, so I put a diaper there because it was running really hard and painful. . . . Some of my friends won’t go to doctors. They don’t want the word spread around, and they say what they don’t know won’t hurt them.¹⁴²

When asked where he sought medical treatment, James P., twenty-six, said, “You come [to Jamaica AIDS Support] if you have something on your bottom,” because when gay men sought treatment elsewhere, health workers pointed out to others that they were gay. “I think that this keeps gay men from getting treatment. Some of them will keep from getting treatment until it stinks [until the discharge from an infection has begun to smell]. [They say] ‘I’ve got gonorrhea and I’m scared to go to the doctor.”¹⁴³ Tonya Clark, a JAS nurse, said:

Most of the gay men that I talk to don’t even want to go to the hospital at all. They come to me one-on-one and say can you get this for me, can you get this medicine. Sometimes ordinary medicines, nothing to do with HIV. But they are afraid to go to a doctor or hospital even with a common cold or flu because they will ask them questions or call them names.¹⁴⁴

Curtis M., twenty-four, explained:

I try to keep myself healthy because if you go to the hospital, they won’t take care of you. If you got a bruise on your anus, that would make it worse. To be honest, if anything should happen to me, I am not going to the public hospital. I would buy over-the-counter medication or speak to my friends. I know that I am at risk but just to keep myself safe I cannot go to the hospital. Because if something should happen to me, I cannot go to the police because they will not help me.¹⁴⁵

Homophobic police actions interfered with HIV/AIDS information and other prevention services by driving gay and bisexual men from places where they might safely receive services. JAS held support group meetings for gay and bisexual men to address a range of issues, including HIV/AIDS, sexuality, violence and discrimination, and spirituality and family life.¹⁴⁶ JAS’ targeted interventions coordinator acknowledged that men who engage in homosexual sex were difficult to reach, noting that “some people won’t come to JAS.”¹⁴⁷ Some men told Human Rights Watch that they had been accosted by police when leaving JAS support group meetings, which may explain some of the reluctance to come to JAS’ offices for services.

Joseph W. said that after they left a support group meeting in 2001, he and his friends were approached by police who asked them, “‘What are you doing? What kind of meeting are you coming from? All you look like battymen.’ They threatened to arrest us because we always have to keep up with our ‘nastiness.’”¹⁴⁸ Harold B., thirty-four, testified he and his friends had been assaulted by police in June 2004, around the corner from where they had just attended a support group meeting.¹⁴⁹

A JAS outreach worker told Human Rights Watch that men who have sex with men would find a safe place to hang out, but police would come and beat them, undermining JAS’ outreach work. In May 2004, he was working in a Kingston area that JAS outreach workers had identified as a gay hangout when the police approached. “The police came and said, ‘Battymen leave the area. Don’t contaminate the area. Don’t come back here.’ One [of the men] ran and broke his foot. . . . We were so frightened . . . that we just drove away.”¹⁵⁰

The Jamaica Forum for Lesbians, All-Sexuals and Gays (J-FLAG) would be a natural place to convene men who have sex with men and women who have sex with women to discuss HIV/AIDS-related issues. J-FLAG’s office, however, is not a safe space, as its own website acknowledges: “Although we provide services and network island-wide, our office is located in Kingston, Jamaica's Capital and largest city. Due to the potential for violent retribution, we cannot publish the exact location. We do receive mail at Box 1152, Kingston 8.”¹⁵¹

Human Rights Watch also received numerous reports from people living with HIV/AIDS that they avoided seeking health care at both public and private facilities because of the abusive treatment they had received and the public disclosure of their HIV status. As described above, after doctors and nurses at the regional hospital and local health clinic chastised Lena B. for having sex while she was living with HIV, disclosed her status to family members who have since tried to kill her, and neglected to attend to her wounds after delivering her baby by caesarean section, she decided that she would no longer seek treatment in the public health system for herself, or in the local clinic for her children. ¹⁵²

Pam B., forty-three, overheard a nurse from the local health clinic telling someone from her town that she had AIDS. Public hospitals in Kingston and Portland parishes had isolated her with other HIV-positive patients, failed to provide her hospital gowns and linens, and made her wait much longer than other patients for care. Although unemployed (she lost her job after her employer learned she had AIDS), she avoided seeking care in health clinics and hospitals in her area “because of the stigma.” She also said that she knew other people living with HIV/AIDS who were afraid to go to the clinic because clinic staff gossiped about their HIV status.¹⁵³

John B., forty-nine, told Human Rights Watch:

I don’t go to the hospital any more because of bad experiences there. There was one experience but it stands out in my mind and I would never go back there. . . . The nurse said that I had to draw up my shirt so she could take my blood pressure. She looked through my docket, saw the referral from Jamaica AIDS Support and that I was HIV-positive, and told me to roll down my shirt and she took my pressure from there [on top of the shirt].¹⁵⁴

