In 2008, AIDS and other sexually transmitted infections were the second leading cause of death for young people between the ages of 15 and 24. Although prevalence rates varied across population groups, men who have sex with men (MSM, 20-30%) and female sex workers (FSW, 9%) were the groups driving the epidemic. However, heterosexual transmission was reported by 90% of persons with HIV.
Risky behaviors included participation in commercial and transactional sex, failure to use condoms with non-regular partners, early initiation of sexual activity, gender inequity and gender roles, poverty, and stigma and discrimination, all of which negatively affected the ability of individuals to improve their health.
Between 2002 and 2012, Jamaica has drawn on World Bank funding to support its National HIV/AIDS Response. Activities supported by the project included increased condom distribution and testing, delivery of integrated treatment to AIDS patients at 23 treatment sites, development of legislation to support an enabling environment, and a strengthened health system through the upgraded capacity of the biomedical waste management plan to treat 83 percent of annual medical waste from public health facilities.
In 2008, the Jamaica Second HIV/AIDS Project was prepared in eight months as part of the Government’s emergency response to HIV/AIDS and in support of the financing needed to implement the National HIV/AIDS Strategic Plan (NSP). It included retroactive financing for a seamless transition from the first to the second project. The project pooled Bank funds and other donor funds to allow the Government the flexibility to finance different activities aligned with NSP priorities. This approach proved to be effective particularly when the 2008 global financial crisis hit Jamaica and limited the resources for implementing the NSP.
Jamaica was able to use the Bank loan as its counterpart funding to meet a condition of a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria. When funding improved, the Government reallocated funds to allow the project to catch up with delayed activities.