hiv and tourism study

Transcription

HIV AND TOURISM STUDY
Slow-onset Disasters and Sustainable Tourism Development:
Exploring the Economic Impact of HIV/AIDS on the Tourism
Industry in Selected Caribbean Destinations
FINAL REPORT
Submitted by:
HEU, CENTRE FOR HEALTH ECONOMICS
Faculty of Social Sciences
The University of the West Indies
Republic of Trinidad and Tobago
Submitted to:
CARICOM Secretariat
Pan Caribbean Partnership Against HIV/AIDS (PANCAP)
Guyana
June 2009
ACKNOWLEDGEMENTS
The HEU, CENTRE FOR HEALTH ECONOMICS wishes to acknowledge the Principal Investigator on
the study, Dr. Marlene Attzs, Lecturer in the Department of Economics and Deputy Coordinator of the
Sustainable Economic Development Unit (SEDU). We also acknowledge and thank Professor Dennis
Pantin, Coordinator, SEDU.
Special thanks are due to Mr. Roger McLean, Dr. Roger Hosein and Dr. Althea La Foucade. The
submission of this report would not have been possible without their contribution.
We acknowledge the research support of Ms. Haleema Ali, Ms. Candice McKenzie, Mr. Machel Pantin,
Ms. Petal Thomas and Ms. Donna Ramjattan. Thanks are also due to all members of the HEU who
provided administrative support on the project.
Karl Theodore
Professor of Economics
Director,
HEU, Centre for Health Economics
HIV and Tourism Study Final Report
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Executive Summary
This study examines the economic impact of HIV/AIDS on the tourism industry in the Dominican
Republic (particularly Punta Cana), North Coast Jamaica, Barbados, Tobago and St. Lucia. These
countries were selected due to the significance of the tourism industry to their economic landscape and
the potential threat a slow-onset disaster like HIV/AIDS fuelled by sex tourism posed to these economies.
The specific objectives of the study are to:
1.
Review the economic impact of tourism on the selected Caribbean tourism destinations
(including the multiplier effects of tourism). This will identify what is at risk in terms of the
economic vulnerability of the countries’ tourism sector;
2.
Distill from the major stakeholders what their perceptions are on the potential impact of
HIV/AIDS on sustainable tourism in the case study countries; and
3.
To provide policy conclusions and recommendations on strategies that may be considered to
ensure the sustainable development of the regional tourism industry given disasters such as
HIV/AIDS.
The methodology employed was a mix of primary and secondary research. Information was collected
through a series of in-depth interviews and focus groups with key informants from the sector across the
different territories. Extensive review of reports and statistics from the tourism, economic and social
sectors in each country was also conducted.
Tourism is a significant contributor to the Economic wealth of all the countries that were the focus of this
study, contributing between 17 and 39 percent of Gross Domestic Product (GDP). In the case of Tobago,
the tourism sector was reported to have contributed over 98 percent to the island’s GDP, based on 1997
data.
The presence of the HIV/AIDS epidemic on these islands poses a significant threat to this industry
especially in the presence of an enabling force, namely the commercial sex industry. The adult HIV
prevalence in these countries ranges from more than 2% in Tobago to 0.12% in St. Lucia with much
higher rates recorded for commercial sex workers (CSW).
In the presence of HIV/AIDS and the ill effects of the commercial sex trade, these countries have
implemented several response programmes in an attempt to mitigate the impact on their social and
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economic conditions. The following are guidelines or phases on HIV and Sex work developed by
UNAIDS as it relates to response programmes.
1. The assurance of universal access to comprehensive HIV prevention, treatment, care and support
to these involved in sex work.
2. Building supportive environments, strengthening partnerships and expanding choices.
3. Reducing vulnerability and addressing structural issues.
Based on these guidelines the comprehensiveness of the response across the five case countries was
evaluated. Based on the information available, countries illustrated varying degrees of visibility in the
programmes that were implemented across the three areas, with higher levels of achieved by the
Dominican Republic (DR), Barbados and, to a lesser extent, Jamaica. Programmes out of St Lucia in
these areas were less noticeable with little or no programmes identified in the Tobago case.
Recognizing that the CSWs represent one of the groups most at risk to exposure to HIV/AIDS, the
effectiveness of these strategies can impact not only prevalence rates within this group but also
prevalence rates at the national level.
HIV/AIDS, due to the long latency period from infection to death, can be compared to other disasters like
famine, where the impacts take time to ‘reveal’ themselves. The Caribbean region is likely to face severe
impacts since it thrives on tourism; a sector heavily dependent on human capital, the resource under
attack by the HIV/AIDS epidemic. In the Caribbean, 83 percent of AIDS cases are in the age group (1554), the core of the region’s labour force which compromises the region’s ability to meet the increasing
demand for tourism activities (World Bank 2001). In analyzing the impact of HIV/AIDS on sustainable
tourism development in the Caribbean, there key institutional impacts may be noted:
•
HIV/AIDS related mortality and morbidity;
•
Staff Attrition (death, dismissal, redundancy, resignation, illness resulting from HIV/AIDS); and
•
Increased absenteeism.
Absenteeism, attrition and vacancies adversely impact productivity, finances and service provision.
Interestingly, all these impacts reinforce each other and multiply as part of a vicious cycle promoting
destruction. As such, sustainable tourism development would be at risk.
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The challenges of dealing with and internalizing the threat of HIV/AIDS in these tourism-dependent
countries will require different approaches at the policy-making/governmental level in line with the
degree of maturity of the sex tourism industry.
Programmes and policies that seek to provide key health and social services to this group and a supportive
environment that facilitates the provision of these services will achieve the success of minimizing the risk
and vulnerability that is associated with this group. Additionally attempts at ensuring that this group
remains accessible to programme interventions will make for a more efficient use of national resources in
addressing the HIV/AIDS epidemic in these territories.
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TABLE OF CONTENTS
ACKNOWLEDGEMENTS ...................................................................................................................................... - 2 EXECUTIVE SUMMARY ....................................................................................................................................... - 3 TABLE OF CONTENTS.......................................................................................................................................... - 6 LIST OF FIGURES................................................................................................................................................. - 9 LIST OF TABLES - 11 INTRODUCTION TO THE STUDY ........................................................................................................................ - 12 STUDY METHODOLOGY ................................................................................................................................... - 14 CHAPTER 1: THE SOCIO-ECONOMIC SIGNIFICANCE OF THE TOURISM SECTOR ................... - 15 1.0
The Jamaican Case .............................................................................................................................. - 15 -
1.0.1
Economic Profile ............................................................................................................................... - 15 -
1.0.2
Jamaica Tourism Profile: The Formal Sector ..................................................................................... - 15 -
1.0.3
Jamaica Tourism Profile: The Informal Sector................................................................................... - 24 -
1.1
The Dominican Republic Case.............................................................................................................. - 25 -
1.1.1
The Economic Profile......................................................................................................................... - 25 -
1.1.2
Dominican Republic Tourism Profile: The Formal Sector .................................................................. - 25 -
1.1.3
Dominican Republic Tourism Profile: The Informal Sector ............................................................... - 28 -
1.2
The Tobago Case ................................................................................................................................. - 31 -
1.2.1
1.2.2
Tobago Tourism Profile: The formal Sector ..................................................................................... - 33 -
1.2.3
Tobago Tourism Profile: The Informal Sector .................................................................................. - 35 -
1.3
The St. Lucia Case ................................................................................................................................ - 36 -
1.3.1
1.3.2
St. Lucia Tourism Profile: The Formal Sector .................................................................................... - 37 -
1.3.3
St. Lucia Tourism Profile: The Informal Sector ................................................................................ - 42 -
1.4
The Barbados Case .............................................................................................................................. - 44 -
1.4.1
Economic Profile ............................................................................................................................... - 44 -
1.4.2
Barbados Tourism Profile: The Formal Sector................................................................................... - 45 -
1.4.3
Barbados Tourism Profile: The Informal Sector ................................................................................ - 49 -
CHAPTER 2:
2.0
HIV/AIDS – A PROFILE OF THE EPIDEMIC ........................................................................ - 51 -
A Summary profile of HIV/AIDS among Case Study Countries ............................................................. - 51 -
2.0.1
HIV/AIDS in Jamaica: An Overview .................................................................................................... - 51 -
2.0.2
HIV/AIDS in the Dominican Republic: An Overview .......................................................................... - 54 -
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2.0.3
HIV/AIDS in the Tobago: An Overview .............................................................................................. - 56 -
2.0.4
A Summary profile of HIV/AIDS in St. Lucia: An Overview ................................................................ - 60 -
2.0.5
HIV/AIDS in Barbados: An Overview ............................................................................................. - 62 -
HIV/AIDS Risk in the Commercial Sex Industry .................................................................................... - 65 -
2.1.1
Jamaica .............................................................................................................................................. - 65 -
2.1.2
The Dominican Republic.................................................................................................................... - 65 -
2.1.3
Tobago............................................................................................................................................... - 66 -
2.1.4
St Lucia ............................................................................................................................................. - 67 -
2.1
2.1.5
Barbados ........................................................................................................................................... - 68 -
CHAPTER 3:
3.0
HIV/AIDS – AN ASSESSMENT OF THE POLICY RESPONSE TO THE EPIDEMIC ............... - 69 -
The Case of Jamaica ............................................................................................................................ - 69 -
3.0.1
The Jamaica National Strategic Plan for HIV/AIDS ............................................................................ - 69 -
3.0.2
HIV/AIDS Initiatives in the Tourism Sector ........................................................................................ - 70 -
3.0.3
Stakeholders perceptions on the threat of HIV/AIDS to the Tourism Industry in Jamaica .............. - 73 -
3.1
The Case of the Dominican Republic ................................................................................................... - 75 -
3.1.1
The Dominican Republic National Response ..................................................................................... - 75 -
3.1.2
3.1.3
Stakeholders perceptions on the threat of HIV/AIDS to the Tourism Industry in
Dominican Republic .......................................................................................................................... - 77 -
3.2
The Case of Tobago ............................................................................................................................. - 79 -
3.2.1.
Background to the HIV/AIDS Programme Response in Trinidad and Tobago ................................... - 79 -
3.2.2
Strategic Initiatives of the Tobago HIV/AIDS Coordinating Committee ............................................ - 79 -
3.2.3
3.3
The Case of St. Lucia ............................................................................................................................ - 81 -
3.3.1.
The St Lucia National Response to HIV/AIDS .................................................................................... - 81 -
3.3.3
3.4
The Case of Barbados .......................................................................................................................... - 84 -
3.4.1.
The Barbados Response to HIV/AIDS ................................................................................................ - 84 -
3.4.2
HIV/AIDS initiatives in the Tourism sector ........................................................................................ - 85 -
3.5
An Assessment of the Response to HIV and Sex Tourism .................................................................... - 86 -
CHAPTER 4:
4.0
HEALTH AND SUSTAINABLE TOURISM DEVELOPMENT ........................................................... - 88 -
Sustainable Tourism Development ...................................................................................................... - 88 -
4.0.1
Sustainable Tourism and Health ....................................................................................................... - 88 -
4.0.2
Tourism’s Contribution to the spread of HIV/AIDS in the Caribbean – Sex Tourism ........................ - 94 -
4.1
HIV/AIDS as a slow-onset disaster ....................................................................................................... - 99 -
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CHAPTER 5:
5.0
THE ECONOMIC SIGNIFICANCE OF SEX TOURISM .................................................................. - 104 -
Economic significance of sex tourism- The Case of Jamaica and the Dominican Republic .................. - 106 -
5.0.1
Estimations of potential fiscal gains from CSWs via GCT ................................................................ - 107 -
CHAPTER 6:
RECOMMENDATIONS FOR SUSTAINABLE TOURISM DEVELOPMENT GIVEN SLOW-ONSET
DISASTERS
- 110 -
6.0
Policy Conclusions and Recommendations ........................................................................................ - 110 -
SELECTED BIBLIOGRAPHY............................................................................................................................... - 112 APPENDIX I
.......................................................................................................................................................
- 120 -
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LIST OF FIGURES
PAGE
Figure 1. Visitor Expenditure 1990 - 2007
13
Figure 2. Distribution of Expenditure between Stop-over and Cruise Tourists 2000 - 2007
14
Figure 3. Tax Revenue from Tourism 1991 - 2000
14
Figure 4. Tourist Arrivals in Jamaica 1990 – 2007
15
Figure 5. Cruise Passenger Arrivals 1990 - 2007
15
Figure 6. Number of Rooms in Jamaica 1990 - 2007
16
Figure 7. Employment in the Accommodation Sector on the North Coast 1995 - 2007
18
Figure 8. Stop-over Tourists on the North Coast 2000 – 2007
19
Figure 9. Cruise Ship Passengers by Major Ports of Call 1997 - 2007
20
Figure 10. Cruise Passengers by Cruise Calls by Major Ports 1997 - 2007
20
Figure 11. Number of Rooms in the Accommodation Sector by Location 1998 - 2007
23
Figure 12. Employment in Tourist Locations 1998 - 2007
24
Figure 13. Cruise Ship Passengers by Major Ports of Call 1997 - 2007
25
Figure 14. Map of The Dominican Republic
26
Figure 15 Map of Tobago
30
Figure 16 International Visitor Arrivals to Tobago 1992-2007
31
Figure 17 Room Capacity at Tobago Hotels 1997-2003
31
Figure 18 Map of St. Lucia
34
Figure 19 Employment in the Tourism Sector 1990-2007
35
Figure 20 Total Passenger Arrivals 1990-2007
36
Figure 21 Stop-Over Tourists Arrivals -1990-2007
36
Figure 22 Total Visitor Expenditure
37
Figure 23 Cruise Passenger Arrivals
38
Figure 24 Number of Rooms in Tourist Accommodations 1998-2007
39
Figure 25 Map of Barbados
42
Figure 26 Total Passenger Arrivals 1990-2007
43
Figure 27 Cruise Passenger Arrivals 1990-2007
44
Figure 28 Stop-Over Tourist Arrivals 1990-2007
44
Figure 29 Employment in the tourism Sector 1990-2007
45
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Figure 30 Number of Rooms in tourist Accommodations 1998-2007
46
Figure 31 Jamaica AIDS Cases and Deaths 1982-2006
49
Figure 32 Jamaica- Estimated Adult HIV (15-49) Prevalence % 1990 – 2007
49
Figure 33 Jamaica - Number of Persons Living with HIV/AIDS, 1990 - 2007
50
Figure 34 Dominican Republic - Number of Persons Living with HIV/AIDS, 1990 - 2007
51
Figure 35 Dominican Republic - Estimated Adult HIV (15-49) Prevalence % 1990 - 2007
52
Figure 36 Tobago New HIV Cases by Gender 203-2007
54
Figure 37 Tobago Total AIDS Cases by Gender 2003-2007
54
Figure 38 Tobago total AIDS Deaths by Gender2003-2007
55
Figure 39 Reported Number of HIV/AIDS Cases and Deaths in Tobago
55
Figure 40 St. Lucia Reported HIV Cases 1990-2007
58
Figure 41 St Lucia Reported AIDS Cases and AIDS Deaths 1990-2005
58
Figure 42 Barbados Reported AIDS Cases and AIDS Deaths 1982-2007
60
Figure 43 Barbados Number of People Living with HIV 1990-2007
60
Figure 44 Estimated Adult HIV (15-49) Prevalence % 1990-2007
61
Figure 45 Health/Tourism Interface
86
Figure 46 The impact of HIV/AIDS on human capital and productivity
91
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LIST OF TABLES
PAGE
Table 1. Population in Tobago by Gender
28
Table 2. HIV/AIDS Morbidity and Mortality Summary for Trinidad and Tobago 2006 - 2007
53
Table 3. HIV/AIDS Treatment Data April 2002 – December 31, 2008
56
Table 4. Classification of countries response to HIV in the Tourism Sectors
84
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Introduction to the Study
The tourism sector, which covers activities such as sports and culture, cruise-ship tourism and yachting,
and all inclusive stop-over visits, is the most economically significant sector for many of the Caribbean
islands. For 2007,the Economic Commission for Latin America and the Caribbean (ECLAC) noted that
for most of the Caribbean economies, tourism had a catalytic effect on manufacturing, transport and
communications and especially on the construction sector. The contribution of tourism to the economy is
generally measured by hotels and restaurants which is actually only a small part of tourism activity. To
more accurately gauge the multiplier impact of tourism on Caribbean economies, some of the islands have
begun to develop Tourism Satellite Accounts (TSA).
Formally, Vassiliou defines sustainable tourism as “…a tourist industry that would grow in harmony with
the economy, the society and the environment and be an integral part of a sound, Sustainable
Development Policy for the economy as a whole”. (Vassiliou 1995, 47). This study seeks to explore the
linkage between the economic sustainability of the regional tourism industry given the incidence of
HIV/AIDS in selected countries with specific focus on the sex tourism industry in these territories.
According to Mullings (2000) the Caribbean is increasingly recognized as a region with a vibrant sex
tourism industry. These islands are sites for a range of different types of sex tourisms, each island catering
to a particular segment of the market. She further highlighted that the islands with predominantly ‘black’
populations of African descent (for example, Jamaica and Barbados) cater to the consumption demands of
white heterosexual women primarily from Europe whereas, Islands with a large Latino population (for
example, Cuba and Dominican Republic) cater to the consumption demands of white heterosexual men
from Europe and North America.