When Human Rights Watch met Patrick D., twenty-five, he was concerned that his health was failing and that “some day soon” he would have to go to the health clinic. He was avoiding doing so, however. “I’m afraid to go to the clinic because there’s a special mark on my docket. The porter sees it and says, ‘that boy’s HIV-positive.’”¹⁵⁵

Eric B., thirty, pulled his own teeth because he had heard that people living with HIV/AIDS had been treated poorly by the dentist in his local health care center. He told Human Rights Watch:

I didn’t go there because on the whole, a lot of people go there and have a bad experience. I just took some pliers and pulled out the teeth myself. I’ve heard that the dentist there treats people badly, so I avoided going. I suffered for six months with a bad tooth because I avoided care.¹⁵⁶

Fostering dangerous practices and complicating health care provision

Under conditions of surveillance by their families and communities, Jamaican gay, lesbian, bisexual, and transgender people find little privacy for their sexual lives at home. As discussed below, many face serious violence and become homeless after being driven from their homes and their towns because of their sexual orientation or gender identity. Men who have sex with men also risk violence for carrying condoms and lubricant—both needed for practicing safer sex. The lack of private space to have sex, the threat of violence based on sexual orientation and for even carrying condoms, and the lack of recourse to police protection makes it difficult for many gay, lesbian, bisexual, and transgender people to take precautions to protect against HIV/AIDS. Sex workers suffer from many of the same threats, and face similar problems in taking measures to protect against HIV/AIDS.

Homelessness carries additional health risks and complicates the provision of even routine medical care.¹⁵⁷ Exposure to harsh weather conditions, poor nutrition, and the stress of living in disordered and unsafe conditions compound health problems for people living with HIV/AIDS.

Albert B., thirty-three, had been homeless since 2001, when he fled his town after his close gay friend was murdered, and he was told that he was next. He told Human Rights Watch that most of the time, he had sex outside, in open land or in the bushes. “Gay people tend to use those places because they can’t carry on at home. . . . But you have to look out, in case you have to run.”¹⁵⁸

Denial of access to transportation

People known or perceived to be living with HIV are denied access to public and private transportation, relegating many to lives isolated from important sources of social support and undermining their capacity to obtain even basic medical care. Men who are known or perceived to be gay are likewise denied passage on public and private transportation, sometimes leaving them vulnerable to attack, and are routinely attacked on public buses because of conduct or appearance perceived as homosexual.

People with HIV/AIDS may be prone to skin infections on large parts of their bodies. Several people with HIV/AIDS told Human Rights Watch that when they suffered visible skin infections, people in their communities would shun them, perhaps because they feared that the skin infections—or HIV more generally—were contagious.

Angela M., forty-one, lived in a remote village, about one hour’s drive from the regional hospital and several miles from the nearest clinic. She was homebound: no public transportation would carry her, and the only private car that would drive her was prohibitively expensive. She told Human Rights Watch that since developing the skin rash, “All the taxi men, they know, they say they won’t carry me. . . . At the bus stop, nobody will stand beside me. I come near, people run away.” When she tries to flag a taxi by her house:

no taxi stops. People tell them that my hair falls off and I run full of sores and I run bloody water, and nobody wants to carry me. . . . I need to go to the doctor, to the hospital and I don’t have money to pay a private man to get me there. To get to [the hospital], I would have to pay a private man 3000 [Jamaican] dollars [U.S.$50] both ways. A road taxi would cost 170 dollars one way [U.S. $2.85], 170 dollars [U.S.$2.85] to come back.¹⁵⁹

Lacking funds for transportation, Angela M. was unable to obtain medical treatment.

John B., a forty-nine-year-old man living with HIV/AIDS, said that taxi drivers sometimes increased fares for people whom they suspected had HIV. He said that on one occasion, he had a chest infection and was coughing and short of breath. He told Human Rights Watch that as he was exiting the taxi, the driver commented, “you have pneumonia; you have AIDS,” and charged him double the usual fare.¹⁶⁰

Adrian S., thirty, told Human Rights Watch that as a man perceived as effeminate, he faced constant verbal and physical abuse and had been denied transportation in public buses and taxis on many occasions. He said that: “I would be denied passage [on public buses] because someone would say I was gay. I would have to seek transportation elsewhere.” Nor would taxis pick him up once they heard that he was gay. And boarding a bus would not guarantee safe passage. Thomas said that he had been assaulted by a conductress, a bus driver, and by passengers while riding the bus.¹⁶¹

Fabian Thomas, coordinator of JAS’ Montego Bay office, told Human Rights Watch that he had been contacted by a man who had been attacked and thrown off a public bus after falling asleep on another passenger’s shoulder. According to Thomas, when other passengers noticed the man’s head resting on his male neighbor’s shoulder, they cried out ‘battyman,’” threw him off the bus, beat him, stabbed him and left him by the side of the road.¹⁶²

Other abuses by non-state actors: violence in the family and in the community

People living with HIV/AIDS, men who have sex with men, and women who have sex with women are subject to violence, discrimination, and other forms of abuse by private actors based on their HIV status and their sexual orientation. State authorities have an obligation to respond, both to offer redress for violations and punish the offenders, but also to prevent these violations in the first instance.

