When she was seventeen years old, Gabrielle's* life took two drastic turns: she became pregnant, and subsequently, during a routine blood test, discovered that she was HIV-positive. In a series of news features being published by the Jamaica Gleaner, we are able to track some of Gabrielle's experiences over the past two years: from losing the father of her child to the disease; to giving birth to a healthy son; and subsequently meeting her current boyfriend (also HIV-positive), and becoming pregnant again.
The series of articles, "The Reality of HIV/AIDS - Diary of an HIV-Positive, Pregnant Girl" gives us a glimpse into a largely hidden world, highlighting some of the challenges faced by pregnant teenagers, in particular those that are also HIV-positive. Now five months pregnant, Gabrielle's stories underline issues such as discrimination and inadequate health care, pointing to how they have shaped her experiences of pregnancy.
One of the issues highlighted is the sexual vulnerability of many HIV-infected persons who, displaced from their homes, may end up in housing arrangements that put them at particular risk. Gabrielle [11], who at the time was living with a relative of her late boyfriend, had to endure the (sometimes violent) advances of a man who felt entitled to sleep with her by virtue of the fact that he was providing her with a place to stay.
Discrimination against those living with HIV/AIDS often takes the form of them being ejected from their households upon discovery of the disease, and subsequently having to live in unsafe domestic situations. Factors such as inadequate job skills;,insufficient education and subsequently, limited job opportunities disproportionately affect women in poorer socio-economic settings. For those with limited income earning abilities, homelessness is not an easily solved challenge. Many people, and women in particular, are forced to endure living arrangements in which they may be subjected to unwanted sexual advances, and further, sexual abuse such as rape.
The teenager's story highlights another impact of discrimination against those living with HIV/AIDS: inadequate service from health care providers. Many teenagers who become pregnant relate the negative ways in which they are treated by health care providers, who judge them for having sex at their young age, and further for becoming pregnant. In the case of a pregnant teenager who is also HIV-positive [12], there is a potential double burden, increasing the likelihood that they will receive inadequate service, as a result of the ways in which they are perceived.
Gabrielle's recollection of interacting with a nurse [13] who persistently scolds her for becoming pregnant knowing she is HIV-positive, is coloued by the obvious discomfort felt by the teenager, a discomfort which has made her fearful and reluctant to go to the health care centre. Noting that the nurse makes her "feel like she is standing on a stool looking down at (her) and judging (her)", Gabrielle brings to the forefront the ways in which health care services for those living with HIV/AIDS is often compromised when intersected with value systems that negatively judge infected persons and their presumed lifestyle.
Poignantly, Gabrielle also highlights the fear that she feels for her child [14], noting that there is a deep concern amongst HIV-infected mothers-to-be that their children will contract the disease. In her emotional tale, the often-ignored nuanced emotional needs of young women such as Gabrielle are brought to the fore, underlining another key shortfall in many of the health care policies on HIV/AIDS - the psychological impact of the disease, particularly in the case, the needs of HIV-positive, pregnant women. Beyond the concerns for self that will typically confront infected persons, there is the further sense of responsibility for the health of one's unborn child.
The experiences of this young woman have touched the hearts of many [15] who may not have otherwise heard her story. While the articles do highlight many of the daily challenges faced by the young woman, my one concern is that it also adopts a common approach to reporting on HIV/AIDS: the heavy focus on the tragedy of the situation. This technique plays heavily on the emotional side of the story, and while it is useful in promoting the humanity of those living the disease, it tends to cast them in somewhat of a victim role. An integrated approach to reporting in contrast, highlights not only the challenges faced, but also the way forward as people find new ways to manage their disease and their lives -- that there is hope for redemption.
That said, the groundbreaking series of articles does take a step towards clearing the air to allow for deeper and more progressive interactions on the issue of HIV/AIDS and the numerous and specific ways in which it affects the lives of those who live with it.
*Names have been changed.