For the purposes of this study a sex worker is one who receives money, goods or services in exchange for
sexual services, either regularly or occasionally (UNAIDS 2009). The countries that will form the basis of
this study are the Dominican Republic (particularly Punta Cana) and the North Coast Jamaica, Barbados,
Tobago and St. Lucia. The selection of countries is based on the economic significance of the tourism
sector in these countries and relatedly, on the potential threat of a slow-onset disaster posed to these
economies by the incidence and prevalence of HIV/AIDS coupled with evidence of sex tourism.
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The specific objectives of the study are to:
4.
Review the economic impact of tourism on the selected Caribbean tourism destinations
(including the multiplier effects of tourism). This will identify what is at risk in terms of the
economic vulnerability of the countries’ tourism sector;
5.
Distill from the major stakeholders what their perceptions are on the potential impact of
HIV/AIDS on sustainable tourism in the case study countries; and
6.
To provide policy conclusions and recommendations on strategies to ensure the sustainable
development of the regional tourism industry given disasters such as HIV/AIDS.
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Study Methodology
The methodology drew on a mixture of primary and secondary research techniques in addressing the
objectives outlined above. In the former case, this took the form of in-depth interviews and focus groups
with key informants from the sector across the different territories. These included:
(a) hoteliers, guests and workers;
(b) others who service the industry from both the formal and informal sectors;
(c) representatives of the key Hotel and Tourism Associations in-country;
(d) representatives of the National AIDS Programmes in-country;
(e) representatives of support groups of PLHIV; and
(f) representatives of other key research and technical agencies in this field.
This was supplemented by the latter approach which entailed a comprehensive review of reports and
statistics from the tourism, economic and social sectors in each country. Particular emphasis was placed
on information as it relates to the stated policy intentions and the actual policy responses of these
countries in this area.
In a number of countries, sector specific interventions in addressing HIV have been highlighted in their
strategic plans. This study was conducted with the assistance of the National AIDS Programmes and the
Tourism sector; their support and endorsement played a major role in achieving the objectives set out for
this study.
In addressing the objectives of this study, this report will begin with a look at the socio-economic
landscape of the five case countries, with particular focus on the profile of their Tourism sectors. This will
be followed by a review of the HIV/AIDS epidemic in each of the countries; here emphasis will be on the
extent of risk that resides in the commercial sex industry in each country. The report next examines the
policy responses by the various countries to the epidemic, with the focus, once again, on the initiatives in
the Tourism sector. We will next locate the dialogue within the context of health and sustainability,
exploring the possible channels through which HIV/AIDS as a slow onset disaster can affect and be
affected by sex tourism. This will lead into an assessment of the economic significance of the Tourism
Sector using two of the case countries. The report closes with a brief listing of policy recommendations.
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CHAPTER 1: The Socio-Economic significance of the Tourism
Sector
1.0
The Jamaican Case
1.0.1 Economic Profile
Jamaica stands among the larger of the English speaking Caribbean territories and is classified as a
middle lower income country. GDP growth between 2004 and 2007 has averaged a modest 1.17 percent.
There was a notable fall in the growth rate in 2007 and negative growth was recorded for 2008 according
to statistics from the Economic Intelligence Unit (2009), as this country begins to face the brunt of the
global economic downturn.
The Jamaican economy is driven largely by the bauxite/alumina and tourism sectors with the services
sector accounting for more than 60% of the country’s Gross Domestic Product (GDP). Migration has
traditionally played a critical role in the Jamaican landscape, and as a result remittances from abroad
represent a key contributor to the country’s economic wellbeing as a source of support especially for
those in the lower socio-economic strata..
Jamaica’s labour force is estimated at 1.3 million with an unemployment rate of just under 10%. It is also
estimated that roughly 14.8% of the population is living below the poverty line (CIA World Fact book
2008).
1.0.2 Jamaica Tourism Profile: The Formal Sector
Jamaica is one of the most popular tourist destinations in the Caribbean Region. The World Travel and
Tourism Council in its 2008 Travel and Tourism Economic Research Report for Jamaica expected the
travel and tourism industry to generate 30.8% of the country’s Gross Domestic Product. The Council
further suggested that the contribution to GDP would increase to 36.2% by the year 2018. Jobs created
directly from the travel and tourism industry constituted approximately 8.2% of total employment in
2008. Direct and indirect employment in the industry accounted for 27.1% of total employment in 2008.
This percentage was expected to increase to 32.1% in 2018. The Ministry of Tourism (MOT) stated that
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presently there are 80,000 persons directly employed in the formal sector. There are hopes to increase this
figure by 58,000 over the next 10 years. 1
There are currently 1,183 active tourism entities in Jamaica. 2 There are 31 apartments, 111 attractions, 18
bike rentals, 84 car rentals, 148 guest houses, 171 hotels, 111 tour operators, 388 villas and 121 water
sport businesses.
Gross foreign exchange earnings in the island increased consistently for 10 years during the period 19902000. In 1990, earnings generated by tourists totalled US$740,000. By 2000, the island’s earnings were
US$1.3 million. Foreign exchange earnings dipped in 2001 to US$1.2 million (Figure 1). Consistent
recovery occurred during 2003 to 2007 with earnings amounting to US$1.9 million in the latter year.
Figure 1. Visitor Expenditure 1990-2007
Source: Annual Travel Statistics, Jamaica Tourist Board (JTB)
Stop-over tourists spent more per person than cruise tourists during the period 2000-2007. The very
nature of the stop-over tourist explains this occurrence as these tourists spend more time on the island.
The average length of stay in 2007 was 9.6 nights. (JTB 2009) The cruise passenger, on the other hand
visits a destination for a number of hours. During the period 2005-2007, average expenditure by both
types of tourists increased.
1
Jamaica Information Service, “Tourism Sector to Employ 58,000 More Workers Over 10 Years,” Caribseek News,
September 12, 2008, http://news.caribseek.com/Jamaica/article_69316.shtml (accessed October 9, 2008).
2
Jamaica Tourist Board, “Active Entity Statistics” 2008.
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Figure 2. Distribution of Expenditure between Stop-over and Cruise Tourists 2000-2007
Source: Annual Travel Statistics, Jamaica Tourist Board (JTB)
The Caribbean Tourism Organization statistics show that the period 1991-2000 was marked by a
consistent upward trend of tax revenue from tourism in Jamaica. In 1991, tax revenue to the government
totalled US$532, 200 million. At the end of 2000, the government earned US$1,977,900 million as seen
in the figure below.
Figure 3. Tax Revenue from Tourism 1991-2000
Source: Caribbean Tourism Organization (CTO)
Page- 17 -
In 2005, Jamaica had 1.5 million visitors to its shores up from 1.4 million in 2004. Since 2001, there has
been an upward trend with respect to the number of tourist arrivals to the island. By 2007, the island had
registered 1.7 million tourists (Figure 4).
Figure 4. Tourist Arrivals in Jamaica 1990-2007
Source: Jamaica Tourist Board 1990-2007 (JTB)
Cruise tourism is also an important market for this country. Cruise passengers who visited Jamaica in
1986 totalled 278,507 persons. The number of passengers ballooned in 2006 to 1,336,994. There was,
however, a notable decrease in the number of passengers to the country in 2007 by 157, 490 to total
1,179,504 (Figure 5).
Figure 5. Cruise Passenger Arrivals 1990-2007
Source: Caribbean Tourism Organization (CTO)
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Jamaica is one of eleven countries that has 70% and over of the share of total rooms in the region. The
number of rooms in Jamaica increased consistently from 1998-2007. The number of rooms increased
from 22,715 in 1998 to 27,580 in 2007 (Figure 6).
Figure 6. Number of Rooms in Jamaica 1990-2007
Source: Caribbean Tourism Organization (CTO) and Jamaica Tourist Board (JTB)
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Tourism on Jamaica’s North Coast
Tourism is concentrated in the major cities of the north coast such as, Negril, Montego Bay, Ocho Rios,
and Port Antonio. The majority of the active tourism entities are operational in those areas. There are 375
active entities in Montego Bay, 245 in Ocho Rios and 187 in Negril.3 Kingston - Jamaica’s capital city,
Mandeville and areas in the South Coast are also popular. Kingston comes in fourth on the list of active
entities with 110. 4
Employment in the accommodation sector mirrors the data on each city’s popularity as tourist hubs:
•
Montego Bay, Ocho Rios and Negril have been able to attract more stop-over tourists and
consequently have higher employment figures than Port Antonio.
•
The Montego Bay area overtook Ocho Rios with respect to the number of persons employed in
2000. The former city employed approximately 10,756 persons in 2000. In 2007, just over 11,000
people are employed in the area.
•
Employment in Ocho Rios ranged between 8,600 persons in 2001 to 9,979 in 2007.
•
Employment in Negril has been improving since 2001 - in 2001, 7,518 persons were employed in
the accommodation sector in Negril. This figure increased to 9,137 in 2007.
•
Port Antonio has the lowest employment figures of the four cities. The number of persons
employed in Port Antonio was at its lowest with 997 in 1996 and peaked at 1,244 in 1999. As of
2007, 1,162 persons are employed in the accommodation sector in Port Antonio.
3
4
Jamaica Tourist Board, “Active Entity Statistics” 2008.
Ibid.
Page- 20 -
Figure 7. Employment in the Accommodation Sector on the North Coast 1995-2007
Source: Annual Travel Statistics 2000-2007, Jamaica Tourist Board
With respect to tourist arrivals, the following is a summary of the data for the study area:
•
For the period 2000-2007, Montego Bay (also referred to as ‘MoBay’), has been a popular
location for stop-over tourists. Arrivals peaked at 481,775 in 2005.
•
In 2007, however, Ocho Rios (also referred to as ‘Ochi’), had a marginal improvement of
442,083 visitors over Montego Bay’s tally of 421,083. There were notable and consistent upward
increases in visitors to Ocho Rios from 2005 to 2007. The visitors to that hub ranged from
approximately 290,000 in 2005 to just over 440,000 in 2007.
•
Visitors to Negril increased during the period 2002 – 2006 with approximately 256,000 in the
former year and 350,000 in the latter. Port Antonio’s visitor totals during the period 2000-2007
have been relatively steady ranging from approximately 16,000 – 18,000 visitors per year. These
trends are captured in Figure 7 above.
Page- 21 -
Figure 8. Stop-over Tourists on the North Coast 2000-2007
Figure 9 illustrates the number of passengers to Ocho Rios and Montego Bay, two of the major ports on
the North Coast. Ocho Rios receives more cruise passengers and calls than Montego Bay. The disparity
with respect to passenger arrivals was as wide as 527,439 passengers in favour of Ocho Rios in 2000.
Montego Bay received 189,408 while Ocho Rios received 716,847 passengers. However, for both ports,
there have been fluctuations in arrivals during the period 1997-2007. Montego Bay had relatively steady
arrivals during the periods 1999-2002 and 2003-2005. Passenger arrivals at both ports fell during the year
2006-2007. Montego Bay registered 485,325 passengers in 2006 and 425,582 in 2007. Similarly, Ocho
Rios registered 840,923 in 2006 and 749,281 passengers in 2007.
Page- 22 -
Figure 9. Cruise Ship Passengers by Major Ports of Call 1997-2007
The aforementioned is supported by the number of cruise ship calls to the ports – as shown in Figure 10.
Ocho Rios appears to be the preferred port of call for cruise lines. The port received as much as 174 more
calls than Montego Bay in 2002. This gap closed to 108 in 2006. The decrease in the number of
passengers to both ports in 2007 mirrors the decrease in the number of calls to the ports in the same year.
Figure 10. Cruise Passengers by Cruise Calls by Major Ports 1997-2007
Page- 23 -
1.0.3 Jamaica Tourism Profile: The Informal Sector
The preceding discussion pointed to the formal aspects of the tourism industry in Jamaica the traditional
“sun, sea and sand” concept. There is, however, the other side of tourism in Jamaica - another aspect of
the industry that thrives economically but is not captured or explicitly referred to in formal tourism
document– the sex sector which has also been referred to as ‘sex tourism’.
This type of sector is outside of the purview of the formal economic environment hence the difficulty to
capture the extent to which this sector operates and generates income and engages in re-investment. To
date, research has been done, however, primarily in the areas of assessing the sexual practices of sex
workers and tourists, and gender and sexuality etc. (Russell (2006), and Kempadoo and Taitt (2006)). The
economic significance of this sector has been minutely addressed particularly in the Caribbean.
A representative of the Ministry of Health noted that a survey determined there are 852 active sex
workers at identified sex sites in Jamaica. The Ministry’s Monitoring and Evaluation Unit, however, says
that less conservative tally would be approximately 8000. The latter estimation was derived at the use of a
model developed by UNAIDS. These estimates exist alongside a formal tourism sector that directly
employs 80,000 persons. Further, most street sex workers ply their trade on average five days a week and
may make an income ranging from JA$8,000 to JA$12,000. Those who work in clubs may generate
incomes ranging from JA$10,000 to JA$20,000. The aforementioned income ranges vary substantially
according to locations and the numbers of nights the sex workers have worked.
Lim (1998) and Russell (2006) share some common conclusions, income is not only generated directly
but indirectly through redistribution in the form of remittances; income from this sector is used by some
of its participants as a means to compensate for the lack of access to public services such as social
security and to combat poverty and to care for families. In the Caribbean and in most countries of the
world, non-existent and ineffective laws to govern this sector and increasing profits are contributing
factors to its success.
Page- 24 -
1.1
The Dominican Republic Case
1.1.1 The Economic Profile
The Dominican Republic (DR) is the largest of the Caribbean territories, with a 2006 estimated Gross
Domestic Product (GDP) of over US$20 billion. In spite of a hurricane in 1998 and the collapse of one of
its major banks in 2003, the economic performance of this country continued to be strong over the last
four years, with GDP growing at an average of roughly 6.68%. The country, like many of those
throughout the region, is however beginning to feel the impact of the global economic crisis. This is
reflected in the significantly reduced growth rate in GDP of 3.8% in 2008. While the Agriculture sector
plays an important role in the economy of the DR, the services sector is its leading employer. The growth
of this sector is driven in large part by activities in tourism.
The World Travel Tourism Council’s (WTTC) 2008 report for the Dominican Republic indicated that
travel and tourism contributed 16.6% (US$ 7.3 million) to Gross Domestic Product (GDP) in 2008. There
is projected to be, however, a downward trend in the next ten years to 16.4%. Further, in 2008, 550,000
(14.4% of total employment) persons were employed directly and indirectly in the travel and tourism
sector. One in every 6.9 jobs is attributed to the sector. This however is expected to fall as well in the
future.
1.1.2 Dominican Republic Tourism Profile: The Formal Sector
The Dominican Republic is a major tourist destination particularly for stop-over tourists with the country
visited by 3.6 million travellers in 2005 5. The tourism product is also characterized by the all-inclusive
resort concept. Further, the Dominican Republic has positioned itself as a low-cost, high volume
destination. This has been achieved within a framework referred to as enclave resort development model.
Visitor expenditure displayed an upward trend for eight years between 1992 and 2000. In the early stages
of tourism in the Dominican Republic (in the 1990’s), visitors spent between US$900 million and US$1.7
billion. Like many islands in the Caribbean, there was a drop in expenditure in 2001. In subsequent years,
however, some recovery was made and by 2005, expenditure amounted to US$3.5 billion.
Popular tourist resort areas in the Dominican Republic span the north, east and south parts of the country.
They include Punta Cana and Higuey in the east; Puerto Plata in the north; and Boca Chica, Juan Dolio
5
Caribbean Tourism Organization.
Page- 25 -
and Santo Domingo to the south. Punta Cana and Puerto Plata are the most popular destinations. Both
destinations offer an all-inclusive, low-cost yet luxurious accommodation tourism product. Punta Cana
was developed in a previously uninhabited area by investors in the late 1980s and 1990s. Punta in the
1990s established itself as the premier tourist destination on the island. As can be seen in figure 11 below,
Punta Cana contains over 50% of all the rooms on the island, followed by Puerto Plata, Santo Domingo,
Juan Dolio and Boca Chica. In 2007, Punta Cana amassed 26,425 rooms. The remaining areas had less
than 5000 rooms each.
Figure 11. Number of Rooms in the Accommodation Sector by Location 1998-2007
Source: The National Association of Hotels and Restaurants (ASONAHORES).
The levels of employment in the tourist hubs also mirror the disaggregation of rooms. Punta Cana
generated the most employment in the accommodation sector. In 1998, Punta Cana matched its 12,000
rooms with 40,051 employees. By 2007, the number of rooms in Bavaro/Punta Cana had increased by
approximately 14,500 and the employees increased by 40,400 (Figure 12). Santo Domingo was ranked 3rd
with respect to the number of rooms but between 2002-2007 employment levels ranked 2nd followed by
Puerto Plata. Employment levels in the accommodation sector in all the locations, with the exception of
Bavaro/Punta Cana, ranged from 4,400 – 19,700 persons. Further, the ratio of employees to rooms ranged
from 2.4 to 1 and 4.2 to 1 during the period 1998-2007.
Page- 26 -
Figure12. Employment in Tourist Locations 1998-2007
Source: The National Association of Hotels and Restaurants (ASONAHORES).