Abuses based on sexual orientation and gender identity

Because gay in Jamaica, it’s hard for us to live anywhere. Those that can afford, they can rent an apartment and not be molested. But we cannot afford it. Some might attempt to rent a little house. But within days, or it doesn’t last for a month, they have to run away, leave everything that they have.
—Aaron H., thirty-eight, Kingston, June 13, 2004

Men who have sex with men and women who have sex with women are routinely subjected to verbal and physical harassment, in many cases violently evicted from their homes and driven from their towns.

On the morning of June 24, 2004, a group of armed men forced their way into a Kingston home, beating up six occupants while shouting homophobic threats.¹⁶³ The dancehall musician Buju Banton (Mark Anthony Myrie) is alleged to have been one of the assailants, reportedly denouncing the occupants for being homosexual and kicking one man in his mouth and beating him with a board. At least two of the men were beaten seriously enough to require medical treatment. All nine residents of the house were forced to abandon their home and possessions that same day, warned by the attackers that they would be killed if they returned.¹⁶⁴ Four of the men returned the following evening with a police escort to find that their home had been ransacked, thousands of dollars stolen, and valuable property (including a new refrigerator and electronic equipment) destroyed.¹⁶⁵ All of the men abandoned the residence and the neighborhood, fearful that they would be killed if they return; since the intrusion, at least one has received death threats.

Charles R., forty-two, Robert E., eighteen, and Ricardo P., twenty, three of the occupants, described the attack. Charles R. told Human Rights Watch that about a dozen men armed with machetes, guns, and knives had come to his front door around 10 a.m. on June 24, one of them pointing a gun at him, threatening to shoot him if he did not let them in. After Charles R.’s landlord ordered him to open the door, the men stepped in the house and ordered the occupants outside. The assailants told Charles R. and the others that they were battymen and could not live there, and threatened to shoot them and burn the house if they remained.¹⁶⁶ Charles R. was kicked in the face and beaten on his back, arm, and leg with a machete and a metal rod by at least three assailants.¹⁶⁷

Robert E. told Human Rights Watch that he was attacked by at least four men, who chased him from the house, hurling insults and stones, threatening him with a knife, and accusing him of being the “battyman ringleader.” Robert E. ran into the street and tripped and fell into a gully, seriously injuring his foot.¹⁶⁸ Ricardo P. told Human Rights Watch that he was beaten with a metal rod, forced to take off his shoes, and told to run from the house.¹⁶⁹

Human Rights Watch documented violent evictions in several towns in Jamaica, many of which occurred either immediately preceding or during the three weeks that we were in Jamaica. A Kingston man said:

Right now, I’m not living in my house because people thought I was gay. . . . About two weeks ago, I got a call at work that there were twenty-five men surrounding the house because they understood we were gay and wanted us to leave because they didn’t want any gay men in the area. [I was told] that the men had machetes. I didn’t go home for two days because I was scared.

When he returned to the house to retrieve some of his things, he noticed several men outside. “I heard the men say, ‘oh the battymen, they move.’ I was scared, because they all had machetes in their hands. In this house, all gay men lived there. Now no one sleeps there.”¹⁷⁰

Daniel S., nineteen, had lived on his own in Montego Bay since he was threatened by neighbors that they would kill him and chop him up because they had heard he had sex with men. He told Human Rights Watch, “I am unable to visit my family in the day. If I want to visit them, it would have to be in the midnight hours.”¹⁷¹ Vincent G., twenty-two, stated, “I don’t live anywhere now.” He had been homeless since 2003, after he was forced to leave his mother’s house and his town when he was threatened by men in the area who told him, “battyman, you have to leave. If you don’t leave, we’ll kill you.”¹⁷²

Human Rights Watch interviewed Sebastian L., twenty-seven, a few days after he and his friends had been attacked outside Sebastian L.’s apartment. He said that he was afraid that the assailants might return. “So I am looking to move now, because I am afraid for my life.”¹⁷³

Women who have sex with women reported that they were subjected to constant threats of sexual violence, in some cases serious enough to force them to leave their homes and their neighborhoods. Several women who have sex with women told Human Rights Watch that the message they were given was clear: that they could be “cured” of their homosexuality by having sex with a man.

