Access to HIV Services for Mobile and Migrant Populations in Antigua

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In Antigua, the highly controlled and regulated environment of the brothels and clubs, coupled with an increase in raids on the clubs for undocumented migrants, appears to have led to a move of some Latin American women into home-based sex work, where they also enjoy a greater independence to organize their business. Migrants and stigma and discrimination In a study conducted in 2010 by Dr. Kamala Kempadoo it was reported that some racism is directed at ethnically noticeable Caribbean immigrants – primarily people from the Dominican Republic. An informant added that “people assume all Spanish-speaking women are prostitutes” with all the negative implications that go with the idea of prostitution. Antagonism between local women and foreign sex workers was noted in several places with a large number of Latinas. Additionally “female sex workers complain to police about men not paying, however because of illegal status, some foreigners cannot access police protection” Most Dominicans, both men and women, however, have been given work permits and many have lived in Antigua for many years. Some are now being refused by immigration. Kempadoo (2010) recommend that “given that many female, male and transgender sex workers experience stigmatization and discrimination in healthcare systems throughout the region, special training and facilities need to be put in place to deliver affordable and confidential healthcare to sex worker populations.” “The small size of some of the countries – where “everybody knows everybody” - and the mobile character of much of the sex work in the region demands discreet and creative approaches to ensure that sex workers are supported wherever their work takes place.” Xenophobia and Violence against migrants The racism/xenophobia in Antigua was escalating to the point of street violence by Antiguan men against Dominicans, who they feel are illegal immigrants, are taking jobs from Antiguans and are committing crimes. But crime statistics do not indicate a high percentage of foreigners involved in crime. Workers at CHAA also mentioned that there have been reports of violent attacks against 27
members of the sex-worker population being reported but not investigated, creating societal discriminations. CHAA (2010) has heard testimonies from “a sex worker who was raped, but who was too ashamed and afraid to access emergency drugs that could help prevent HIV transmission, or medical care to heal her physical injuries. Silence and fear around these issues leave perpetrators of violent crimes free to commit acts of violence against women in our society.” Legal aspects related to sex work in Antigua Dr. Kamala Kempadoo (2010) “Aside from raids to pick up persons who are undocumented or who have overstayed, it is either on arrival or at application for an extension of a permit where many persons who are believed to be sex workers are ‘detected” and refused entry by Immigration Authorities under the Antigua laws” In Antigua, deportation is by court order, yet so far “no deportations for prostitution – even if found at a house -this is difficult to prove” so the person is deemed a prohibited immigrant. “We would ask [persons suspected of prostitution] to leave. Immigration officers receive tips about potential sex workers sometimes before they arrive at the airport and may have a lead about the club, [i.e. bar with exotic dancers] Most persons choose to leave and are placed on a ‘watch list.’” There have been no male sex workers suspected or denied entry. Kempadoo (2010) reports that the laws also extend to immigration matters, and with the mobility of women around the region for work in the sex industry, coupled with xenophobia and a fear of an influx of migrants from poorer Caribbean nations – especially in Antigua, St. Kitts and Nevis, Barbados, Suriname, and Trinidad – the sex industry is targeted for raids on undocumented migrants. Almost invariably it is the undocumented migrant women sex workers who are rounded up in such raids. One of the institutional informants of the Kempadoo study stated that “HIV test is not compulsory for work permit and extension in Antigua.” 28
Page 1 and 2: APRIL 2012 A Mapping Study on Acces
Page 3 and 4: FACTS ABOUT ANTIGUA • Capital - S
Page 5 and 6: 5. Design of Survey Tools………
Page 7 and 8: 3.2.4. HIV Information and Testing
Page 9 and 10: List of Acronyms AIDS ABHAN APPA AR
Page 11 and 12: Executive Summary Background Due to
Page 13 and 14: There is clearly a lot of stigma an
Page 15 and 16: Background to Study A quick search
Page 17 and 18: Table 1 - Population by Parishes Pa
Page 19 and 20: Relevance of Study Several reports
Page 21 and 22: ‣ Desk Review - a compilation of
Page 23 and 24: This review attempts to examine som
Page 25 and 26: Kempadoo (2010) recalls that “Ant
Page 27: Table 6 - Remittances as Percentage
Page 31 and 32: use of intravenous drugs. She state
Page 33 and 34: population about their role in the
Page 35 and 36: CHAA, based on an Inter-American Pa
Page 37 and 38: The Government of Antigua and Barbu
Page 39 and 40: Population Services International (
Page 41 and 42: MAPPING METHODOLOGY Population Due
Page 43 and 44: Design of Survey Tools The survey f
Page 45 and 46: STAKEHOLDERS REPORT For this projec
Page 47 and 48: AIDS Secretariat/NAP office Redclif
Page 49 and 50: Mount St. John’s Medical Centre M
Page 51 and 52: suspicion in the department of some
Page 53 and 54: services as this does act as a barr