The major ports of call are located in Puerto Plata, La Romana (south east), Samana, Manzanillo (north
west), Barahona (south west) and Santo Domingo. The latter includes ports in Boca Chica, Sans Souci
and Don Diego. Cruise passenger arrivals have been sporadic. The ports at Santo Domingo and La
Romana seem to be the more popular ports. During the period 1996-2000, Santo Domingo received the
largest number of arrivals despite substantial decreases in 1999 and 2000. Arrivals to the port peaked at
270,932 in 1998. In 2001, the La Romana port exceeded Santo Domingo with 103,346 arrivals. Increases
continued consistently to 2004 with 365,308 arrivals. Despite decreases in arrivals to the La Romana port,
it remains the most popular port for cruise passengers (Figure 13).
Page- 27 -
Figure 13. Cruise Ship Passengers by Major Ports of Call 1997-2007
Source: The Central Bank of Dominican Republic
1.1.3 Dominican Republic Tourism Profile: The Informal Sector
The Dominican Republic is considered the fourth largest exporter of commercial sex workers in the world
and therefore represents the most significant presence in the country’s informal sector. Through personal
communication with NGOs and other organizations, sex tourism was identified as an important sector in
the Dominican Republic. While a considerable proportion of the sex work industry interacts with the
foreign tourist, it is also acknowledged that a majority of the clients of DR sex workers are local men.
There are however a number of areas in the country that have over the years developed a reputation as
being popular spots for tourist to meet the local sex workers. The two main areas that are typically
mentioned are Boca Chica along the south coast and Sosua along the north coast.
A country progress report on HIV and AIDS produced by the Presidential Council on AIDS cited
interviews with over 2000 sex workers (COPRESIDA 2008). However, COIN, in 2005, has indicated
that a conservative estimation of Female Sex Workers (FSWs) in the Dominican Republic would be
72,000, while other estimates put this figure as high as 10,000 (Science 2006). It is estimated that sixty
percent (60%) of the FSWs work on the streets and 40% work in sex trade establishments such as discos,
liquor stores, brothels, rendezvous residences, erotic massage residences and at car washes.(COIN, 2008)
Page- 28 -
Figure 14 Map of the Dominican Republic
Sex tourism manifests itself in the Dominican Republic in the form of “all-inclusive adult vacation”.6 Sex
workers and their services are offered as part of the vacation package. Brothels, bars and discos are also
popular sex sites. 7 In some tourist hubs, the sex workers are employees in the all-inclusive resorts and
radio advertisements are posted on community stations which outline opportunities for persons to earn
money in tourist locations. 8 Foreign tourists were preferred by both male and female sex workers, as they
were inclined to pay more than local clients and treated the sex workers better. Local men have been
found to be abusive. A study conducted in Santo Domingo and Boca Chica revealed that 58% of the Male
Sex Workers (MSWs) interviewed preferred foreign tourists. 9 American male clients were particularly
preferred. Of the 107 MSWs interviewed, 36% of the clients were American; 16% were Puerto Rican and
14% were Italian. Regular partners were also mainly foreigners – 61%. MSWs are also more inclined to
service older clients because they were known to pay more and are a steadier source of income. Older
6
Adult vacations - DR Nights Exotic Resort, http://www.drnights.com/dominican-escorts.html (accessed June 30,
2008).
7
Sharon Haddock, “Policy Empowers: Condom Use Among Sex Workers in the Dominican Republic,”
http://www.populationaction.org/Publications/Research_Commentaries/Policy_Empowers/Policy_Empowers.pdf
(accessed November 17, 2008).
8
Personal communication with representative of the NGO, Centro de Orientación e Investigación Integral (COIN).
9
Mark Padilla, Caribbean Pleasure Industry: Tourism, Sexuality and AIDS in the Dominican Republic (Chicago:
University of Chicago, 2007), 31and 43.
Page- 29 -
clients were usually looking for steady and intimate relationships, and were also believed to have more
money than younger clients. 10
Additionally, foreign regular clients did not pay for sex only. They contributed to the acquisition of basic
needs, tuition payments, child support, vehicles etc. An important way in which the money is transferred
is in the form of remittances. Remittances are an important form of income for the Dominican Republic.
In 2001, remittances tripled the amount of the country’s agricultural exports.
Gay sex tourism is also a vital source of income to the Dominican Republic. Travel agencies specially
geared towards gay tourists (from the United States, other Latin American countries and Europe) provide
travel advice and packages. The MSWs who service other males are often referred to as “bugarrones” and
“sanky pankies.” The MSWs act as tour guides or interpreters. Their clients often include middle-aged
men who may be one-time tourists to the island or repeat visitors. Repeat visitors also include Dominican
homosexuals who live abroad. In Santo Domingo, the largest urban centre and the capital of the island,
encounters between clients and sex workers are facilitated through organized businesses and the internet.
Further, popular meeting places include bars and discos, hotels, beaches, parks and restaurants. There are
openly gay establishments in Santo Domingo which presents easy access for both parties. In smaller
tourist hubs such as Boca Chica, male sex workers would pose as pimps for female sex workers as a ploy
to ascertain to the sexual preferences of the potential client. In Boca Chica, the popular locations for
initial contact between parties are on beaches, bars and discos and restaurants.11 An interesting aspect to
gay sex tourism in the Dominican Republic is the notion of sexual culture – many of the MSWs identify
themselves as heterosexuals despite having sexual relations with men. 12
Another dimension of the sex tourism trade in the Dominican Republic is that of child prostitution. A
2001 study conducted by the International Labour Organization and its International Program for
Eradication of Child Labour (IPEC) showed that 21.2% of the children interviewed in the country, the
majority of the clients serviced by them were tourists.13 Further, COIN cites the findings of Cáceres,
Cairo, and De Moya (2001). They contend that commercial sexual exploitation of minors occur most
10
Ibid.
Ibid.
12
Ibid.
13
Sorensen, Bente, “ILO: Protecting children and adolescents against commercial sexual exploitation in Central
America, Panama and the Dominican Republic,” http://www.iin.oea.org/OIT-ing.PDF (accessed November 19,
2008).
11
Page- 30 -
frequently in the big cities of Santo Domingo and Santiago and in the tourist locales of Puerto Plata, La
Altagracia and La Romana.14
While sex tourism is not officially recognized in the DR, the industry is however varied and range from
the standard sex worker, to the male prostitutes ‘Sankie pankies’, to what is known as the “beeper chicas”
who cater to the more affluent Dominican clientele. The societal underpinnings with respect to sex work
in the DR however, set the country apart from the English-speaking Caribbean. Despite similar injustices
toward FSWs, MSMs are not harassed in the DR. Further, CSWs are more empowered through NGOs.
1.2
The Tobago Case
According to the 2000 CSO Population and Housing Census, Tobago, the sister isle of the twin island
republic of Trinidad and Tobago, has an estimated population of 54,084. This represents roughly 4% of
the country’s population. The last three censuses have shown a consistent increase in the population size
with the latest figures showing 50.5% female and 49.5% male. This is illustrated in the table below.
Male
Female
Total
1980
19, 607
19, 917
39, 524
Table 1
Population in Tobago by Gender
Population
% Total
1990
% Total
49.6
20, 666
47.2
50. 4
23, 105
52.8
100
43,771
100
2000
26, 768
27, 316
54,084
% Total
49.5
50.5
100
Source: CSO Population and Housing Census Reports 1980, 1990 and 2000
The only year for which Gross Domestic Product was made available for Tobago, 1997, puts the figure at
TT$850.2 millions. Tobago has a small, open economy highly dependent on the performance of the
services sector. This is reflected by the share of this sector’s accounting for 98.36% of the GDP in 1997.
The remaining 1.64% of the GDP was contributed by Domestic Agriculture (1.03%), Manufacturing
(.52%) and Petroleum Industries (.09%). In spite of the lack of published data on GDP for Tobago, one
can safely assume that growth in Tobago hinges in large part on the Services Sector.
14
Centro de Orientacion e Investigacion Intergral (COIN), “ Trabajo Sexual, Trata de Personas y VIH/SIDA:
Estudio Cualtivo sobre la situación de la mujer migrante en países del Caribe,” April 2008. Correct format
Page- 31 -
The 2008 Tobago Social and Economic Statistical Digest indicated that labour market conditions had
improved, with the 2007 unemployment rate being 4%, a significant decrease from the figures in the late
1980’s which averaged in the high twenties. From 1997 – 2007, Tobago’s unemployment rate has been
below 10% with the exception of 2001, during which time it increased to 12.5%. Employment as a
percentage of the labour force was a record high of 96% in 2007 as compared with 74% in 1987. The data
show that for the recorded period the island has experienced favourable levels of employment with the
lowest figure being 71% recorded in 1989.
Consistent with its employment trends, Tobago’s labour participation rate over the past two decades has
increased steadily; from 57.5% in 1987 to 71.2% in 2007. During the period 1987 – 2007, the male’s
participation rate has been consistently higher than the females however as the years progressed and the
females’ participation rate increased and the percentage gap between the sexes decreased drastically; from
a 34.2 % gap in 1987 to an 8.6% gap in 2007. This may be attributed to the increased investment in the
tourist sector.
From 1993 – 2007, the industrial sectors which dominated the job market were; Community, Social and
Personal Services, Construction and Wholesale and Retail Trade Restaurants and Hotels, in 2007, the job
concentration in these areas were 36%, 24% and 21% share respectively. Elementary Occupations was the
occupational group which has consistently had the majority of workers with 34% in 2007; however in all
occupations the general trend has been positive with a steady improvement in numbers in each successive
year during the period.
Page- 32 -
1.2.2
Tobago Tourism Profile: The formal Sector
Figure 15 Map of Tobago
Tourism is central to Tobago’s economy; this can be seen by the statistics on the number of arrivals to the
island. In 1992, domestic passenger arrivals by air alone was 183,951, this fell by 29% in 1993 and took
four years to reach and surpass its 1992 figures. In 1997, passenger arrivals to the sister island was 187,
785 and by 2006 it had reached to 308, 849, a 68% increase since 1992 in domestic travel.
International visitors to the sister Isle averaged 70,677 arrivals peaking at 86,466 in 2005, as shown in
Figure 16 below. For 2007 the number of arrivals numbered 66, 266 compared with 23,111 in 1992, a
187% increase. International arrivals to Tobago is dominated by persons from the United Kingdom which
accounts for roughly one half of the total arrivals to this destination, followed by Other European
travellers and travellers from the United States of America, accounting for between 14 and 20 percent of
total international arrivals respectively. In terms of room capacity, figure 17 below illustrates an upward
trend from the period 1997 to 2003. Despite this favourable outlook, events of the last two years have
seen a marked reduction in this trend, with an estimated 30 percent drop in occupancy rate recorded
across most hotels in Tobago between December and April, according to the Head of the Tobago
Hoteliers Association.
Page- 33 -
Figure 16
International Visitor Arrivals to Tobago
1992 – 2007
Source: Tobago Social & Economic Digest 1980 – 2008
Figure 17
Room Capacity at Tobago Hotels
1997 - 2003
Source: Tobago Social & Economic Digest 1980 - 2008
Page- 34 -
1.2.3
Tobago Tourism Profile: The Informal Sector
The Commercial Sex trade, while not as well defined or as large as in Jamaica or the Dominican
Republic, is present in the Tobago landscape and has been for some time. During the 1980’s and 1990’s it
is reported that commercial sex work was very prevalent with the CSW intermingling with the tourists in
bars and night clubs. During this time there were a lot more international flights to the sister Isle and this
provided the clientele to fuel the demand in the commercial sex industry at that time. This is captured in
the statement by one past male CSW:
You would find CSWs flocking to the airport or port to have ‘your pick’ for the next 2
weeks or so when the tourists would be on the island. During this time also it had ‘a lot
of the repeaters’ visiting the island who would have preferences in the CSW
community.
Key Informant
This trend gave rise to inter-racial relationships on the island and it became common to see a black man
with a white female tourist or vice versa. Some of the local CSWs are even known to have given birth to
mixed race children. Some of the female sex workers developed long term relationships with these
tourists and even got married and emigrated with their partners. During this time more European tourists
were involved in the sex trade.
With the upsurge in the number of persons diagnosed with HIV, there was an increase in AIDS related
deaths among commercial sex workers. This resulted in a significant reduction in activity in this sector on
one hand, and a more cautious approach adopted by those who continued to ply their trade in commercial
sex on the other hand.
Many of the female CSWs are said to come from the south of Tobago. For the beach boys or beach bum,
the Store Bay and Pigeon Point areas are where these commercial sex workers ply their trade and lure
tourists. With respect to facilities, guest houses and small establishments are more likely to facilitate this
type of activity because of their 'rent an hour’ policy as opposed to the larger establishments where rooms
are rented per night and are therefore much more expensive.
Page- 35 -
1.3
The St. Lucia Case
St Lucia is a member of the Organisation of Eastern Caribbean States (OECS) and is among the smaller
islands of the Caribbean in terms of its land mass with a total land area of 616 sq km and a population of
approximately 170,649 people. The St. Lucian economy depends largely on its tourism and agricultural
sectors for its economic survival. According to the International Monetary Fund (2008), St. Lucia’s
estimated GDP (current prices) is over US$1.025 billion and its GDP per capita is just over US$6,000. St.
Lucia has an estimated labour force of 79,695 workers and an unemployment rate estimated at roughly
21% (World Bank). According to the World Travel and Tourism Council (WTTC) approximately 28,769
persons of St. Lucia’s labour force is employed in the tourism sector representing over one third of the
total labour force. The growth of the tourism sector in St. Lucia continues to show an upward trend
despite a noticeable fall in tourist arrivals from 996,160 persons in 2005 to 793,670 persons in 2006.
Page- 36 -
1.3.2 St. Lucia Tourism Profile: The Formal Sector
Figure 18 Map of St. Lucia
The tourism sector in St. Lucia continues to play a significant role in the economy in terms of its
contribution to GDP and the generation of employment. According to statistics from the World Travel
and Tourism Council [WTTC] (2008), the travel and tourism sector in St. Lucia is expected to contribute
42.1% of GDP by the year 2019. Information from this same source also revealed that 12,955 persons are
employed directly in the tourism sector while 15,814 benefits indirectly from tourism. Exports services in
the island has also increased significantly for the period, from US$150.6million in 1990 to US$295.5
million in 2007 (WTTC 2008).
Employment in the tourism sector in St. Lucia has generally increased over the period from 21, 522
workers in 1990 to 28,595 workers in 2007 (Figure 19). There was a fall in employment in the tourism
sector in the post-2001 period, however tourism recovered and employment peaked in 2005 at 34,550
workers. Furthermore, employment in the travel and tourism sector is expected to increase from 37.1% of
total employment in 2009 to 42.2% of total employment by 2019 (WTTC 2009).
Page- 37 -
Figure 19. Employment in the Tourism Sector 1990-2007
Employment in the Tourism Sector
36
No.of Persons (000's)
34
32
30
28
26
24
22
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
Ye ar
Source: World Travel and Tourism Council (WTTC)
The World Travel and Tourism Council (WTTC) statistics reveals that the total international visitors 15 in
St. Lucia increased over the period from 248,429 passengers in 1990 to 905,000 in 2007 (Figure 20),
which is almost four times the islands population of 168,000 people.
15
Total international visitors consist of tourists, cruise passengers, same-day visitors and stop-over visitors.
Page- 38 -
Figure 20 Total Passenger Arrivals (000’s) 1990-2007
No. of Persons (000's)
Total Passenger Arrivals (000s) 1990-2007
1000
800
600
400
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
200
Year
Figure 21. Stop-over Tourists arrivals (000’s) (1990-2007)
Stop-over Tourists Arrivals (000s) 1990-2007
350
300
250
200
150
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
100
Year
The number of stop-over tourist’s arrivals to the island has also increased over the period 1990 - 2007,
from an estimated 141,000 arrivals in 1990 to 287,000 arrivals in 2007. Stop-over tourist’s arrivals in St.
Lucia peaked at 318,000 in 2005, but have witnessed a decline from 2006 (Figure 21).
Page- 39 -
Figure 22. Total Visitor Expenditure (EC$M)
Total Visitor Expenditure (EC$M)
1000
EC$M
900
800
700
600
500
2001
2002
2003
2004
2005
2006
2007
Year
Source: Caribbean Tourism Organization (CTO): Tourist Board, Saint Lucia
Cruise tourism is an important component of the St. Lucian tourism product. Specifically cruise passenger
arrivals to St. Lucia have exploded from 41.7% (103,766 persons) of total international arrivals in 1990 to
67.4% (610,000 persons) of total international arrivals in 2007 (see Figure 23 below). There was a
persistent upward trend in cruise arrivals to St. Lucia, however there are two notable declines in cruise
arrivals into the country, which are the periods 2001-2002 and the period 2005-2006. Despite this minor
slowdown in cruise passenger arrivals, cruise tourism is a growing industry in St. Lucia and is becoming
an essential element of St. Lucia’s tourism product.