Phoebe S., forty-nine, owned a home in St. Thomas parish, where she lived alone for five years. Men in her community called her “sodomite,” pressured her to have sex with them, and spied on her while she was bathing. She told Human Rights Watch: “Men try to get friendly. They say, ‘you’re living alone for so long. You need some sex.’” She said that she had decided to sell her house “because some of the men know I’m gay and want to rape me.” She could not discern, however, whether she was continuously targeted for sexual violence because she was a woman or because she was a lesbian. She told Human Rights Watch: “I have been raped three times. Sometimes I wonder if it is because I refuse to be with a man.”¹⁷⁴

Cynthia S., twenty-seven, said that a lesbian friend of hers had to move out of her neighborhood because she faced constant verbal and physical harassment by men who knew that she was a lesbian. “They would say, ‘Hey girl, don't you know you are supposed to take cock,’ and put their hands on her when she passed by.”¹⁷⁵ Ryan N. was with two lesbian friends in a local park when a man approached the women and said, “I want to give you a good fuck and you will leave women and start with men.”¹⁷⁶

Homosexual men and women also face violence and abuse by their own family members. After Edward P.’s mother found out that he was gay, she threatened to poison him, which she was encouraged to do by others in their town. Edward P. told Human Rights Watch: “My mother said she wanted to poison me. . . . I could go for days after days starving myself. I won’t eat her cooking. Yes, I actually believe she might. People went to her and said, ‘after all, he is her son.’”¹⁷⁷ When Lillie P.’s mother found out that she was lesbian, she threw her out of the family home, leaving her without a place to live.¹⁷⁸

Abuses against people living with HIV/AIDS

My mother said she would kill me herself if I stayed in the house.
—Ray B., eighteen, Kingston, June 8, 2004

Abuses based on sexual orientation reflect and reinforce abuses against people living with HIV/AIDS. Health workers, AIDS outreach workers, and people living with HIV/AIDS told Human Rights Watch that they faced abuse by family and community members who feared that they could contract HIV/AIDS through casual contact with them and who associated the disease with homosexuality and prostitution. Several people living with HIV/AIDS said that they had been thrown out of their family homes or evicted from private housing when their HIV status became known. Others kept their HIV status secret for fear that disclosure would subject them to violence.

After Ray B., eighteen, told his mother that he was HIV-positive, she threatened to poison him. He could not return home because his mother was afraid that she would catch HIV from him. Ray told Human Rights Watch: “My mother is afraid that if I touch the gate, she will catch AIDS.”¹⁷⁹ When a JAS outreach worker heard someone telling a person living with HIV/AIDS that “AIDS smoke” from his burning rubbish would affect him and his children, the outreach worker tried to explain that the virus was not transmitted through the air. His efforts were unsuccessful, however. “People started to murmur [gossip]. They said they didn’t care, this guy had to leave. And he had to move out of the community.”¹⁸⁰

Neither age nor disability affords protection from abuse. Tonya Clark, a JAS nurse, told Human Rights Watch that the previous week, she had heard from an elderly woman living with HIV/AIDS whose son made her sleep on the porch and fed her from a pan, like a dog. “Her son tells everyone in the community she has AIDS. They reject her, except for one neighbor, who gives her food—but she can’t let anyone in the neighborhood see her giving her food.”¹⁸¹ Leonard S., a thirty-year-old disabled man living with HIV, lived with his family. His mother, who knew that he was gay, told him that if he contracted HIV, she would abandon him at the hospital. He feared worse. He told Human Rights Watch that if his family or neighbors found out that he was HIV-positive, he would flee because they would beat or kill him.¹⁸²

[37] Henry Bucknor, “Alleged Gay Man Chopped to Death in MoBay,” Western Mirror, vol. 24, no. 72, June 19, 2004, p. 1.

[38] “Rastaman” is a term used to refer to men with dreadlocks (a hairstyle in which the hair grows and is left uncombed, and forms ropelike locks that hang down from the head) and to Rastafarians, a religious group whose members wear their hair in dreadlocks.

[39] Human Rights Watch telephone interview with Fred L., Montego Bay, July 6, 2004.

[40] Ibid.; Human Rights Watch interview with Dennis M., Montego Bay, June 21, 2004; Human Rights Watch interview with Joseph W., New York, June 28, 2004.

[41] Human Rights Watch interview with Joseph W., New York, June 28, 2004. Joseph W. was an acquaintance of Victor Jarrett’s. A third witness told Human Rights Watch that he saw the police beating the victim and a crowd throwing bottles and stones at him as he ran from the police, and heard people shouting that the victim was gay and should be killed. Human Rights Watch interview with Dennis M., Montego Bay, June 21, 2004.

