Attitudes towards Key Populations in Three Fast Track Caribbean Countries: Haiti, Jamaica and the Dominican Republic

Introduction: Attitudes and behavior of the general population of a country towards people living with HIV (PLHIV), homosexuals, lesbians, sex workers and sex work, influence the successful implementation of that country's HIV response. The degree of stigmatization and discrimination of the general public in Haiti, Jamaica and the Dominican Republic was ascertained through the use of opinion polls, in these HIV high burden and Fast Track countries. The global Fast Track strategy has targets to “end AIDS by 2030”, including zero discrimination against key populations, significant reductions in the annual number of people newly infected with HIV and ensuring that most PLHIV are appropriately managed and receiving antiretroviral treatment. Methods: Opinion polls of the general populations using standardized questionnaires adapted to local conditions were performed in Haiti (2017), Jamaica (2016) and the Dominican Republic (2015). Results: 73% of Haitians, 29% of Jamaicans and 15% of Dominicans indicated that they “hate” homosexuals and lesbians; 21% of Haitians, 64% of the Jamaicans and 39% Dominicans “tolerate” them, while 6% of Haitians, 7% Jamaicans and 46% of Dominicans said they “accept” homosexuals and lesbians. Most Haitian respondents were against these populations having equal rights and in favour of penalizing some behaviors, while substantial number of respondents in Jamaica and the Dominican Republic held similar discriminatory views. Overall, women were more accepting of and less discriminatory towards people from these populations than men. Conclusions: The reasons for the high degree of stigma and discrimination towards these populations need to be further explored through in-depth mixed method studies to devise and implement context-specific, cultured-centred and culture sensitive campaigns focused to reduce stigma and discrimination by the “general” population against these populations. To reduce stigma and discrimination, punitive laws also need to be revised and abolished, and laws that reduce stigma and discrimination against these populations introduced and implemented. Unless these issues are addressed it is unlikely that the Fast Track targets can be met in these countries.