Page- 40 -
Cruise Passenger Arrivals (000s) 1990-2007
700.00
600.00
500.00
400.00
300.00
200.00
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
100.00
Year
Total visitor expenditure in St. Lucia increased from EC$629.05 million in 2001 to EC$857.14 million in
2007. Visitor expenditure increased consistently from 2002 to 2005 where it peaked at EC$996.160
million. After 2005, however, St. Lucia experienced a fall in its tourist’s expenditures to EC$ 793.67
million in 2006, although by 2007 there was a marginal increase (Figure 22).
Page- 41 -
Figure 24. Number of Rooms in Tourists Accommodations 1998-2007
Number of Rooms in Tourist Accommodations 1998-2007
6000
5176
No. of Rooms
5000
4000
3769
4125
4,525
4,525
4511
3,711
3,749
3,974
2002
2003
2004
4889
3000
2000
1000
0
1998
1999
2000
2001
2005
2006
2007
Years
Source: Caribbean Tourism Organization
1.3.3 St. Lucia Tourism Profile: The Informal Sector
The previous section discussed the formal sector in St. Lucia’s tourism industry, the main attraction of
visitors to this sector is the natural beauty16 of the island, such as, its rainforest, mountains, waterfalls etc.
There also exists an informal tourism sector in St. Lucia which is driven partly by its commercial sex
industry (sex tourism). The commercial sex industry in St. Lucia from key informant interviews and
stakeholder information appears to be a thriving industry; however, it is largely unstudied and
unmeasured. The Bureau of Democracy, Human Rights, and Labour (2006) noted that;
“The country (St. Lucia) has a growing sex tourism industry with a number of strip
clubs and brothels, many of which are staffed by women from the Dominican Republic
and other Caribbean islands”.
To date, very limited information is available on the prevalence and sexual practices of sex workers and
tourists in the St. Lucian economy. In 2007 the PLACE Study 17 was conducted by
MEASURE
Evaluation and USAID, in the areas of Castries, the island’s capital, as well as Anse la Raye and Gros
16
St. Lucia Simply Beautiful- The Original Official Site of the St. Lucia Tourist Board http://www.geographia.com/stlucia/lceco01.htm
17
The Priorities for Local AIDS Control Efforts (PLACE) method is a monitoring tool to identify areas likely to
have higher incidence of HIV/AIDS infection
Page- 42 -
Islet, all very popular for social activity with active tourism, street parties and night clubs. In this study,
out of a sample of 541 men, 5.5% indicated that they received money in exchange for sex, while 1.5% of
the 322 women indicated the same. This percentage must however be considered within the context of a
general reluctance to address this area due to the social stigma faced by commercial sex workers. There is
therefore likely to be a significant under-reporting factor in this statistic (Measure Evaluation, 2007).
The income earned by commercial sex workers varies significantly; the type of sex worker, sexual
preference and willingness to take risk all influence the final price. This price ranges from EC$300 –
EC$700 for MSM, for commercial sex workers (CSW) it starts at EC$500 and goes up to EC$2000 per
night. Foreign CSWs are known to make as much as US$1,000 per day, their clientele are almost
exclusively the wealthy foreign tourist who come in via yachts and rendezvous on the local Marina. Also
located on the higher end of the spectrum are the part time CSWs. These are typically women who are
employed in the formal sector, but would engage in commercial sex in order to earn extra income as a
means of maintaining their lifestyle.
Page- 43 -
1.4
The Barbados Case
1.4.1 Economic Profile
Barbados is an upper-middle-income country that is endowed with fish and quarries as well as small
levels of petroleum, natural gas. The economy is based largely on its tourism industry as well as offshore
banking and financial services.
Barbados, like many other CARICOM countries is highly dependent on its export sectors as indicated by
its high export to GDP ratio (Barbados export ratio increased from 49.10% in 1990 to 58.44% in 2005. Its
GDP is estimated to be US$3.409 billion with a GDP per capita of US$12,404.39 and a GDP growth rate
of 3.8% in 2006 (IMF 2007). The tourism sector’s contribution to the GDP stood at 39% in 2008 and is
projected to increase to 40.6% in 2019 (World Travel and Tourism Council (WTTC), 2009).
Barbados’s population is approximately 293,942 persons (World Bank 2007), and it has a labor force
estimated at 174,978 workers, while the island’s unemployment rate in 2006 stood at 9.76%.
Page- 44 -
1.4.2 Barbados Tourism Profile: The Formal Sector
Figure 25 Map of Barbados
The major attractions for tourists to the formal tourism sector in Barbados are its natural beauty, beaches
and resorts 18. The total number of visitor arrivals to Barbados has increased from 906,027 in 1990 to
1,122,770 arrivals in 2007 and peaked at 1,273,000 in 2004 (Figure 26). For the period 1992 to 1998 there
was a consistent increase in passenger arrivals, after which there were fluctuations in total visitor arrivals.
Total visitor arrivals decreased by 13.4% from 2004 to 2006, with a marginal increase from 2006 to 2007.
Total tourist arrivals are comprised of cruise passenger arrivals, stop-over arrivals, and overnight visitors.
The majority of tourist arrivals to Barbados are from United States and the United Kingdom (in 2006,
approximately 23.2% of tourist arrivals were from the United States while 37.6% were from the United
Kingdom (Caribbean Tourism Organization, 2008).
18
Barbados major tourism attractions- http://www.planetware.com/tourist-attractions/barbados-bar.htm
Page- 45 -
Figure 26 Total Passenger Arrivals (000’s) 1990-2007
Total Passenger Arrivals (000’s) 1990-2007
1300.00
1250.00
No. of Persons
1200.00
1150.00
1100.00
1050.00
1000.00
950.00
900.00
850.00
800.00
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Year
The total number of cruise passenger arrivals to Barbados was 547,948 persons in 2007. This represents
an increase by 15.6% from 1990. There was a general upward trend in cruise passenger arrivals to
Barbados with cruise passenger arrivals increasing from 422,455 in 1992 to 518,000 in 1997. From 1997
onwards cruise passenger arrivals to Barbados fluctuated and peaked at 721,000 in 2004 (Figure 27). Like
most of its Caribbean neighbours, cruise passenger arrivals form an integral part of the tourism industry in
this economy accounting for 48.8% of total international visitors in 2007.
Page- 46 -
Cruise Passenger Arrivals (000's) 1990-2007
750.00
No. of Persons
700.00
650.00
600.00
550.00
500.00
450.00
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
400.00
Year
Figure 28. Stop-over Tourists Arrivals (000’s) (1990-2007)
Stop-over Tourists arrivals (000’s) (1990-2007)
600.00
No. of Persons
550.00
500.00
450.00
400.00
350.00
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Year
Page- 47 -
Stop-over tourist’s arrivals increased from 432,000 in 1990 to 574,823 in 2007, an increase of 33% as
shown in figure 28 above. The number of stop-over arrivals grew consistently from 385,000 in 1992 to
545,000 in 2000, after which stop-over arrivals declined to 498,000 in 2002, since then stop-over tourists
arrivals increased consistently and peaked at 574,000 in 2007.
Figure 29. Employment in the Tourism Sector 1990-2007
Employment in the Tourism Sector (000's) 1990-2007
No. of Persons
70
65
60
55
50
45
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
40
Year
The level of employment in the tourism sector increased from 51,949 workers in 1990 to 63,677 workers
in 2007 and peaked at 67,906 in 2005, after which there was a decline in employment in the tourism
sector, as seen in figure 29 above. Approximately 28,675 are employed directly in the tourism industry
while 35,002 are employed indirectly. Employment in this sector is projected to increase from 43.7% of
total employment in 2009 to 46.2% of total employment by the year 2019 (WTTC).
Page- 48 -
Figure 30. Number of Rooms in Tourists Accommodations 1998-2007
Number of Rooms in Tourists Accommodations 1998-2007
8000
No. of Rooms
7000
6000
6456
5752
5643
1998
1999
6781
6,742
6,210
5945
2003
2004
6353
5,945
6,353
5000
4000
3000
2000
1000
0
2000
2001
2002
2005
2006
2007
Year
Source: Caribbean Tourism Organisation
Tourists accommodations in Barbados comprises mainly of hotels, apartment hotels, guesthouses and
apartments and cottages. The number of rooms in tourist accommodations in Barbados increased from
5,752 in 1998 to 6,353 in 2007.
1.4.3 Barbados Tourism Profile: The Informal Sector
The commercial sex industry in Barbados also plays a significant role in attracting tourist to the island,
however, this sector’s contribution of to the economy is largely unmeasured. The growth in the tourism
sector in Barbados over the years has created a steady and increasing demand for the services of sex
workers. Some of the activities that these sex workers engage in are erotic dancing, sex for money and
other related activities. The sex tourism industry in Barbados as is the case in the wider Caribbean is
largely driven by the economic and social conditions of sex workers; most sex workers in Barbados are
unemployed and have very little education and they usually belong to the age group 18-35 years. The
commercial sex industry in Barbados consists of both male and female sex workers, the male sex workers
are also known as “beach boys” and they are strategically located at major ports of entry to attract mostly
white female tourists. According to Phillips (1999):
“Beach hustlers are young, underemployed black men who provide sexual services
and act as escorts to white female tourists of varying age in exchange for economic
goods and services, which range from brand name clothes to airline tickets. Although
these liaison might start off as “sex for money” in the one extreme, if continued,
emotional attachments are formed and the relationship is extended over a period of
time, sometimes resulting in marriage”.
Page- 49 -
There is very limited information available on the prevalence of female sex workers on the island, but
casual observation reveals that they also play a central role in attracting tourist arrivals.
From the review of the economies of the five case countries certain areas of commonality can be
highlighted; firstly the countries covered all represent economies that are characterized by a dominant
Tourism industry, the extent of this varies across the territories. Secondly, side by side with the formal
Tourism sector, there exist an informal, and in some cases, underground, industry. These industries are
driven by commercial sex work, catering to the needs of the foreign clientele as well as locals who are
willing to pay for services. In the sections to follow we will address the HIV/AIDS situation in these case
countries as well as the link between the epidemic and the activities of the informal sex industry on these
countries.
Page- 50 -
Chapter 2:
2.0
HIV/AIDS – A Profile of the Epidemic
A Summary profile of HIV/AIDS among Case Study Countries
2.0.1 HIV/AIDS in Jamaica: An Overview
The 2008 UNGASS report of the National HIV Program in Jamaica 19 noted that at the end of 2006, the
cumulative number of persons reported with AIDS in Jamaica was 11,739 and the cumulative number of
AIDS deaths was 6,673. The adult prevalence rate as at 2007 was measured at 1.6% and, based on
UNAIDS estimates, the number of persons living with HIV increased from 3,600 in 1990 to 27,000 by
the year 2007 as illustrated in figure 33 below,(UNAIDS/WHO, July 2008). The epidemiological profile
of the epidemic is quite standard and resembles that of most Caribbean territories; it is estimated that 65%
of all reported HIV/AIDS cases in Jamaica are largely in the labour force (20-44 year old age group).
Additionally, women continue to be increasingly affected, with the adult male: female ratio declining
from 2.6:1 in 1988 to between 1.2 to 1.3: up to 2007, (Ministry of Health, Jamaica, 2008). Also, the
number of newly reported HIV/AIDS cases in young girls in the 15-24 year old age group was two times
higher than that of boys of the same age group in 2006. (UNGASS, 2006). The data for 2005 also
revealed that adolescent females in the 10 to 19 year old age group had three-times-higher risk of HIV
infection than boys of the same age group. These findings have been linked to the high rate of sexual
intercourse with HIV-infected older men.
Among reported HIV/AIDS cases on who risk data are available (73% of cases), the main risk factors
fuelling the epidemic are multiple sex partners, history of STDs, crack/cocaine use, and sex with
commercial sex workers.
19
http://data.unaids.org/pub/Report/2008/jamaica_2008_country_progress_report_en.pdf
Page- 51 -
Figure 31
Jamaica AIDS Cases and Deaths (1982 to 2006)
Source: Caribbean Epidemiology Centre
Figure 32. Jamaica
Source: UNAIDS/WHO, 2008
Page- 52 -
Figure 33. Jamaica
Page- 53 -
2.0.2 HIV/AIDS in the Dominican Republic: An Overview
The number of persons living with HIV/AIDS in the Dominican Republic is estimated to have increased
from 21,000 in 1990 to 62,000 in 2007 (UNAIDS, 2008). The adult prevalence rate is estimated to have
remained at 1.1% since 2004 since reaching a high of 1.3 in 1996 as shown in the figures below. Like
many countries in the, region the epidemic in the DR is heterosexually driven, accounting for over 80% of
infections (USAID, 2008). As in the case of Jamaica, younger females are also reported to be a greater
risk of contracting HIV than their male counterparts; according to UNAIDS, females under 24 years of
age are twice as likely to contract HIV as males in the DR; this is again due to younger women having
relationships with older men. Multiple partnering, men who have sex with men (MSM) and the activity of
sex workers were also identified as the key factors that continue to drive the epidemic in the DR.
Figure 34 Dominican Republic
Page- 54 -
Figure 35 Dominican Republic
Page- 55 -
2.0.3 HIV/AIDS in the Tobago: An Overview
The first AIDS cases were reported in Trinidad and Tobago in 1983 among homosexual men. At the end
of third quarter of 2008 (September), the National Surveillance Unit reported that the cumulative number
of HIV positive cases stood at 19,793, with 6,020 AIDS cases and 3,693 deaths due to AIDS ( See Table
2 below).
Table 2
HIV/AIDS Morbidity and Mortality Summary
For Trinidad and Tobago
2006-2007
Cases
2005
2006
2007
2008(September) Cumulative Total
New
HIV 1,436
positive*
1,425
1,348
1047
1983-2008***
19793
HIV Non- 1,288
AIDS**
1,334
1,300
1032
13994
AIDS
217
194
104
39
6020
Deaths
101
113
86
38
3,693
*Total New HIV Laboratory confirmed cases from TPHL/CAREC
** Includes HIV asymptomatic and symptomatic (Non-AIDS cases)
*** Data inclusive of September 2008
Source: National Surveillance Unit (Report 2008)
Forty-five percent of all new HIV cases occur in females, while 70% of new infections among 15 – 24
year olds occur in women in Trinidad and Tobago. The prevalence rate in Trinidad and Tobago
(approximately 2.25%) is significantly higher than the overall world rate of 1.0% and the United States
rate of 0.6%. There has however been a marked decline in the number of new HIV cases (reported) as
well as both AIDS cases and deaths over the last five years.
Page- 56 -
Figure 36
Tobago - New HIV Cases by Gender 2003-2007
900
800
700
600
500
400
300
200
100
0
2003
2004
Male
2005
Female
2006
2007
No Gender Reported
Source: Ministry of Health, National Surveillance Unit
Figure 37
Tobago -Total AIDS Cases by Gender 2003-2007
250
200
150
100
50
0
2003
2004
Male
2005
Female
2006
2007
No Gender Reported
Page- 57 -
Figure 38
Tobago -Total AIDS Death by Gender 2003-2007
120
100
80
60
40
20
0
2003
2004
Male
2005
Female
2006
2007
No Gender Reported
Figure 39
Reported Number of HIV/AIDS Cases & Deaths in Tobago
1999-2008
Page- 58 -
As it relates to Tobago, the prevalence rate is estimated to be significantly higher than the reported rate of
the country as a whole. Tobago’s HIV rate is estimated to be over 5%; which represents an almost
doubling of the rate reported for the country as a whole. As illustrated in figure 39 above, HIV cases,
while fluctuating significantly over the period 1999 to 2007 has followed a gradually increasing trend,
while both the number of AIDS cases and AIDS related deaths have recorded, however, decreased over
the last decade. This reduction is in no small measure due to the increased access to antiretroviral drugs
by PLHIV. In Tobago as illustrated in the Table below the treatment programme achieved coverage rates
averaging 93% of the patients on care.
Table 3
HIV/AIDS Treatment Data April 2002 – December 31, 2008
Institution
HIV/AIDS
HIV/AIDS
% HIV/AIDS
Patients in Care Patients on ART Patients on
ART
Tobago Health
Adults
344
320
93.0
Promotion Clinic*
Tobago Hospital
Children
17
16
94.1
Total
361
336
93.1
* THPC – 2003-8: Deaths and Loss to Follow up 59. – Awaiting Data
Page- 59 -
2.0.4 A Summary profile of HIV/AIDS in St. Lucia: An Overview
The prevalence of HIV/AIDS in St. Lucia is among the lowest in the Caribbean, as according to the
United Nations Generally Assembly Special Session on HIV/AIDS (UNGASS, 2006) report, the
prevalence of HIV/AIDS in St. Lucia is estimated at 0.12%. HIV/AIDS was first reported in 1985 on the
island and since then there has been a steady increase in reported HIV cases, AIDS cases and AIDS
deaths. Specifically, the number of reported HIV cases increased from 14 in 1985 to 62 in 2007 (Figure
40), while the number of AIDS cases increased from 4 in 1985 to 26 in 2005. The number of people that
have died from AIDS also increased from 3 in 1985 and peaked at 41 in 2002. Since then , there has been
a steady decline in AIDS deaths, reaching 8 in 2007 (Figure 41). The age group (25-34 years) accounts
for approximately 32.5% of all infections, of which men accounts for 31%, while women in the same age
group accounts for 34% of infections (UNGASS 2006).
The UNGASS (2008) report for St. Lucia also noted that 25% of all reported cases stem from
heterosexual transmission while the mode of transmission for 55% of cumulative HIV cases is unknown.