[42] Human Rights Watch interview with Dennis M., Montego Bay, June 21, 2004.

[43] Human Rights Watch interview with Nicholas C., Kingston, June 9, 2004.

[44] Human Rights Watch interview with Albert B., Kingston, June 9, 2004.

[45] Human Rights Watch interview with Peter T., Kingston, June 9, 2004. Machetes are common property in Jamaica and are used for agricultural work, for personal protection at home (in case of break-ins), and as weapons.

[46] Human Rights Watch interview with Harold B., Kingston, June 9, 2004.

[47] Human Rights Watch interview with Peter T., Kingston, June 9, 2004.

[48] Ibid.

[49] Human Rights Watch interview with Paul M., Kingston, June 6, 2004.

[50] Offences against the Person Act, sections 76, 79. Caribbean states in the British Commonwealth inherited similar penal codes from the British colonial administration, some of which have since been amended or nullified. For example, Bahamian law proscribes consensual same sex sexual activity between adults in public but not in private. Sexual Offences and Domestic Violence Act of the Bahamas, section 16(2)(b). Jamaican and Guyanese laws are silent on lesbianism, while all acts of homosexuality are illegal in Trinidad and Tobago, Barbados and St. Lucia. “Sodomy Laws in the Carribbean,” http://www.sodomylaws.org/world/caribbean.htm (retrieved November 3, 2004). In 2000, Britain issued an order repealing sodomy laws in its Overseas Territories, which it had to do to meet its own international treaty obligations under the European Convention on Human Rights and the International Convention on Civil and Political Rights. This order affected laws in Anguilla, the British Virgin Islands, the Cayman Islands, Montserrat, and the Turks and Caicos Islands. “U.K. Ends Territories’ Sodomy Laws,” PlanetOut, December 22, 2000. Prime Minister P.J. Patterson’s opposition to foreign intervention to repeal Jamaican sodomy laws is ironic, as it is not the same-sex behavior, but the laws that prohibit it, that are the colonial imposition.

[51] Ibid., section 76. According to Jamaican lesbian, gay, bisexual and transgender rights advocates, most buggery prosecutions involve adult men suspected of engaging in consensual anal sex. Jamaica Forum for Lesbians, All-Sexuals and Gays, “Parliamentary Submission with Regard to ‘An Act to Amend the Constitution of Jamaica to Provide for a Charter of Rights and for Connected Matters,” http://www.jflag.org/programmes/parliamentary_sub.htm (retrieved August 24, 2004).

[52] Offences against the Person Act, section 79. This provision follows Victorian law on “gross indecency,” which was known as the “blackmailer’s charter,” because a man could be convicted on the strength of a blackmailer’s accusation. H. Montgomery Hyde, The Other Love: An Historical and Contemporary Survey of Homosexuality in Britain (London: Heinemann, 1971), p. 136.

[53] Offences against the Person Act, section 80.

[54] Towns and Communities Act, sections 3(r), 4 (empowering police to arrest without warrant based on charges made by any “credible person” that certain offences committed within view of charging party).

[55] In June 2004, Human Rights Watch requested police statistics on arrests, convictions and charges imposed under laws proscribing sodomy and prostitution, but as of this writing has not received them.

[56] Human Rights Watch e-mail communication with Lawson Williams, August 10, 2004. “Lawson Williams” is a pseudonym.

[57] Human Rights Watch interview with Clarence Taylor, Kingston, June 18, 2004.

[58] Human Rights Watch interview, St. Ann’s Bay, June 16, 2004.

[59] Human Rights Watch interview with K.K. Knight, senior police superintendent, Kingston, June 18, 2004.

[60] Human Rights Watch interview with Newton Ames, superintendent of police, Kingston, June 18, 2004.

[61] Human Rights Watch does not oppose punishment for sexual violence or coercion that would fall within the sodomy law. We urge Jamaica to amend the criminal law so that sexual violence or coercion against and between men is subject to equal punishment as sexual violence against women.

[62] See, e.g.,The Jamaica Observer, January 11, 2003; The Star, January 18, 2000.

[63] Human Rights Watch interview with Allen C., Kingston, June 8, 2004.

[64] Human Rights Watch interview with Ryan N., Kingston, June 9, 2004.

[65] Human Rights Watch interview with Harold B., Kingston, June 9, 2004.

[66] Human Rights Watch interview with Vincent G., Kingston, June 14, 2004.

[67] Human Rights Watch interview with Ryan N., Kingston, June 9, 2004.

[68] Human Rights Watch interview with Patrick D., Kingston, June 9, 2004.

[69] Human Rights Watch interview with Lillie P., Kingston, June 19, 2004.

[70] Human Rights Watch interview with Harold B., Kingston, June 9, 2004.