Page 55 and 56: Non-Governmental Organizations (NGO
Page 57 and 58: and MSM’s are referred to Directo
Page 59 and 60: in navigating the health care syste
Page 61 and 62: Questionnaires are issued and there
Page 63 and 64: There are costs attached to the pro
Page 65 and 66: to her by the social worker at the
Page 67 and 68: funding, but they are still very fu
Page 69 and 70: Encouragement should be made to civ
Page 71 and 72: Where are the places that you provi
Page 73 and 74: Do you collaborate with any other a
Page 75 and 76: MSM Survey and Focus Group Report M
Page 77 and 78: Free Condoms Figure 13- Free condom
Page 79 and 80:
Table 9- Reasons for not having an
Page 81 and 82:
care. Some had no answer as they ha
Page 83 and 84:
coming out or dealing with the stig
Page 85 and 86:
Misconceptions At least 90% of the
Page 87 and 88:
Create a job bank - having a job co
Page 89 and 90:
57.8% of the young ladies work on t
Page 91 and 92:
them to read. “Only CHAA really w
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It is quite evident that fear has c
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care and an inviting friendly atmos
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They need to be able to access a gy
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Type of facility frequented for tre
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Their expectations for their core g
Page 103 and 104:
General Discussion and Conclusion T
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Many of the ladies expressed a desi
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Policy Aspects The National
Page 109 and 110:
target population. Purpose: this wo
Page 111 and 112:
information on existing testing sit
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ANNEX _____________________________
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Support Clothes Populations Served
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Demographic 8 participants Sex: Mal
Page 119 and 120:
3. Where are the places/spots that
Page 121 and 122:
that most MSM’s are very particul
Page 123 and 124:
‣ Men’s health care clinic - wh
Page 125 and 126:
‣ Confidential organizations wher
Page 127 and 128:
French 3 3.1 Other 0 0.0 Total 105
Page 129 and 130:
their country as a group. 5.2% of t
Page 131 and 132:
Partner History Partners in Antigua
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Sex for pay (how many of the sexual
Page 135 and 136:
Table No. 25- Partner has spouse or
Page 137 and 138:
Condom Supply The majority of the p
Page 139 and 140:
How to use condoms/Instructional co
Page 141 and 142:
percentage when one considers that
Page 143 and 144:
Ability to pay for HIV testing Tabl
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They don’t speak my language 0 0.
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Never 15 15.7 Don’t recall 24 25.
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Other foreigners are there 12 12.6
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Facility not clean and tidy 4 4.2 O
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Sometimes 24 25.2 Rarely 16 16.8 Ne
Page 155 and 156:
Responses Number Percentage Public
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No response 1 1.0 Total 95 99.8 Tab
Page 159 and 160:
Focus Group Responses 1- What are s
Page 161 and 162:
5- What are some of the factors tha
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oyfriends. One participant also sai
Page 165 and 166:
Marital Status: All were unmarried
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They face a lot of difficulties whe
Page 169 and 170:
Figure35 - Breakdown of country of
Page 171 and 172:
Table No. 61- Length of time in Ant
Page 173 and 174:
groups of other persons from their
Page 175 and 176:
Number of Respondents Number of Res
Page 177 and 178:
Table 70- Showing how clients are c
Page 179 and 180:
Condom Supply When asked where they
Page 181 and 182:
How to use condoms /Instructional c
Page 183 and 184:
Table 79- Showing amount of persons
Page 185 and 186:
discrimination. Some 59.6% of the r
Page 187 and 188:
Reasons for not having had a recent
Page 189 and 190:
Availability of HIV testing or educ
Page 191 and 192:
Table 90- Showing their perception
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Reasons for not recommending facili
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DISCRIMINATION Discrimination faced
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“They call me Spanish and they al
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Back to school program Back to scho
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Training center where we can learn
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Disagree 91 79.8 Don’t know 20 17
Page 205 and 206:
7. What social connections do you h
Page 207 and 208:
c. Between 1and 3 months ago g. Nev
Page 209 and 210:
. Stigma and discrimination e. Faci
Page 211 and 212:
CSW INTERVIEW SHEET Date of Intervi
Page 213 and 214:
18. In the past 12 months, have you
Page 215 and 216:
36. Would you go back yourself or r
Page 217 and 218:
52. If you could implement a progra
Page 219 and 220:
The CARICOM single Market and Econo
Page 221 and 222:
CHAA (2012) International Day: Stop
Page 223 and 224:
Thomas-Hope, Elizabeth (1986),”Tr
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Access to HIV Services for Mobile and Migrant Populations in Antigua

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