The report further suggested that men having sex with men and bi-sexual men also play a significant role
in the spread of the disease.
Page- 60 -
Figure 40 Reported HIV cases 1990-2007
Reported HIV Cases 1990-2007
90
77
No. of Persons
80
70
62
60
52
50
43
35
40
30
20
10
15
9
18
21
13
30
40
45
41
30
23
19
17
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
0
Year
HIV Cases
Sources: Caribbean Epidemiology Centre (CAREC)
Figure 41. Reported AIDS Cases and AIDS Deaths 1990-2005
Reported AIDS Cases and AIDS Deaths 1990-2005
No. of Persons
50
40
30
20
10
0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Year
AIDS Cases
AIDS Deaths
Sources: Caribbean Epidemiology Centre (CAREC)
Page- 61 -
2.0.5 HIV/AIDS in Barbados: An Overview
The first AIDS case in Barbados was reported in 1984, and since then like most other Caribbean
countries, Barbados has experienced a significant increase in its HIV and AIDS cases. The number of
reported AIDS cases in Barbados in 1984 was 2, by 1990 the number of cumulative AIDS was 172 and
by 2007 this had increased to 2,078. There was also a similar trend in reported HIV cases, which
increased from 2 in 1984 to 163 in 2007 and peaked at 190 in 2004. By June 2006, a total of 3,381cases
of HIV and 1,314 AIDS-related deaths had been reported according to the Ministry of Health. Between
2001 and 2006 however, the number of annual AIDS cases and deaths declined by 46% and 85%
respectively. This was attributed to inroads in the treatment programme as well as interventions in
prevention programmes.
HIV/AIDS poses a serious problem for the Barbados economy since AIDS has been the leading cause of
death in the age group 15-49 years, which is the most economically productive population (UNGASS,
2008). UNGASS (2008) also stated that the majority of HIV infections occur through heterosexual
transmissions with the most at risk populations being the youth, men having sex with men, and sex
workers. The adult prevalence rate was estimated to be 0.5% in 1990 and increased to 1.2% in 2007 as
shown in the figures below.
Page- 62 -
Figure 42
Barbados
HIV and AIDS Cases and AIDS Deaths 1982 - 2007
Source: Caribbean Epidemiology Centre
Figure 43
Barbados
Page- 63 -
Figure 44 Barbados
Page- 64 -
2.1
HIV/AIDS Risk in the Commercial Sex Industry
2.1.1 Jamaica
In 2006, about 25% of persons living with HIV/AIDS reported ‘sex with prostitutes’ as one of their risk
factors (Ministry of Health, Jamaica, 2008). The results of a survey of four hundred and fifty (450) sex
workers showed that condom use with clients≥( 80%) was significantly higher than condom use with
non-paying partners (52%). While knowledge about ways to prevent HIV/AIDS transmission was high,
rejection of myths was low among SW, as in the general population. Ninety-seven percent of SW reported
having easy access to condoms (accessible within 5 minutes). HIV prevalence was found to be 9% in this
population. The sample included primarily street-based SWs, who are more likely to be HIV infected.
2.1.2 The Dominican Republic
In 2004, the HIV prevalence among sex workers in Puerto Plata was 3.94%; La Romana - 2.54%; and
Santo Domingo – 3.36%. In 2006, however, HIV prevalence declined sharply to 2.9% among this
population. 20In the Dominican Republic commercial sex work is effectively legal as there is no law which
proscribes it 21. Further, no one is prosecuted for engaging in the activity. Some stakeholders acknowledge
that the spread of HIV/AIDS can be facilitated by sex tourism, however, the impact on the tourism
product may be limited due to the low national prevalence of HIV/AIDS on the island and the significant
strides made in the area of awareness and prevention. In the 1990s, the incidence of HIV among sex
workers in tourist zones ranged from 7%-10%. 22 A more recent sentinel surveillance survey in 2006
reported the HIV prevalence for this group at between 2.4% and 6.5%.
The impact of HIV/AIDS on the tourism product will be felt through CSWs and MSMs. These population
groups overlap and are both connected to the tourism industry, either directly or indirectly. Strides have
been made, however, with respect to the change in attitudes to HIV/AIDS prevention initiatives by the
church and educational institutions.
20
Ibid.
Sharon Haddock, “Policy Empowers: Condom Use among Sex Workers in the Dominican Republic,”
http://www.populationaction.org/Publications/Research_Commentaries/Policy_Empowers/Policy_Empowers.pdf
22
Centro de Orientación e Investigación Integral (COIN), “Trabajo Sexual, Trata de Personas y VIH/SIDA: Estudio
Cultivó sobre la situación de la mujer migrante en países del Caribe,” April 2008.
21
Page- 65 -
2.1.3 Tobago
Sex tourism is usually interpreted as not accompanied by safe sexual practices resulting in an increased
risk of sexually transmitted infections (STIs), including HIV. In 1995 a Swiss visitor named Simonetta
(Simona) was deported from Trinidad and Tobago after she made public that she was HIV positive and
had unprotected sex with several locals while in Tobago. A number of the men with whom she had sexual
intercourse who did not get tested eventually fell victim to the epidemic. With the spread in HIV, some
CSW were ultimately affected as captured by this key informant.
After the epidemic and the death of quite a number of those employed in the sex
trade, there was somewhat of a ‘slacking off’ where people were more cautious.
Commercial sex work still exists today but on a ‘low key’. The ‘beach bum’ case still
exist (men and women) and is very
open at Store Bay
Key Informant
The CSWs who ply their trade along the beaches (beach bum) usually conduct business under the pretext
of a more legitimate service to the tourist. Through key informant interviews with a number of these
CSWs it was revealed that their clients are usually on the beach or among those who are taken on tours on
the island’s reef. Less popular meeting sites are at parties and at bars. Condom use among this group is
not consistent as many of the CSWs claim to not like using them. Sex usually takes place on the beach, in
smaller guest houses, or on their boats. Unlike the more organized CSWs, testing for HIV is not seen as a
priority among this group. Those who had tested at some time in the past were not interested in doing so
presently, while those who had never been tested were not very interest in doing so. The rewards from the
trade were varied as captured by one of the CSWs:
We get money. We get meals, and sometimes get to travel. They buy things for us
like clothes, shoes, chains etc. Some of these things I never see or get in my life
before. We think this is good, because we can’t get this kind of stuff from our own
people here in Tobago
Key informant
Page- 66 -
2.1.4 St Lucia
Information on the prevalence of HIV and the use of condoms among sex workers in St. Lucia are not
available; however because of the growing sex tourism industry it increases the risk of HIV transmission
among sex workers and tourists. There also exists the commercial sexual exploitation of children in St.
Lucia; this increases the risk of HIV transmission among the youth. Statistics revealed that approximately
26% of young men and women (15-24 years) had sexual intercourse before the age of 15 years (UNGASS
2008). Furthermore, a study conducted by Population Services International (PSI) in the Eastern
Caribbean region revealed that many commercial sex workers in the Eastern Caribbean of which St. Lucia
is a member do not practice safe sex and are “anxious” for information on measures to protect themselves
against HIV/AIDS and other Sexually Transmitted Diseases (STD’s). The report also highlighted that
HIV/AIDS is of “top concern” among commercial sex workers in the Eastern Caribbean, as illustrated by
the sentiments of a commercial sex worker interviewed by PSI’s /Earle Phillip:
“Getting AIDS is the biggest fear…I know women that have sex with men [without
condoms] for extra money but as far as I’m concerned, no rubber, no flubber, no
extra money is worth my life…not even a million dollars”.
In discussions with CSWs and NGOs who work closely with this group, it was mentioned that Female
Sex workers, in particular, were conscious of the need to use condoms consistently and were inclined to
so do. The FSWs were also concerned with their general health, particularly those who worked in more
structured settings and arrangements such as the clubs, etc. These women were known to have regular
medical checks, not only for HIV, but for other STIs, including pap smears. In interviews with them they
were quick to identify the importance of keeping their bodies healthy so as to not jeopardize their income
flow. This more health conscious practice is however less likely to be adhered to among the younger
FSWs and the men who have sex with men (MSMs). This is also less likely to be the case with the CSWs
who work the streets and those who are likely to be drug addicts.
Page- 67 -
2.1.5 Barbados
Sex workers in the commercial sex industry in Barbados as in other countries are at a higher risk of
getting HIV/AIDS as they engage in risky sexual practices. The UNGASS (2008) report revealed that
approximately 73% of a sample of 30 female sex workers in Barbados under the age of 25 years uses
condoms consistently, while 86.7% of those over the age of 25 years consistently use condoms.
Information from the same sample of commercial sex workers indicate that 40% of female sex workers
were knowledgeable about the ways of preventing the sexual transmission HIV.
Furthermore, 80% of female sex workers under the age of 25 years in the sample had an HIV test and was
aware of their result, while only 66.7% of those over the age of 25 years had an HIV test and knew their
result. Beach boys (male sex workers) also appear to be knowledgeable about the ways of preventing
HIV, but from interviews with “beach boys” by Population Services International (PSI), it was found that
there has been a decline in condom use among this high risk population mainly because of drug abuse.
Having reviewed the nature of the HIV/AIDS epidemic across out five case countries and assess the level
of risk in the sex work industry across these territories, we will next explore the policy response to HIV in
general and specifically the policy response as it relates to the commercial sex industry across the five
countries.
Page- 68 -
Chapter 3:
HIV/AIDS – An Assessment of the Policy
Response to the Epidemic
3.0
The Case of Jamaica
3.0.1 The Jamaica National Strategic Plan for HIV/AIDS
The Jamaica National Strategic Plan (JNSP) 2007-2012 outlined the GOJ plan of action for addressing the
disease. The JNSP stipulated, inter alia, indicators to measure progress and targets for the period and the
cost of intervention. The drivers of the spread of the disease in Jamaica were identified as:
1. Behavioral:
engaging in intercourse with multiple sex partners, early sexual encounters,
transactional sex and inconsistent use of condoms; inaccurate calculation of personal risk of
infection and a disconnect between knowledge and behaviour
2. Economic: slow economic growth which manifests itself in poverty and high rates of
unemployment and subsequent rises in the informal sector activities which stem from the illegal
trade in drugs, tourism and population mobility
3. Socio-cultural: the stigma and discrimination by the wider society that alienates those in need of
services and information to protect themselves is a major issue; gender inequality – men who
are the sexual decision-makers places women at a disadvantage with respect to the negotiation
of condom use and deep-seeded homophobia seriously hinders intervention programmes among
this group.
The national strategic plan for the period 2007-2012, highlighted the areas on which attention will be paid
in order to mitigate against the spread of HIV/AIDS in Jamaica. Particular attention was paid to
prevention (mitigation) factors, including:
1. Continued emphasis on knowledge, belief and behaviour change via discarding myths about how
HIV/AIDS can be transmitted; accurate risk assessment and a change in risk behaviour;
2. The inclusion of all sectors – private and public in prevention efforts. The aim is to encourage all
establishments for example clubs, hotels and bars to have education programmes and distribution
of condoms as ways to implement the said programme;
3. Increased interventions to reach vulnerable groups; extension of intervention to massage parlours
and other places not traditionally targeted; and implementation programmes which address
negotiation skills for condom use;
Page- 69 -
4. Continued attention paid to workplaces. Three (3) agencies continue to work together in this
initiative – the Ministry of Labour and Social Security (MLSS), the Jamaica Employers
Federation (JEF) and the Jamaica Confederation of Trade Unions (JCTU) and
5. Addressing issues in tourism sector such as condom access and to enlist the support of tourism
establishment to engender a change in individual behaviour.
In the area of treatment and care, successes have been realized but challenges to continued success in this
area stem from a large number of people who do not know their status; constraints in getting
antiretroviral medications to people who need it, and persistent stigma and discrimination against PLHIV.
Suggestions for dealing with these challenges include: Increased provider initiatives to conduct HIV
testing at hospitals and improved testing for TB. A related but undocumented challenge will be the cost
of implementing these mitigation measures.
3.0.2 HIV/AIDS Initiatives in the Tourism Sector
The Tourism Sector HIV/AIDS Workplace Policy
In Jamaica, in addition to the National HIV/STI Prevention and Control Programme, an important
strategy for addressing the HIV/AIDS epidemic is targeting employees. The HIV/AIDS Workplace
Policy, which was accepted by Cabinet in 2007, has been implemented by some private and public sector
players 23. The policy is then tailored into Programmes specific to the company. It is expected that the ongoing process of revision of the Organizational Safety and Health Act to include a policy on HIV/AIDS
will pave the way for mainstreaming such policy into operational plans for any establishment.
In 2002 the Ministry of Tourism (MOT) was mandated to spearhead the Tourism Sector HIV/AIDS
Workplace Policy. In fulfilling this mandate, the MOT partnered with the Tourism Product Development
Company (TPDco) to conduct the technical aspects of the preparation of the policy. The Tourism Sector
HIV/AIDS Workplace Policy was launched and implemented in November 2007 24 with the Ministry of
23
The International Labour Organization provided the international standards for HIV /AIDS workplace
programmes. The “ILO Code of Practice on HIV/AIDS and the world of work” provides the foundation from which
policies and programmes are employed in the workplace.
24
Notes taken at a meeting with representatives of the Ministry of Tourism and the Tourism Product Company in
August 2008.
Page- 70 -
Tourism, Entertainment and Culture (MTEC), Ministry of Health (MOH), the Jamaica Hotel and Tourist
Association (JHTA) as tourism partners.
This policy initiative is geared towards the achievement of three broad objectives:
1. Reduction of the transmission of HIV/AIDS within the tourism sector. This can be addressed by
the use of vending machines at sites and by sharing knowledge on negotiation skills for condom
use and accurate assessment of risk;
2. Mitigation of the impact of HIV/AIDS on the tourism sector. It is important that knowledge about
HIV/STI prevention is integrated into the human resource development plans in formal
establishments and the operations of informal ones; and
3. Reduction of HIV/AIDS-related stigma and discrimination. Establishments can document
incidences of the aforementioned and penalize parties for those acts.
A situational analysis done in relation to the Tourism HIV/AIDS in the workplace Policy acknowledges
that “sex is heavily linked to tourism.”
In order to achieve these broad objectives the policy seek therefore to:
1. Provide guidelines with respect to how the tourism sector should address the issues surrounding
the prevention of transmission of HIV/AIDS;
2. Set examples of behaviour with respect to employees in both the formal and informal sector;
3. Streamline compliance with local and international laws which focus on HIV/AIDS;
4. Recommend ways in which existing laws and policies can be altered in accordance with the
National HIV/AIDS Policy, The National HIV/AIDS Workplace Policy, the Tourism Sector
HIV/AIDS Workplace Policy and others;
5. Be a point of contact for referrals to accommodate heads and employees of formal and informal
establishments who need treatment and support for PWLH or have been affected by the disease;
6. Provision of guidelines which inform how managers and employees deal with issues surrounding
HIV/AIDS in the working environment;
Page- 71 -
Jamaica Hotel and Tourist Association (JHTA)’s HIV/AIDS Workplace Policy 25
The JHTA is one private sector tourism association that has adopted the HIV/AIDS Workplace Policy and
implemented its HIV/AIDS Workplace Programme. The programme seeks to utilise the organizational
structures and a range of activities that result in the animation of the HIV/AIDS Workplace Policy.
Adoption of the policy is an acknowledgement that there is a need to address issues such as limited usage
of condoms by locals and tourists during sexual intercourse; the refusal to adhere to rules which govern
the relationship between employees and guests etc. The programme aims to educate employees in the
industry; reduce stigma and discrimination against persons living with HIV/AIDS; create channels
through which the programme’s best practices can be shared and provide the mechanisms through which
the aforementioned can be achieved.
HIV/AIDS Programmes which target sex workers 26
In Jamaica, a number of programmes have been tailored to combat the spread of HIV/AIDS among sex
workers. The Priorities for Local AIDS Control Efforts (PLACE), used by the Ministry of Health to
identify areas characterised by high transmissions of the disease, has identified areas on the north coast,
such as Ocho Rios. The North East Regional Health Authority has teamed up with an NGO, the Jamaica
AIDS Support for Life (JASL) in order to target MSM and MSW. The National HIV/STI Prevention and
Control Programme has been one which has worked extensively with sex workers over a long period of
time. However, the main hindrance is the recognition of sex work as an illegal activity. This prevents
access to sex workers.
The Association for the Control of Sexually Transmitted Diseases (ACOSTRAD) embarked on a venture
to encourage sex workers to visit drop-in centres located in Kingston and St. Andrew but this initiative
was met with only a small degree of success. When evaluating that initiative it was also found that it was
difficult to share test results with sex workers who did come to the centres because they are a highly
mobile population.
Programmes that catered to Peer Education and Club Operators received a more active participation
from sex workers and club owners. Peer education entailed training sex workers to share issues on
25
Notes taken at the meeting with representatives of the Jamaica Hotel and Tourist Association in August 2008.
Patricia Delores Russell, “Exploring the Safer Sex Practices of Sex Workers with Paying Clients and Regular
Partners in St. Ann, Jamaica.”
26
Page- 72 -
sexuality and promote safer sex practices. The Club Operators’ programme also recorded successes with
respect to increased condom sales and awareness of HIV/AIDS among sex workers and fellow club
operators.