[71] Human Rights Watch interview with Lawrence O., Kingston, June 19, 2004.

[72] Human Rights Watch interview with Paul M., Kingston, June 6, 2004.

[73] Human Rights Watch interview with Lawson Williams, Kingston, June 23, 2004 and statements of complainant and accused to police. A “buggery” defense appears to have been used by a man charged with felonious wounding, who claimed he stabbed another man after having been forced by him to have sex in the car at knifepoint. John Tavares, “Buggery, Case Continues June 22,” The Jamaica Observer, June 4, 2004.

[74] Human Rights Watch interview with Joseph W., Kingston, June 11, 2004.

[75] Human Rights Watch interview with Lawrence O., Kingston, June 19, 2004.

[76] Human Rights Watch interview with Leroy J., Ocho Rios, June 16, 2004.

[77] Human Rights Watch interview with Allen C., Kingston, June 8, 2004.

[78] Human Rights Watch interview with Edward P., Ocho Rios, June 16, 2004.

[79] Human Rights Watch interview with Nicholas C., Kingston, June 9, 2004.

[80] Human Rights Watch interview with Nicholas C., Kingston, June 9, 2004.

[81] Human Rights Watch interview with Paul M., Kingston, June 6, 2004.

[82] Human Rights Watch interview with K.K. Knight, senior superintendent of police, Kingston, June 18, 2004.

[83] Ibid.

[84] Human Rights Watch interview with Newton Ames, superintendent of police, Kingston, June 18, 2004.

[85] Human Rights Watch interview, Kingston, June 10, 2004. A newspaper columnist commenting on Brian Williamson’s murder wrote that “based on cursory investigations, all indications are he was murdered by someone ‘in-house.’ The police report suggests that he was chopped all over his body. This is fairly consistent with previous murders in Jamaica involving male homosexuals.’” Mark Wignall, “Those Flamin’ Homosexuals,” The Daily Observer, June 17, 2004. See also S. Escoffery, “Letter of the day – Outrage! and hypocrisy in dancehall attack,” The Jamaica Gleaner, October 6, 2004 (arguing that in Jamaica, “98 per cent, if not all crimes against homosexuals are homosexual on homosexual crimes”).

[86] See, e.g., “Homocide in Homosexual Victims: A Study of 67 Cases from the Broward County, Florida, Medical Examiner’s Office (1982-1992), with Special Emphasis on ’Overkill,’” The American Journal of Forensic Medicine and Pathology, vol. 17, no. 1 (March 1996), pp. 65-69 (comparing number and extent of injuries in homosexual and heterosexual homicide victims and finding that homosexual homicides were more violent); Douglas Victor Janoff, “Tales from the Turkish Crypt: Ottawa Researcher Explores Homophobia, Violence and Murder,” Capital Xtra!, July 1, 2004 (reviewing studies of serious violence against lesbian, gay and transgender people).

[87] See, e.g., Human Rights Watch and International Gay and Lesbian Human Rights Commission (IGLHRC), Public Scandals: Sexual Orientation and Criminal Law in Romania (New York: Human Rights Watch and IGLHRC, 1998), pp. 65-66.

[88] Human Rights Watch interview with Percival Buddan, sub-officer in charge, Jamaican Constabulary Force First AID Center, Kingston, June 18, 2004.

[89] Human Rights Watch interview, St. Ann’s Bay, June 16, 2004.

[90] Human Rights Watch interview with Ernest N., Kingston, June 11, 2004.

[91] Human Rights Watch interview with Ellis R., Kingston, June 25, 2004.

[92] Human Rights Watch interview with Vincent G., Kingston, June 14, 2004.

[93] Human Rights Watch interview, Kingston, June 6, 2004.

[94] Human Rights Watch interview with Jennifer S., Kingston, June 9, 2004.

[95] Human Rights Watch interview with Vincent G., Kingston, June 14, 2004.

[96] See, e.g., Ministry of Health, “Jamaica HIV/AIDS/STI National Strategic Plan 2002-2006,” January 2002; see also Pan-Caribbean Partnership on HIV/AIDS, “The Caribbean Regional Strategic Framework for HIV/AIDS 2002-2006,” March 2002.

[97] Jamaica AIDS Support is an NGO that also provides HIV/AIDS information and services to men and women who sell sex for money and engage in transactional sex, hearing-impaired individuals, and inmates, ex-convicts and correctional services staff. This work is funded by the Ministry of Health through the Global Fund and USAID. The Caribbean Epidemiology Centre (CAREC) and several United States NGOs also support condom distribution work. Jamaica AIDS Support, “Targeted Intervention,” http://www.jamaicaaidssupport.com/services/intervention.htm (retrieved August 1, 2004).

