Stigma, HIV Vulnerability, and Reproductive Health Inequities among LGBT Youth in Jamaica

Authors: Valentina Beatriz González1
1Fundación Santa Fe de Bogotá, Fundación Cardiovascular de Colombia FCV – FCV

Abstract

HIV remains a central reproductive health concern, particularly in regions where stigma and structural inequities undermine access to healthcare. Young transgender women and sexually diverse men in Jamaica face disproportionate HIV risk due to overlapping vulnerabilities including poverty, criminalisation, and social discrimination. This paper examines the intersection of stigma, HIV vulnerability, and reproductive health outcomes within this population. By integrating qualitative insights with reproductive medicine frameworks, we highlight how structural barriers influence access to contraception, fertility planning, pregnancy-related care, and prevention of mother-to-child transmission (PMTCT). Policy reforms and targeted interventions are proposed to reduce inequities and improve reproductive health outcomes for marginalised groups.

Keywords: HIV, transgender women, PMTCT, LGBT

References

  1. Braakhekke M, Kamphuis EI, Van Rumste MM, Mol F, Van Der Veen F, Mol BW. How are neonatal and maternal outcomes reported in randomised controlled trials (RCTs) in reproductive medicine?. Human Reproduction. 2014 Jun 1;29(6):1211-7.
  2. Dingake OB. The state of human rights in relation to key populations, HIV and sexual and reproductive health. Reproductive Health Matters. 2018 Jan 1;26(52):46-50.
  3. Ara I, Maqbool M, Gani I. Reproductive Health of Women: implications and attributes. International Journal of Current Research in Physiology and Pharmacology. 2022 Nov 28:8-18.
  4. Shaw D. Access to sexual and reproductive health for young people: bridging the disconnect between rights and reality. International Journal of Gynecology & Obstetrics. 2009 Aug 1;106(2):132-6.
  5. Logie CH, Marcus N, Wang Y, Lacombe-Duncan A, Levermore K, Jones N, Bryan N, Back R, Marshall A. Contextualising sexual health practices among lesbian and bisexual women in Jamaica: a multi-methods study. Reproductive Health Matters. 2018 Jan 1;26(52):109-27.
  6. Amin A. Addressing gender inequalities to improve the sexual and reproductive health and wellbeing of women living with HIV. Journal of the International AIDS Society. 2015 Dec;18:20302.
  7. Nattabi B, Li J, Thompson SC, Orach CG, Earnest J. A systematic review of factors influencing fertility desires and intentions among people living with HIV/AIDS: implications for policy and service delivery. AIDS and Behavior. 2009 Oct;13(5):949-68.
  8. Martins A, Alves S, Chaves C, Canavarro MC, Pereira M. Prevalence and factors associated with fertility desires/intentions among individuals in HIV‐serodiscordant relationships: a systematic review of empirical studies. Journal of the International AIDS Society. 2019 May;22(5):e25241.
  9. H. Logie C, Lee-Foon N, Jones N, Mena K, Levermore K, Newman PA, Andrinopoulos K, Baral S. Exploring lived experiences of violence and coping among lesbian, gay, bisexual and transgender youth in Kingston, Jamaica. International Journal of Sexual Health. 2016 Oct 1;28(4):343-53.
  10. Chilaka VN, Konje JC. HIV in pregnancy–An update. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2021 Jan 1;256:484-91.
  11. Laar A. Balancing the Socio-Political and Medico-Ethical Dimensions of HIV: A Social Public Health Approach. Springer Nature; 2022 Jul 8.
  12. Logie CH, Lacombe-Duncan A, Levermore K, Jones N. Conceptualizing empowerment practice with lesbian, gay, bisexual and transgender youth in Jamaica. Social work education. 2017 May 19;36(4):456-65.
  13. Mezzina R, Gopikumar V, Jenkins J, Saraceno B, Sashidharan SP. Social vulnerability and mental health inequalities in the “Syndemic”: Call for action. Frontiers in Psychiatry. 2022 May 30;13:894370.
  14. Haaga JG, Wasserheit JN, Tsui AO, editors. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions.
  15. Wingo E, Ingraham N, Roberts SC. Reproductive health care priorities and barriers to effective care for LGBTQ people assigned female at birth: a qualitative study. Women’s Health Issues. 2018 Jul 1;28(4):350-7.
  16. Carpenter E. “The Health System Just Wasn’t Built for Us”: Queer Cisgender Women and Gender Expansive Individuals’ Strategies for Navigating Reproductive Health Care. Women’s Health Issues. 2021 Sep 1;31(5):478-84.
  17. Agénor M, Murchison GR, Najarro J, Grimshaw A, Cottrill AA, Janiak E, Gordon AR, Charlton BM. Mapping the scientific literature on reproductive health among transgender and gender diverse people: a scoping review. Sexual and Reproductive Health Matters. 2021 Jan 1;29(1):57-74.
  18. Logie CH, Wang Y, Marcus N, Levermore K, Jones N, Ellis T, Bryan N. Syndemic experiences, protective factors, and HIV vulnerabilities among lesbian, gay, bisexual and transgender persons in Jamaica. AIDS and Behavior. 2019 Jun 15;23(6):1530-40.
  19. Price NL, Hawkins K. A conceptual framework for the social analysis of reproductive health. Journal of Health, Population, and Nutrition. 2007 Mar;25(1):24.
  20. Ferguson L, Grant AD, Watson‐Jones D, Kahawita T, Ong’ech JO, Ross DA. Linking women who test HIV‐positive in pregnancy‐related services to long‐term HIV care and treatment services: a systematic review. Tropical Medicine & International Health. 2012 May;17(5):564-80.
  21. Senderowicz L. Contraceptive autonomy: conceptions and measurement of a novel family planning indicator. Studies in Family Planning. 2020 Jun;51(2):161-76.
  22. Fraser H. Illegality, exploitability, and precarity: repressive migration policies, carceral borders and their impact on migrant lives (Doctoral dissertation, St. Francis Xavier University).
  23. Norris M, Borneskog C. The Cisnormative Blindspot Explained: Healthcare Experiences of Trans Men and Non-Binary Persons and the accessibility to inclusive sexual & reproductive Healthcare, an integrative review. Sexual & Reproductive Healthcare. 2022 Jun 1;32:100733.