3.0.3 Stakeholders perceptions on the threat of HIV/AIDS to the Tourism Industry
in Jamaica
There is a general impression among stakeholders that HIV/AIDS does not pose a threat to the
sustainability of the tourism sector. This view differs from the stakeholders interviewed in the Ministry
of Health who readily acknowledge that there is a burgeoning threat which, left unchecked, could have
catastrophic impacts on the Jamaican tourism sector. This in fact is the definition of a disaster – a hazard,
in this case HIV/AIDS, which if it interacts with an environment that is vulnerable e.g. a tourism sector
that does not admit to the significance of the sex trade as a key component of that sector, could result in a
disaster, “which outstrips the ability of a government to deal with such a disaster” (culled from the
EMDAT definition of a disaster).
Representatives of the MOT and TPDco outlined the process which resulted in the launch of the Tourism
Sector HIV/AIDS Workplace Policy in November 2007. Since then, the Jamaica Employers’ Federation
(JEF), the Ministries of Labour, Education, Social Security (MOLSS); the Local Government Department
in the Office of the Prime Minister and the Jamaica Hotel and Tourist Association have implemented their
respective HIV/AIDS Workplace Programmes. Hotel chains, for example Sandals, were praised for their
stewardship with respect to implementing measures such as the installation of condom vending machines
and STD testing for staff members. The drive to encourage the tourism sector to take action with respect
to HIV/AIDS in the workplace gained popularity in 2004-2005. In the latter year 1500 staff members
across various properties were screened for HIV/AIDS. There is, however, reluctance to place condom
machines in full view of guests or staff. This is slowly changing.
It was suggested that corporate social responsibility on the part of the properties has been a key
motivating factor for this change. Further, firms are becoming aware of the Voluntary Compliance
Programme (VCP) on HIV/AIDS which was launched by the MOL. The VCP is a certification for firms
across sectors who have adopted HIV/AIDS Workplace programmes or policies. Points are disseminated
based on the presence of activities that promote HIV/AIDS awareness among staff and or HIV/AIDS
Workplace programmes. So as an awareness of VCPs grow, so does the adoption of the HIV/AIDS
Workplace programme. VCPs and the Tourism Sector HIV/AIDS Workplace Policy are under the
Page- 73 -
purview of the draft OSHA Act. Therefore, firms must comply with the OSHA Act in order to be certified
to operate in Jamaica. The representatives of TDPco agree that tourism enterprises perceive the adoption
of the HIV/AIDS Workplace programme as a means of protecting an asset – their staff. Ways in which
insurance companies such as Sagicor and the Government of Jamaica through the National Health Fund
(NHF) provide care for PLWH also came to the fore. However, a hindrance to the overall success of this
drive is the limited focus on workers in the informal sector. The position of representatives here is that the
issues surrounding sex workers in the tourism sector will be addressed by the Ministry of Health.
The representatives of the Ministry of Health (MOH) also communicated their views on the threat of
HIV/AIDS to sustainable tourism. It was further reiterated that there is collaboration between the private
and public sector in Jamaica. The contribution of the Sandals hotel chain was again noted. However, it
was suggested that hotels may, at most, want their staff to be tested in order to confidently state that no
members are HIV/AIDS positive. The root cause of the inability to address the issues of HIV/AIDS and
its impacts on tourism and the work place stem from extensive and unrelenting attention placed on the
economic underpinnings of the tourism industry.
The formal tourism sector, possibly in the form of the increasing number of spas, also acts as show piece
for increased transactional sex sites. Another formal tourism sector business operation that encourages
casual sex encounters are parties and festivals held in the tourist hubs on the north coast of the island.
These activities target tourists and young people who are in the prime of their productive lives.
There was an overall acknowledgement among the representatives of the MOH that formal and informal
workers in the tourism industry are well-poised to create an avenue for the promotion of transactional sex.
The example of a night auditor on a property who was engaging in sex in exchange for money was raised.
This re-enforces that there is no specific ‘face’ that can be placed on a sex worker. In most tourism
facilities, particularly hotel accommodations, the salaries are quite low. This is so for both locally and
foreign-owned establishments. Entertainment co-coordinators (also known as ‘Playmakers’), bar
attendants do not have high salaries and are best positioned to have transactional sex. Other workers in
formal establishments who are best positioned for transactional sex include nightclub and transport
workers. Commercial sex workers fall outside the formal sector but are able to interact with tourists either
on their own or through workers in formal establishments. A non-governmental organization (NGO)
perspective contributed substantially to the discourse. The delegates of the Jamaica AIDS Support for
Life (JASL) and Caribbean Vulnerable Communities Coalition (CVC) re-emphasized that low salaries in
the formal tourism sector was a major reason for formal workers to engage in transactional sex and or act
Page- 74 -
as go-betweens for the tourists and sex workers outside of the respective property. They also shared their
views on the definition of a commercial sex worker (a person who engages in physical sex in exchange
for money) and who they may be (masseuses, drug addicts, men who perform in sex shows, and escorts
who cater to lonely professionals).
The representatives of the MOH and the NGO community also shared the view that Jamaican society
prefers to ignore that sex tourism exists and not address the issues that accompany it. Further, there is a
perception that sex tourism and its issues plague the poor and working class and therefore should not
feature prominently in public discussion nor should it be a part of the government’s policy preoccupations. Additionally, religious boundaries set by society also play a major role in the criminalization
of sex tourism.
The representatives of the JHTA, a private sector tourism association with a total membership of 300
firms, indicated that there is a lack of empirics which show how the “bottom-line” of tourism
establishments can be adversely affected. The absence of this data only fuels the perception that
HIV/AIDS in the workplace does not affect daily operations and profit margins. Further, despite the
strides that have been made, there is a perception within the tourism industry that promotion of the
HIV/AIDS in the Workplace Policy is negative marketing and can deter tourists from visiting the island
and accommodation properties. Of the 20 hotels that have expressed interest in suggesting that their
employees be screened for HIV/AIDS, 5 have actively set out to do it. The JHTA has suggested that in
order to combat this formidable barrier to change, its members need to understand that tourists can quite
possibly see this campaign as a step in the right direction and be encouraged to visit the island. This also
applies to the marketing approach that can be adopted by the Jamaica Tourist Board (JTB).
3.1
The Case of the Dominican Republic
3.1.1 The Dominican Republic National Response
Like many of its Caribbean neighbours and guided by international standards, there has been a fairly
comprehensive response by the authorities to the HIV/AIDS programme. The Presidential Council on
AIDS (COPRESIDA) was formed in 2000 coordinates the national response, while the Ministry of Health
implements HIV/AIDS services in the public sector. Other key organizations that are central to the
national response include SESPAS, an umbrella organization responsible for a number of key HIV/AIDS
projects, COIN, CEPROSH and DIGETICSS, the National Program for the control of STIs and AIDS.
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A number of international agencies provide critical support to the Dominican Republic’s HIV/AIDS
response; this comes in the form of both technical and financial support. Included among this group is
William J. Clinton Foundation, UNAIDS (ONUSIDA), which offers technical support to COPRESIDA,
while The World Bank and USAID has provided financial support to the response.
COPRESIDA coordinates the HIV/AIDS National Strategic Plan (2007-2015), its activities include
implementing public policies, providing care for those living with HIV/AIDS, promoting private sector
involvement in response to the epidemic, and reducing stigma and discrimination (S&D). The National
AIDS program/DIGECITSS is responsible for developing HIV/AIDS-related norms, protocols, and
surveillance. At the National-level the key activities involve:
•
Conducting information, education, and communication campaigns
•
Coordinating care and support for people living with HIV/AIDS (PLWHA)
•
Reducing mother-to-child transmission
•
Ensuring blood supply safety
•
Monitoring and evaluating national and provincial health plans
•
Distributing condoms to at-risk individuals 27
At the level of the community the international agencies also work closely with local and international
NGOs, including the church, forming close alliances to develop and deliver key programmes and services
to high risk and vulnerable groups and areas.
While a national strategic plan was developed, the plan has not been costed and there is no monitoring
and evaluation (M&E) component. ONUSIDA is attempting to strengthen the latter issue of M&E. These
deficiencies are exacerbated by the sole focus on satisfying the stipulations of donor institutions (USAID
and the Global Fund). As a result, the HIV/AIDS response programme in the DR has been described as
‘project-oriented,’ and lacking in clearly identified long term goals or internal funding mechanism as
COPRESIDA relies only on external funding, and The Global Fund also drives private sector
interventions. The ONUSIDA’s concept of the 3 ones is partially in place in the DR - there is one
HIV/AIDS Action Framework; one National AIDS Coordinating Authority, but no one country-level
M&E system. In addition, because of the heavy reliance of the national response on international support,
27
United States Agency for International Development. (2008) HIV Health Profile. Dominican Republic:
http://www.usaid.gov/our_work/global_health/aids/Countries/lac/dominicanrep.html
Page- 76 -
the sustainability of the national plan to fight HIV/AIDS had been heavily discounted due to the global
financial crisis (UK, US and Germany are the major contributors to the Global Fund).
Initiatives in the Tourism sector have been focused largely on information, education and communication
campaigns, and on activities geared to the minimizing of risks among the at-risk individuals. Unlike the
case of Jamaica, there has not been a widespread HIV in the workplace programme in this sector; these
programmes have been conducted in only a few hotels and have not been sustained. The sector has
benefitted from wider initiatives that seek to reach MSM and female sex workers such as the “100%
Condom Strategy”. This programme has seen the prevalence rate in sex workers in Santo Domingo
decrease consistently to reach the level of pregnant women nationally, and condom use by the FSWs
increased from 75 percent to 94 percent in one year. (USAID, 2008)
3.1.3 Stakeholders perceptions on the threat of HIV/AIDS to the Tourism Industry
in Dominican Republic
The representatives of Population Services International (PSI) indicated that the impact of HIV/AIDS on
the tourism sector may be low due to the low adult HIV prevalence in the DR. PSI has completed its
survey called ‘TRACK’ which is its version of a knowledge, attitudes, beliefs and practices (KABP)
study. The summary of the findings reiterated that sex workers used condoms consistently with clients but
not main partners. In addition, sex workers in establishments have health cards and have periodic health
checks. The health checks include STD tests.
On the issue of HIV/AIDS posing a threat to the Tourism Industry, the Representative from the Ministry
of Tourism (SECTUR) noted that due to interventions with respect to HIV/AIDS prevention and
increased awareness over the past 5-6 years, the threat was not as great. It was indicated that work had
been done to address the issues of child prostitution in the country. Child prostitution is a major issue in
the DR.
The representative for Center for Integrated Training and Research (COIN) acknowledged that
prostitution is not legal in the DR but no one is prosecuted for engaging in the activity: laws address
trafficking of women but not the illegality of prostitution. It was noted that 12-13 year old girls were the
vulnerable group. The Catholic Church allows sex education that focuses on abstinence in its schools.
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Government schools have sex education classes that focus on both abstinence and contraception (more
emphasis on the latter).
Another vulnerable group highlighted was self-employed SWs (street walkers). This group is highly
migrant and range in age between 10 and 50 years old. They tend to be from households prone to violence
and parents who encourage them to engage in sex work. The parents are often times proud of the day’s
rewards (food and money). There are those, however, who wish to break the cycle of intergenerational
poverty and sex workers.
A new dimension to the HIV/AIDS epidemics is the increased occurrence of drug use among female sex
workers (FSWs). Street walkers and SWs who are drug users do not necessarily cater to high class clients.
Those clients are served by SWs in massage parlours. The primary motive for engaging in sex work is to
meet economic needs. Some 60-70% of the sex workers in the DR do not want to be sex workers. They
engage in the activity to escape poverty, abusive relationships and the lack of alternatives. Single FSWs
have 3-5 children on average. A survey in 2005 showed that women are having few children. The average
age of SWs is 25-35 years old. Prevention programs in hotels to promote HIV/AIDS prevention in the
work place exist but the hotels have the responsibility of overseeing the effectiveness of these programs.
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3.2
The Case of Tobago
3.2.1. Background to the HIV/AIDS Programme Response in Trinidad and Tobago
In recognition of the significant and very real threat posed by the HIV/AIDS epidemic to the
developmental goals of the country, the Government of Trinidad and Tobago developed a number of
initiatives partnering with various global organizations in order to mitigate the negative impact of the
HIV/AIDS Epidemic.
The national response to the HIV and AIDS epidemic began in 1987 with the establishment of the
National AIDS Programme (NAP) under the aegis of the Ministry of Health, with assistance from the
World Health Organisation (WHO) Global Programme on AIDS as well as the European Union. During
this period the main focus of the programme was the prevention of HIV transmission. In 2003, the
Government of the Republic of Trinidad and Tobago embarked on the development of a strategic plan for
a wider multi-sectoral and nationally coordinated approach directed towards the reduction in the
incidence of HIV. This initiative was facilitated through the establishment of the National AIDS
Coordinating Committee (NACC) in 2003 under the auspices of the Office of the Prime Minister. The
multi-sectoral NSP, which covers the period 2004-2008, incorporated policies and strategies to address
five key priority areas in response to the HIV and AIDS epidemic:
Priority Area I:
Prevention
Priority Area II:
Treatment, Care and Support
Priority Area III: Advocacy and Human Rights
Priority Area IV: Surveillance and Research
Priority Area V: Programme Management, Coordination and Evaluation
The NACC, as the coordinating body, performs a policy-advisory function with representation from the
public and private sectors, civil society organizations, faith based organizations, and persons living with
HIV (PLHIV). Sub-committees were also established to support activities linked to the five (5) priority
areas.
3.2.2 Strategic Initiatives of the Tobago HIV/AIDS Coordinating Committee
An additional entity, the Tobago HIV/AIDS Coordinating Committee and Secretariat, was established in
2005 to manage the Tobago component of the response to HIV/AIDS. The organization of this response
Page- 79 -
includes coordination with the Tobago House of Assembly (THA), which works through the
Coordinating Committee of the THA (THACC) in responding to the needs in the island.
The THACC’s strategic response has been formulated along the five broad priority areas articulated under
the NSP and so had outlined a number of strategies under each of the priority areas to guide Tobago’s
response for the period 2004 to 2008. These include:
•
Strategies to Promote healthy sexual attitudes, behavior and practices among vulnerable and highrisk populations under the Prevention Priority; Here the focus includes youth, prison employees
and prisoners
•
Under Treatment, Care and Support among the key strategies include those that seek to improve
access to treatment and care and the creation of a supportive environment for the care of persons
with HIV/AIDS
•
Under Advocacy and Human Rights the key strategies include ensuring the human rights of
PLWHA and other groups affected by HIV/AIDS
The Tobago Hoteliers Association is the umbrella body for these establishments in Tobago. According to
the past president of the Association, in the earlier days of the epidemic, HIV/AIDS was recognised and
acknowledged as an issue of importance for the sector. During this period emphasis was placed on
sensitizing staff of the sector through presentations from professionals in the field of HIV/AIDS. There
was also some level of engagement with the then National AIDS committee.
With a change of leadership and almost 10 years later, it is the view of the residing President that
HIV/AIDS is not seen as impacting the tourism sector significantly and as such is not seen as a real
concern for the association. As such there is no HIV/AIDS policy in either the hotel industry or the wider
tourism sector in Tobago. There is however a policy of no discrimination towards PLHIV in the industry.
In cases where the individual poses a health hazard to the guests or other staff the Association intervenes
under the guidance of medical professionals to address the issue.
Generally however the Association, through its President, sees HIV/AIDS as no real threat and is best left
to be addressed by the Tobago HIV/AIDS Coordinating Committee which is charged with addressing the
problem of HIV/AIDS under the supervision of the Tobago House of Assembly (THA)
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3.3
The Case of St. Lucia
3.3.1. The St. Lucia National Response to HIV/AIDS
The St. Lucian national response to the HIV/AIDS epidemic is based on its National Strategic Plan (NSP)
(for the time period 2005-2009). Funding for the NSP comes largely from the World Bank and the Global
Fund to fight AIDS, Tuberculosis and Malaria (GFATM). This plan focuses primarily on prevention
measures and seeks to address the specific context of the prevalence of HIV/AIDS in St. Lucia. The
national response proposes four main strategies:
1.
Advocacy and policy development. This strategy is focused on the allocation of funds for
HIV/AIDS prevention programs, socio-economic development, poverty reduction and human
rights.
2.
Comprehensive HIV/AIDS care for all Persons Living with HIV/AIDS (PLWHA): This strategy
involves improving the treatment, care and support for PLWHA and also seeks to eliminate the
stigma and discrimination against PLWHA.
3.
Preventing further transmission of HIV: This involves the Prevention of Mother-To Child
Transmission of HIV (PMTCT), the provision of services such as Voluntary Counselling and
Testing (VCT) and targeting groups in society that are most vulnerable to HIV/AIDS.
4.
Strengthening national capacity to deliver an effective and coordinated multi-sectoral response:
Strengthening the national capacity includes strengthening the institutional framework such as,
the National Coordinating Committee on HIV/AIDS (NACCHA), conducting extensive research
and surveillance on HIV/AIDS, and promoting a well coordinated multi-sectoral response to the
HIV/AIDS epidemic.