[98] Human Rights Watch interview with Dr. Yitades Gebre, Kingston, June 23, 2004.

[99] Human Rights Watch interview with [name withheld on request], Kingston, June 18, 2003.

[100] Ibid.

[101] Ibid.

[102] Ibid.

[103] Ibid.

[104] Human Rights Watch interview with Steve Harvey, coordinator of targeted interventions, Jamaica AIDS Support, Kingston, June 6, 2004.

[105] Ibid.

[106] Human Rights Watch interview with Joyce D., Kingston, June 9, 2004.

[107] Human Rights Watch interview with Orchid Gowe-Hunter, Montego Bay, June 21, 2004.

[108] Human Rights Watch interview with Tonya Clark, Kingston, June 14, 2004.

[109] Human Rights Watch interview, Ocho Rios, June 16, 2004.

[110] Human Rights Watch interview with Curtis M., Ocho Rios, June 16, 2004.

[111] Human Rights Watch interview with Leroy J., Ocho Rios, June 16, 2004.

[112] Human Rights Watch interview with Craig F., Ocho Rios, June 16, 2004.

[113] Human Rights Watch interview with Eric B., Kingston, June 8, 2004.

[114] Human Rights Watch interview with Craig F., Ocho Rios, June 16, 2004.

[115] HIV is not spread by casual contact nor by any airborne means of transmission, including sneezing or spitting. There is therefore no public health justification for segregating people living with HIV/AIDS from other patients, or in any way isolating their food, laundry or medical equipment for non-invasive procedures solely because someone has HIV. Such actions threaten to reveal HIV status, and undermine public health efforts by creating a false sense of protection from the disease, creating harmful stigma, and thus keeping people from seeking health care and prevention services. See UNAIDS, HIV/AIDS and Human Rights-International Guidelines, p. 42. International health organizations recommend that workers in settings where the possibility of occupational HIV transmission does exist, as where there may be exposure to bloody injuries or being stuck with unsterile syringes, be trained in “universal precautions” (simple measures to protect against HIV and other blood borne illnesses) and provided with adequate supplies (such as gloves) to take such precautions. World Health Organization, “Universal Precautions, Including Injection Safety,” http://www.who.int.hiv/topics/precautions/universal/en/ (retrieved September 16, 2004).

[116] Human Rights Watch interview with Orchid Gowe-Hunter, Montego Bay, June 21, 2004.

[117] Human Rights Watch interview with Deborah Manning, director, CHARES, Kingston, June 14, 2004.

[118] Human Rights Watch interview with Joseph W., Kingston, June 11, 2004.

[119] Human Rights Watch interview with Patrick D., Kingston, June 9, 2004.

[120] Comments made at workshop to discuss quality of care for HIV-positive patients, Kingston, June 7, 2004.

[121] Ibid.

[122] Ibid.

[123] Ibid.

[124] Ibid.

[125] Ibid.

[126] ICCPR, 999 U.N.T.S. 171, entered into force March 23, 1976, art. 17; American Convention on Human Rights, entered into force July 18, 1978, art. 11. Jamaican law provides that physicians, nurses and midwives may be subject to sanctions for failure to protect confidential patient information. See The Medical Act, section 11; The Nurses and Midwives Act, section 11.

[127] Caesarean section delivery has been shown to reduce the risk of mother-to-child HIV transmission. It may not be appropriate in resource-constrained settings because of limited availability, cost and risk of complications. World Health Organization, HIV in Pregnancy: A Review, WHO/CHS/RHR/99.15, UNAIDS/99.35E (Geneva: UNAIDS, 1999), pp. 9, 25. Insistence on caesarean sections may also present a substantial ethical problem if women are not properly briefed about both the risks and the advantages associated with undergoing caesarean sections.

[128] Human Rights Watch interview with Lena B., Montego Bay, June 22, 2004.

[129] Lena B. said that in the first few months of 2004, she had been threatened at home several times: her drinking water had been poisoned; an armed man had come to her house and warned her that he had been hired by her family to kill her; and she had found materials used in obeah (witchcraft) outside her room. Ibid.

[130] Human Rights Watch interview with Lena B., Montego Bay, June 22, 2004.

[131] Comments made at workshop to discuss quality of care for HIV-positive patients, Kingston, June 7, 2004.

[132] Human Rights Watch interview, Kingston, June 6, 2004.

[133] Human Rights Watch interview with Glenn C., Kingston, June 13, 2004.

[134] Human Rights Watch interview with Craig F., Ocho Rios, June 16, 2004.

[135] See United States Centers for Disease Control and Prevention, Fact Sheet: Prevention and Treatment of Sexually Transmitted Diseases as an HIV Prevention Strategy [online], http://www.cdc.gov/hiv/pubs/facts/hivstd.htm (retrieved October 27, 2003).

[136] Human Rights Watch interview with Craig F., Ocho Rios, June 16, 2004.

[137] Human Rights Watch interview with Harold B., Kingston, June 9, 2004.

[138] Human Rights Watch interview, Kingston, June 11, 2004.

[139] Human Rights Watch interview with Martin B., Kingston, June 14, 2004; Human Rights Watch interview with Adrian S., Kingston, June 13, 2004.

[140] See testimony of Nicholas C., p. 19, above.

[141] Human Rights Watch interview with Adrian S., Kingston, June 13, 2004.

[142] Human Rights Watch interview with Edward P., Ocho Rios, June 16, 2004.

[143] Human Rights Watch interview with James P., Kingston, June 8, 2004.

[144] Human Rights Watch interview with Tonya Clark, Kingston, June 14, 2004.

[145] Human Rights Watch interview with Craig R., Ocho Rios, June 16, 2004.

[146] Human Rights Watch interview with Steve Harvey, coordinator of targeted interventions, Jamaica AIDS Support, Kingston, June 6, 2004.

[147] Ibid.

[148] Human Rights Watch interview with Joseph W., Kingston, June 11, 2004.

[149] Human Rights Watch interview with Harold B., Kingston, June 9, 2004.

[150] Human Rights Watch interview, June 6, 2004.

[151] Jamaica Forum for Lesbians, All-Sexuals and Gays website, http://www.jflag.org/misc/contact.htm (retrieved August 27, 2004).

[152] Human Rights Watch interview with Lena B., Montego Bay, June 22, 2004.

[153] Human Rights Watch interview with Pam B., Kingston, June 8, 2004.

[154] Human Rights Watch interview with John B., June 21, 2004.

[155] Human Rights Watch interview with Patrick D., Kingston, June 9, 2004.

[156] Human Rights Watch interview with Eric B., Kingston, June 8, 2004.

[157] See, e.g., Institute of Medicine, Homelessness, Health, and Human Needs (Washington, D.C.: National Academy Press, 1988), chapter 4.

[158] Human Rights Watch interview with Albert B., Kingston, June 9, 2004.

[159] Human Rights Watch interview with Angela M., June 15, 2004. In June 2004, 1 Jamaican dollar was equivalent to U.S. $0.015.

[160] Human Rights Watch interview with John B., June 21, 2004.

[161] Human Rights Watch interview with Adrian S., Kingston, June 13, 2004. A conductor collects fares on public buses. A conductress is a female bus conductor.

[162] Human Rights Watch interview with Fabian Thomas, Montego Bay, June 22, 2004.

[163] Human Rights Watch interviews with Charles R., Kingston, June 24 and 25, 2004 and statement of Charles R. to police. Banton composed and performed “Boom Bye Bye,” a song that celebrates the killing and burning of gay men.

[164] Human Rights Watch interviews with Charles R., Kingston, June 24 and 25, 2004; Human Rights Watch interviews with Ricardo P., Kingston, June 24 and 25, 2004; Human Rights Watch interviews with Robert E., Kingston, June 24 and 25, 2004.

[165] A Human Rights Watch researcher accompanied the victims to the residence and observed the condition of the home and the victims’ property.

[166] Human Rights Watch interview with Charles R., Kingston, June 24, 2004.

[167] Ibid.

[168] Human Rights Watch interview with Robert E., Kingston, June 24, 2004. The physician who examined his foot told Human Rights Watch that Robert E.’s heelbone was broken and he risked further serious injury if he did not take good care of it.

[169] Human Rights Watch interview with Ricardo P., Kingston, June 24, 2004.

[170] Human Rights Watch interview with Paul M., Kingston, June 6, 2004.

[171] Human Rights Watch interview with Daniel S., Montego Bay, June 21, 2004.

[172] Human Rights Watch interview with Vincent G., Kingston, June 14, 2004.

[173] Human Rights Watch interview with Sebastian L., Ocho Rios, June 15, 2004.

[174] Human Rights Watch interview with Phoebe S. Kingston, June 14, 2004.

[175] Human Rights Watch interview with Cynthia S., Kingston, June 8, 2004.

[176] Human Rights Watch interview with Ryan N., Kingston, June 9, 2004.

[177] Human Rights Watch interview with Edward P., Ocho Rios, June 16, 2004.

[178] Human Rights Watch interview with Lillie P., Kingston, June 19, 2004.

[179] Human Rights Watch interview with Ray B., Kingston, June 8, 2004.

[180] Human Rights Watch interview, Kingston, June 6, 2004.

[181] Human Rights Watch interview with Tonya Clark, Kingston, June 14, 2004.

[182] Human Rights Watch interview with Leonard S. , Kingston, June 11, 2004.

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November 2004