To effectively undertake its prevention programs the government established the National AIDS
Coordinating Council (NACC) to coordinate, manage and facilitate the national response to the epidemic.
Also, the umbrella NGO, AIDS Action Foundation (AAF) has been working with other NGOs and a
number of private sector organizations to curb the spread of the HIV/AIDS epidemic on the island
through a variety of interventions. The national response to the epidemic has seen some success in terms
of the reduction of AIDS deaths in 2007 and also the number of cases among children has been on the
decline.
Page- 81 -
The development of the tourism industry in St. Lucia has simultaneously led to the development of the
commercial sex industry and an increase in the risk of HIV/AIDS among sex workers and tourists.
Consequently, there exists the need for specific initiatives to combat the spread of HIV/AIDS in the
tourism sector. The main focus of initiatives in St. Lucia’s tourism sector is closely aligned to its national
response; which includes education, prevention and information dissemination on HIV/AIDS. Some of
the programs implemented thus far are the HIV in the workplace program by the AIDS Action
Foundation (AAF), which seeks to reach out to a number of private sector organisations. Also, the
Caribbean Association of Feminist Research and Action (CAFRA) and Population Services International
(PSI) work closely with sex workers on the island, most of which belong to the informal tourism sector.
Initiatives here are geared towards sensitization of this group on the risks associated with unsafe sex and
the importance of consistent condom use.
The Ministry of Tourism and Civil Aviation (MOT) is one of the ministries with an HIV/AIDS focal
point. The MOT has also developed and an approved their work plan (January 2008-June 2009) of HIV
activities. These activities include:
1. Encouraging the practice of universal safety precautions in the workplace – procurement
of first aid kits and latex gloves;
2. Media campaign using industry personnel;
3. Conduct first aid training for MOT staff and external clients;
4. Hold HIV/AIDS sensitization and education seminars for senior management and key
stakeholders;
5. Hold meetings with senior management and other key stakeholders for presentation of
MOT’s HIV/AIDS work plan;
6. Train HIV/AIDS core committee members and key partners on issues of HIV/AIDS;
7. Undertake VCT group education training for key stakeholders.
Most of the programmes of the Ministry are geared towards increasing the levels of awareness among
staff in the tourism industry, recognizing that these employees are themselves members of communities
who impact and are impacted by the epidemic. The activities implemented thus far have centered on
activities during the Carnival festival and the distribution of IEC material. There however has been
Page- 82 -
limited implementation of a significant amount of these planned activities, due in large part to the lack of
human capacity and a lack of commitment on the part of the members of the industry to attend and take
part in these sensitization programmes.
In addition, while there exists a strong and vibrant St. Lucia Hotel and Tourism Association with a
membership of 160 companies, there is no clear coordinated strategy between this association and the
MOT in addressing HIV in the Tourism sector.
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3.4
The Case of Barbados
3.4.1. The Barbados Response to HIV/AIDS
The National Advisory Committee (NAC) on HIV/AIDS managed the National AIDS Program (NAP) in
Barbados from 1987-2001. In 2001, the government established the National HIV/AIDS Commission
(NHAC) under the office of the Prime Minister comprising 16 members representing various
stakeholders. The National HIV/AIDS Commission (NHAC) is now responsible for coordination and
implementation of the multi-sectoral national response to the epidemic. The key elements of this national
response include prevention of HIV/AIDS, care and treatment and creating a more supportive
environment for persons living with HIV/AIDS.
The goals of the National AIDS Program from 2001 were:
i.
To reduce the mortality from AIDS by 50% over a five year period.
ii.
To reduce incidence of HIV by 50% over a five year period and slow the rate of progression
of HIV infection to AIDS.
iii.
To reduce the number of opportunistic infections and hospitalisations due to HIV/AIDS.
iv.
To improve the well being of PLWHA, thus facilitating their return to work and other
activities in society.
Source: (UNGASS, 2006)
The government of Barbados has provided financial support to the fight against HIV/AIDS, with
government
expenditure
on
HIV/AIDS
increasing
from
BDS$6,822,482
in
2001-2002
to
BDS$13,016,449 in 2006-2007. The government also secured a US$15.1 million dollar loan from the
World Bank with the following planned allocation schedule:
i.
Prevention and Control of HIV/AIDS Transmission – US$5.7 million
ii.
Diagnosis, Treatment and Care for HIV/AIDS –US$14.3 million
iii.
Management and Institutional Strengthening – US$3.5 million
Source: (UNGASS, 2006)
The National AIDS Program has made significant breakthroughs in the fight against HIV/AIDS through
its prevention initiatives. These initiatives include the expansion and strengthening of the Voluntary
Counselling and Testing (VCT) and the Prevention of Mother to Child Transmission (PMTCT) programs,
the distribution of condoms and its ongoing information and education programs on HIV/AIDS.
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Consequently, the incidence of new infections has decreased from 2%-2.5% to 1% per year (UNGASS
2006). Furthermore, there has been a decline in AIDS deaths (AIDS related deaths decreased from 60 in
2002 to 50 in 2007 reaching a low of 32 in 200428) since the provision of free Anti-Retroviral (ARV)
drugs to Barbadians in 2002. The Elroy Phillips Centre was also established to provide a supportive
environment for homeless persons living with HIV/AIDS.
3.4.2 HIV/AIDS initiatives in the Tourism sector
The major HIV/AIDS initiatives in the tourism sector focus mostly on the provision of information and
education on ways of preventing the sexual transmission of the HIV/AIDS to those high risk groups (men
having sex with men (MSM) and other sex workers). These education and information programs attempt
to create awareness of HIV/AIDS, promote less risky sexual practices and reduce the stigma and
discrimination against people living with HIV/AIDS. This sector has also benefited from the
government’s national response, specifically, with the distribution of condoms, sex workers are now in a
better position to negotiate safer sex with their clients, which will reduce the risk of HIV transmission
among tourists and sex workers.
28
http://www.carec.org/
Page- 85 -
3.5
An Assessment of the Response to HIV and Sex Tourism
A review of the situation of sex tourism and sex work across the five case studies and the various
responses to HIV/AIDS in the tourism sector generally and specifically as it relates to sex tourism have
been presented. In order to gauge the comprehensiveness of the response across the five case countries
we will evaluate the country response against a set of key guidelines on HIV and Sex work developed by
UNAIDS. The development of these guidelines was done in recognition of the continued inadequate
support, financial and otherwise, that has been committed to commercial sex work, in spite of the early
recognition of its strong link to HIV/AIDS. 29 The guidelines are geared toward an effective, evidenceinformed response to HIV and Sex work.
These guidelines are rooted in the human rights approach toward universal access to HIV prevention,
treatment, care and support and built on the human rights principles which support the rights of people to
make informed choices about their lives, in a supporting environment that empowers them to make
choices free from coercion, violence and fear (UNAIDS, 2009). The Guidelines are formulated on three
main pillars, they are:
1. The assurance of universal access to comprehensive HIV prevention, treatment, care and
support to those involved in sex work. This involves interventions that seek to address such
areas as the structural barriers to accessing these programmes and introducing the necessary
policies, legislation to facilitate these efforts. It also involves the formulation of policies and
programmes that focuses on key supportive elements to this pillar in such areas as freedom from
violence, abuse, and discrimination, and consistent access to quality contraceptives as well as
supportive health and social support. This includes voluntary HIV testing and counselling
services.
2. Building supportive environments, strengthening partnerships and expanding choices. This
entails programmes and policies that are geared towards the empowering of this group as well as
providing the relevant incentives which will facilitate the forging of greater partnerships which
can further address the needs of sex workers
3. Reducing vulnerability and addressing structural issues. This pillar seeks to address those
factors that hinder attempts at reducing vulnerability. These factors include gender inequality,
discrimination and social exclusion.
Using the above three pillars as the basis, one can evaluate the programme that have been identified in the
national response across the five focus territories. Based on the programmes identified and the constraints
highlighted the table below seeks to classify the country programmes and policies that are geared towards
enhancing the quality of life of the CSWs who work in the tourism sector. According to the table a full
tick (√) indicates that particular phase was successfully achieved at the national level. The smaller
29
It is estimated that less than 1% of global funding for HIV/AIDS is being allocated to address HIV and sex work
Page- 86 -
exploration (√) indicates that this phase has been partly done, while the dashes indicated that the phase
has not been addressed. From the table below Barbados, Dominican Republic and to a lesser extent,
Jamaica stood out among the countries researched, while St. Lucia and Tobago are less far advanced in
their response programmes for addressing HIV/AIDS in the Tourism sector. Recognizing that the CSWs
represent one of the groups most at risk to exposure to HIV/AIDS, and are quite capable of merging into
society in the presence of a less than enabling environment, the effectiveness of these strategies can
impact not only prevalence rates within this group but also prevalence rates at the national level.
Table 4
Classification of Countries Response to HIV in the Tourism Sectors
Phases
2
3
Country
Jamaica
1
√
√
√
St. Lucia
√
√
---
Dominican Republic
√
√
√
Tobago
---
---
√
Barbados
√
√
√
Source: Author
Page- 87 -
CHAPTER 4:
4.0
Health and Sustainable Tourism Development
Sustainable Tourism Development
“Sustainable tourism” means different things to different people depending on the audience and the
perspective of the particular stakeholder.
•
The private sector stakeholders in tourism, e.g. hoteliers, see sustainable tourism as being
synonymous with sustaining tourism growth--largely in economic and marketing terms: How can
the tourism market be sustained and grow in the long term?
•
Local communities may see sustainable tourism in terms of the socioeconomic benefits that may
accrue to them, responding to a question such as: Is this tourism development sustaining the
community/contributing to the socio-economic development of the community or is it impacting
negatively on the community in terms, for example, of its culture?
The definition of sustainable tourism development provided by Hunter (1995)30 states that the first aim
should be the improvement of living standards of local residents. As such, a key objective of sustainable
tourism development should be to minimize the spread of diseases and illnesses in the host country
resulting from tourism activities. This would ensure that one of the most important resources in the
tourism sector, the human capital, is protected. Hunter also noted the importance of safeguarding the
resource base for tourism. The second aim is to satisfy the demands of tourists and to continue to attract
them. Tourists demand a healthy environment. Gartner (1996) notes that, tourists are unwilling to travel to
some of the most exotic locations in the world because of the high risk of becoming ill. A sustainable
tourism programme should therefore seek to maintain tourists’ health, which in the first instance would
satisfy their demand and, secondly continue to attract them in the future. The ultimate outcome would be
the improvement of the quality of life for those in the host country.
4.0.1 Sustainable Tourism and Health
Epidemics and diseases negatively affect the health of individuals. In the tourism context, the concept of
‘health’ can be discussed from two dimensions: the ‘health’ of the tourists – the consumers of the tourism
product and the ‘health’ of the locals, who produce the ‘tourism product’. The tourists face the threat of
experiencing travel-related illness such as ‘jet-lag’, sea sickness and/or contracting a disease or illness
during his/her stay in the host country such as diarrhea, malaria, HIV/AIDS and so on. Similarly, locals
30
See page 10.
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face the risk of being infected by tourists with a host of infectious diseases such as gonorrhoea, hepatitis,
syphilis, HIV/AIDS and so on. This dilemma has been described by Gayle and Goodrich (1993) as the
‘health/tourism interface’.
Figure 45 – Health/tourism interface
Health of Tourists
Tourism
Health of
Sector
Locals
Sustainable Tourism Development
Source: Author
As Figure 45 above shows, the interaction between tourists and locals are facilitated through the tourism
sector. The nexus between the sustainable tourism and health may be seen where negative externalities,
such as communicable diseases, may expose local residents to infected tourists which in turn negatively
affects the human capital base thus compromising sustainability in the tourism sector and, by extension,
the economy. Conversely locals, the producers of the tourism product, may be infected with diseases and
the existence of diseases and infections in the host country may also infect tourists. Diseases act as a
deterrent to travel (Gartner 1996) consequently as long as tourists are convinced that the risk of
contracting a particular disease or illness is high, they would be less willing to travel to that destination. It
is therefore vital that tourism dependent countries seek to maintain tourists’ health during their stay and
should try to minimize the potential risk associated with the contraction of diseases within their country.
The figure above also illustrates the two way relationship between the tourism sector and sustainable
tourism development i.e. activities in the tourism sector may or may not be sustainable, either positively
contributing to or adversely affecting sustainable tourism development.
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The impact of HIV/AIDS on Sustainable Tourism Development
A major health concern for governments, potential tourists, locals, and all other stakeholders in the
Caribbean is HIV/AIDS. Agrusa (2003) notes that
“HIV/AIDS is a disease currently without a cure or vaccine...the transmission of HIV is through
conscious behaviours in which individuals choose to engage in sexual intercourse or intravenous drug
use.” (Argusa 2003, 169).
The author goes on to note that the movement of tourists “...increases the potential for the transmission of
life-threatening diseases such as AIDS. In addition, the behaviour of tourists may be linked to the rapid
rate of transmission of AIDS and other STDs. He explains that tourism thrives on the opportunities it
offers for persons to have new experiences and as such it creates an environment where a disease like
HIV/AIDS can manifest itself. The frequent identification of tourism with sexual adventure forms the
basis for the growth of such a disease.
An interesting observation by Lewis (1989) is “…for both visitors and the host country, tourism becomes
a risky business when tourism and sex are sold together.” (Lewis 1989, cited by Agrusa 2003: 169)
With particular reference to the increasing figures worldwide for STDs and HIV/AIDS, tourism has
become a relatively controversial business as tourists are presumed transmitters of infectious diseases
(Apostolopoulos and Sonmez 2002). This dilemma leaves tourism dependent regions with two options.
The first is to ignore the threat posed by HIV/AIDS and the second is to seek to mitigate and/or
internalize the associated HIV/AIDS risks arising from tourism.
Tourism is a medium through which people can purchase and consume cultural experiences and as such
many tourists to the Caribbean are using their economic power to obtain sexual experiences (Taylor
2000). At a time when the island states of the region are forced to look to the tourism sector as a means
for growth and development, the frightening reality is that, the Caribbean has the second highest
HIV/AIDS prevalence rate in the world. What is even more frightening is that, tourism itself, may be
promoting the spread of such a deadly and destructive disease. Therefore, for sustainable tourism
development planners in the region, ‘sex tourism’ is an important element that needs careful attention.
HIV/AIDS has considerable potential to cause negative impacts on economic sectors in particular
agriculture, tourism and mining (World Bank 2001). The Caribbean region is likely to face severe impacts
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since it thrives on tourism; a sector heavily dependent on human capital, the resource under attack by the
HIV/AIDS epidemic. In the Caribbean, 83 percent of AIDS cases are in the age group (15-54), the core of
the region’s labour force which compromises the region’s ability to meet the increasing demand for
tourism activities (World Bank 2001).
According to a macroeconomic impact study of HV/AIDS in Jamaica and Trinidad, both countries
revealed contractions in major variables, in particular, economic growth (World Bank 2001). At present
however economic growth as a result of the booming energy sector in Trinidad and Tobago may actually
be masking the ‘real’ impacts of HIV/AIDS on the economic system. The projected impacts for the
Caribbean are declining per capita economic growth, increased need for expenditures for treatment of
AIDS and AIDS related diseases from government budgets and household savings and declining
investments (World Bank 2001).
According to the World Bank (2001) HIV has a long latency period, so some of its associated social and
economic consequences may not be felt immediately. In addition, HIV/AIDS is seen as a developmental
catastrophe that threatens to dismantle the social and economic achievements of the past. The United
Nations (2004) notes that the HIV/AIDS epidemic can affect the economy in a number of ways:
1) The pandemic is expected to slow or reverse growth in the labour supply. For economies that rely
on labour intensive sectors such as agriculture or tourism for its growth, development and
survival, labour shortages can be devastating. In addition, the extent to which the epidemic affects
‘hard-to-replace skilled labour’ is also a key impact that must be taken into consideration.
2) Savings and investments of families will be reduced as a result of the increase in HIV/AIDS
related expenditures. Some families may even engage in dissaving in an effort to meet the cost of
HIV/AIDS treatment. Saving and investments are important drivers of economic growth and
development. Diminished saving and investment levels would compromise the progress of any
economy.
3) Families’ income may be lost resulting from the ill-health or death of sole income earners within
the household. This would deepen the poverty dilemma in most of the affected countries. As
heads of households fall ill and die as a result of contracting the disease, many countries could see
a worsening of the dependency ratio. Even as families lose income, there is an increase demand
for resources to treat affected members of the household. The ultimate outcome would be a
worsening of the poverty situation, and a dampening of growth and development prospects.
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4) There would be an increase in demand on a national level for resources to prevent, treat and care
for those affected by the epidemic. Resources may have to be redistributed away from productive
uses into the health sector in an effort to curb the spread of the disease. Coupled with this, the
economy may also face reductions in output and income resulting from the inability of workers to
perform effectively and efficiently.
In analyzing the impact of HIV/AIDS on sustainable tourism development in the Caribbean, the following
institutional impacts may be noted:
•
The tourism sector is mainly a service driven sector (Raina 2005). As such, the sector is heavily
dependent on human capital which is, the primary ‘victim’ of the HIV/AIDS epidemic.
HIV/AIDS related mortality and morbidity therefore can significantly affect institutions in the
tourism sector, thereby threatening the sustainability of the industry.
•
Staff Attrition (death, dismissal, redundancy, resignation, illness resulting from HIV/AIDS)
amounts to loss of what may have been once productive labour. There is then the problem of
filling the gap or getting a replacement for those departing. Therefore, attrition produces
vacancies, and when such exist, this prevents the achievement of objectives and disrupts overall
performance at the institutional level. Within the tourism sector, service providers facing labour
shortages would have difficulties meeting demand within the sector. This would have negative
effects on output, growth and income for those in the tourism sector.
•
HIV/AIDS also increases absenteeism as those who are infected with the disease seek treatment
and care and those who absent themselves with the intention of caring for their loved ones who
have contracted the disease. In both scenarios, planning, implementation, productivity and output
are compromised. Sustainability planning becomes even more difficult if not impossible.
•
High rates of absenteeism coupled with an increased number of vacancies results in the work load
becoming great for the ‘survivors’. The survivors may be stressed, and de-motivated and such
even their productivity and output may be affected. Under these conditions, Sustainable tourism
development planning may be out of reach for policy makers.
•
Absenteeism, attrition and vacancies adversely impact productivity, finances and service
provision. Interestingly, all these impacts reinforce each other and multiply as part of a vicious
cycle promoting destruction. Consequently, sustainable tourism development would be at risk. It
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is therefore quite important that the threats/risks associated with tourism be identified and
managed so that impacts on the sustainability of the tourism sector are minimized.
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Figure 46 – The impact of HIV/AIDS on human capital and productivity
Source: Suarez et al. (2008)
4.0.2 Tourism’s Contribution to the spread of HIV/AIDS in the Caribbean – Sex
Tourism
As illustrated earlier, the Caribbean sex industry has segmented the market with each country developing
its own product name and seeks to satisfy the demands of a particular segment of the market. For
example, Jamaica has a specialized place for the consumers who seek the services Rent a Dreads: black
men with Rastafarian dreadlocks; Barbados and Tobago for Beach Boys: Black men with well developed
bodies, and the Dominican Republic for Sanky Pankies: Latin men offering hetero-and bisexual services
and fair skinned women (Mullings 2000).
In addition, Mullings (1999) notes that the highest incidence of AIDS in Jamaica can be found in St.
James, the parish encompassing the tourist resort area of Montego Bay. In fact, according to a survey for
the period 1982-1997, the HIV/AIDS incidence level in St. James was estimated to be twice that of the
national average. The HIV prevalence rates are relatively high in the Bahamas, Barbados, Dominican
Republic and Jamaica which are key tourist destinations (Grenade 2008).
Given the possible link between tourism and the spread of HIV/AIDS in the Caribbean, there is an
urgency for policy makers to formulate a strategy to address the question of HIV/AIDS and tourism in the
Caribbean (Grenade 2008). In pursuing sustainable tourism development, the Caribbean should identify
the risks/threats posed by HIV/AIDS and seek to internalize or mitigate these risks in an effort to ensure
the sustainability of the tourism industry.
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Just as the HIV/AIDS epidemic negatively impacts Sustainable Tourism Development, tourism growth
may also influence the spread of HIV/AIDS. Tourists, carrying the disease may infect locals and locals
carrying the disease may also infect tourists. The key modes of transmission for the epidemic are sexual
intercourse and intravenous drug use. As such, the spread of the disease from tourist to local or from local
to tourist is possible where the sex tourism market exists or where tourists engage in intravenous drug use
with locals or vice-versa. It is however quite difficult to estimate the extent of these activities on the
spread of the disease since the market for sex tourism for example, is a hidden one.
Boxhill (2004) 31 expressed caution with respect to definitively concluding that there is a link between
tourism and HIV/AIDS. He stated,
“...we have to ask ourselves ...whether or not HIV/AIDS infection rates are more
prevalent in these areas because they are tourism areas, because tourism promotes a
certain type of behaviour, or is it that people with HIV or AIDS are coming to the tourist
areas?...Is tourism a victim of its own success? Or is tourism creating the environment
for high risk behaviour?”
Boxhill (2004) also notes that Sharpley (1999) suggested that tourism may not necessarily be the cause of
prostitution but it contributes to the activity. Human Resources managers were also asked to express their
views on the link between tourism and HIV/AIDS. One of the respondents communicated that the disease
is spread by employees who make business trips, engage in unsafe sexual activities and subsequently
return to transfer the disease to their regular partners. Another respondent indicated that the tourism
industry was one of the major contributors to the spread of HIV/AIDS.
Common conclusions about the relationship between tourism and HIV/AIDS include, unaccompanied
travellers were more likely to engage in sexual activity with the local population, the use of condoms
between tourists, fellow tourists and locals was inconsistent, young people make new friendships while
on holiday and engage in unsafe interactions, and the consumption of alcohol is an important factor in the
sexual behaviour of tourists.
Boxhill (2004) notes, that in relation to the question, how can HIV/AIDS affect tourism?, some
researchers have suggested that, in addition to an increasingly ill population, a country can become
31
Ian Boxhill, “An Exploratory Study of the Relationship between Tourism and HIV/AIDS in Jamaica and The
Bahamas,” Photocopy, Department of Sociology, Psychology and Social Work, University of the West Indies,
Mona.
Page- 95 -
stigmatized for its high levels of HIV/AIDS which can result in the decreased numbers of tourists. It was
believed that tourists would have reservations about the safety of hospitals and related institutions.
Forsythe et al (1998), however, countered that argument with the results of a survey conducted on tourists
to the Dominican Republic. Eighty-three percent (83%) of the visitors interviewed said that their
knowledge of the spread of HIV/AIDS had nothing to do with the choice of destination. However,
Forsythe (1999) indicated that due to the mobility of the workforce, the nature of the industry, the
presence of sex tourists and the heavy dependence on tourism revenues, tourism can be significantly
affected by HIV/AIDS.
Sex Tourism as a threat to Sustainable Tourism
Some authors have discussed sex tourism not only as a threat to health tourism but also to sustainable
tourism. Omondi (2003) defined sex tourism as “tourism for which the main motivation or at least part of
the trip is to consummate or engage in sexual relations.” 32 Omondi (2003) also suggested that the rise in
tourism industry also spurred the increase in sex tourism. The author further stated that sex tourism “is
both an economic and political phenomenon because (there must be) a market and the transactions must
be considered socially and politically legitimate.”
Three key factors that motivate persons to engage in sex in exchange for cash or kind have been given
Trumbull (2001). Firstly it is seen as an avenue through which daily expenses can be supported.
Secondly, sex work often finances education and finally, it is a way to obtain material possessions.33
Perkins (2008) suggests that poverty and limited education are not the only reasons for engaging in sex
work – the activity is an economically viable option. She supports this position by recounting the
experiences of sex workers who received a secondary education and voluntarily decided to forego tertiary
education to pursue work in the sex industry.
The sex tourist was often illustrated as an older man whose physical appearance has deteriorated and
travels to developing countries such as Asia, Africa, Latin American and the Caribbean. Existing sex
tourism research tends to revolve around the exploitation of developing countries by high inflows of male
tourists. Child exploitation is also often the highlight. Research also neglects to discuss sex workers who
travel abroad, homosexual tourism, voyeuristic tourism and sex tourism in developed countries. In the
32
Rose Kisia Omondi, “Gender and the Political Economy of Sex Tourism in Kenya’s Coastal Resorts,”
http://www.arsrc.org/downloads/featu res/omondi.pdf (accessed August 3, 2008).
33
Charles Trumbull, “Prostitution and Sex Tourism in Cuba,” (paper presented at the Eleventh Annual Meeting of
the Association for the Study of the Cuban Economy (ASCE), FL, August 2-4, 2001)
http://www1.lanic.utexas.edu/project/asce/pdfs/volume11/trumbull2.pdf (accessed June 24, 2008)
Page- 96 -
latter instance, it is difficult to attach the concept of dependency to developed countries. The literature
also paints the sex worker as the ‘abused’ party because that person’s body is used for the pleasure of the
customer. However, the customer may be the abused party when they send money to the provider in
between visits.
The debate about the relationship between sex work and tourism is covered in three (3) ways. Some
researchers suggest that all sex work is a subset of tourism; the whole of tourism is a subset of sex work,
and while sex work and sex tourism are interrelated – they are not similar.
The concept of the sex tourist has changed. Increasingly, there are more female tourists who are
economically independent who travel alone to countries such as the Dominican Republic and Jamaica to
have relations with male entertainment staff at hotels and “Sanky-Pankies” (male commercial sex
workers). 34 The women exert financial power over the male prostitutes.
Oppermann (1999) suggests that the traditional perspective of sex tourism ignores five (5) additional
parameters in addition to monetary exchange that can be used to define the former. In the first parameter,
travel purpose, intentions, and opportunities, proposes that business travellers or persons attending
conferences make use of prostitutes while away from home. They then become ‘situational sex tourists’.
These individuals may not travel with the sole intention of engaging in activities with a commercial sex
worker (CSW) but the opportunity arises. This raises questions about what criteria should be present in
order to classify someone as a sex tourist; does sexual behaviour need to be pre-planned? Or is the
possibility of contact enough? And what about individuals who are induced to engage in activity via
advertisements?
The second parameter is monetary exchange. Prostitution is an economically viable option for many
people. However, sex tourism moves beyond the financial transaction. For mistresses, they are provided
with accommodation, clothing and travel and sexual encounters occur without direct exchanges for
money. The provider and the seeker sometimes refer to the operation as ‘courtship’. Payment can also be
made in the form of a visit to the seeker’s home country. Seekers also pay for hospital visits, education
and other family members of the provider. When payment is made in the aforementioned ways, the
prostitute is more of a ‘friend’. This is also a distinction in the way sex tourism is manifested in
34
Steven Forsythe et al., “Protecting paradise: tourism and AIDS in the Dominican Republic”, Health Policy and
Planning 13, no. 3(1998), http://heapol.oxfordjournals.org/cgi/reprint/13/3/277 (accessed 30 June, 2008).
Page- 97 -
developing countries as opposed to developed. The ‘soft-selling techniques’ of developing nations lets
both parties interpret the nature of the relationship.
Oppermann adds that the length of time spent ‘together’ by the sex provider and the sex seeker is an
important factor. Visits can span from days to weeks. The seSex tourist seekers can see themselves as
being in love or involved in a sexual and emotional relationship in order to conceal the economic
underpinnings from themselves.
Fourthly, the seeker-provider relationship can evolve from sexual service for cash to travel companions
to marriage over time. This progression can reduce the extent of ‘risk-taking’ by both parties.
The sexual encounter has traditionally been viewed as heterosexual in nature. This definition ignores
homosexual encounters. Also, questions are raised about the criteria for encounters. Sex tourists do not
always seek direct physical contact. This applies to voyeurists and persons who require sexual stimuli.
Finally, who really travels? is asked. There are cyberspace sex tourists who do not actually travel but use
the internet and pay for live performances. Further, there are circumstances when the sex provider
becomes the business tourist. There are instances where both the provider and the seeker are foreign to the
area. Male immigrant populations are sometimes serviced by immigrant prostitute populations who have
come to the country solely for that purpose. This may be an important area for Trinidad and Tobago
which currently houses a Chinese male immigrant population who are primarily employed as construction
workers. Prostitutes in the Dominican Republic who live in inland rural areas often travel to tourist hubs
on the coast during peak seasons but return home.
The parameters discussed above unravel the notion of an ‘ideal’ sex tourist. Oppermann theorizes that
“sex tourism is more a matter of continua than a hard and fast definition”.
The above discussion allows the following question to be asked - ‘Does the perception that sex tourism
exists to a large extent in a tourist destination influence the destination choice? Marshalls (2007) cited
the World Trade Organization (WTO) (2006) as stating that “the tourism sector is highly sensitive to the
impacts of the natural and man-made disasters.” 35 The WTO classified the effects on tourism as
35
Maurice Ndalahwa Marshalls, “Country Image and its Effects in Promoting a tourist destination,”
http://www.bth.se/fou/cuppsats.nsf/all/5cf5064f9fb0e3e6c12572bb00020a80/$file/Marshalls%20Evaluation%20cop
y.pdf (accessed July 11, 2007).
Page- 98 -
environmental, geopolitical, societal and technological. Societal effects included pandemics such as
HIV/AIDS, Severe Acute Respiratory Syndrome (SARS), and Ebola.
Dolin Car (2007) noted that authors Cossens & Gin (1994) concluded that tourists allocated a higher level
of risk to countries with HIV rates. Further, 15% of the respondents said that that perceived risk
influenced their travel decision.
In an assessment of the ‘average strength of event influence on booking decision on a scale from low
(1%) to high (100%),’ for student tourists, Dolin Car (2007) also noted that contagious diseases were
assigned the highest level of perceived risks in international travel. For adventure tourists, the occurrence
of life threatening diseases would prevent 60% of travellers from making a booking to a destination. It
suggests that for both segments of tourists, health concerns are an important factor when making purchase
decisions.
Han (2005) also contributed a response to the aforementioned question in his dissertation on perceived
risk playing a dominant role in travel decisions. The dimensions of perceived risk which were identified
include, ‘financial risk,’ physical risk,’ ‘social risk,’ ‘psychological risk,’ ‘time risk,’ satisfaction risk,’
equipment risk,’ ‘terrorism risk,’ ‘political instability risk’ and ‘health risk.’ Perceived risk can add to a
tourist’s anxiety. Further, a general perception of risk can result in economic losses. ‘Health risk’ was
defined as “the possibility of becoming sick while travelling to or at the destination.”
4.1
HIV/AIDS as a slow-onset disaster
In light of the foregoing discussion, the key question therefore is whether or not HIV/AIDS is a
‘Disaster’. In other words, does HIV/AIDS meet the intricacies of the definitions of disaster in literature?
Before attempting to contextualize HIV/AIDS within the disaster literature, it is useful to make two
statements about the disease. Firstly and as stated before, HIV can be transferred via sex, blood or birth.
In addition, at present there is no cure for the epidemic (AIDS) but treatment is available in the form of
anti retroviral treatment.
The epidemic attacks the human immune system causing severe illness which ultimately leads to death. It
has the capacity to cause widespread human loss thus disrupting the functioning of a community, country,
region and the world. In the literature, many of the researchers defined disaster along the line of social
Page- 99 -
disruption which results in the failure of social systems or in social relations and/or a collapse of social
structural arrangements. Strangely enough, the HIV/AIDS epidemic causes social disruption, and if
manifested, results in failure of the social system and more so, influences the collapse of structural
arrangements! As such, the epidemic contains all the ingredients to be classified a disaster. The question
that arises now is: what category does HIV/AIDS fit into: slow-onset disasters or rapid-onset disasters 36?
HIV/AIDS has been regarded as a creeping disease since the period between HIV infection and full blown
AIDS covers an average period of ten years or more (Burger and Brynard 2001). As such the impacts take
time before they manifest themselves. HIV/AIDS, due to the long latency period from infection to death,
can be compared to other disasters like famine, where the impacts take time to ‘reveal’ themselves. As
such, HIV/AIDS can be classified as a slow-onset disaster. However, it is worth noting that once the
epidemic gains momentum the impacts can be quite devastating37. It is in this regard that HIV/AIDS can
be classified as an unfolding disaster!
Burger and Brynard (2001) highlighted two different categories of disasters. The categories are defined in
terms of the speed at which the disaster occurs, for example, rapid-onset disasters and slow-onset
disasters. There are also phases for each category of disaster. Rapid-onset disasters occur over a relatively
short space of time and their phases include: mitigation, rehabilitation, reconstruction, relief and
preparedness. Slow-onset disasters occur over a relatively long period and follow the following phases:
early warning, emergency and rehabilitation.
The World Disasters Report 2008 compiled by the International Federation of Red Cross and Red
Crescent Societies also referred to HIV/AIDS as “national and society-wide disaster” and an
“emergency.” The report noted the definition of an “emergency” by Whiteside and Whalley (2007),
“An emergency can be thought of as an event affecting a group of people, causing a
social, infrastructural or health impact which places the population under an excessive
amount of stress and exceeds their coping capacity.” 38
The position with respect to a typology of disasters is supported via a discussion about some of the effects
of HIV/AIDS which include a drastic decrease of life expectancy rates, and a threat to the enhancement of
36
See page 54 for definitions of slow-onset and rapid-onset disasters.
See section on: Impact of HIV/AIDS on Sustainable Tourism Development
38
Alan Whiteside and Amy Whalley, “Reviewing ‘Emergencies’ for Swaziland Shifting the Paradigm in a New
Era,” http://data.unaids.org/pub/Report/2007/swaziland%20emergency%20report_final%20pdf_en.pdf (accessed
July 11, 2008).
37
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human capabilities in the form of high mortality rates and, by extension, human development. While all
countries are affected by the disease, the aforementioned is acutely experienced on the African
continent. 39
Further, the World Disasters Report 2008 discussed indicators in nations with the highest prevalence of
HIV to re-enforce its position on the classification of HIV/AIDS as a disaster. These included: 40
1. “Macroeconomic dislocation and priority-shifting,” here, due to an undersized pool of taxpayers,
the revenue to government in the form of taxation decreased. Concomitantly, there was also
increased public spending to attempt to control the spread of the epidemic. An indirect result of
the aforementioned is the heightened perception of economic instability by the international
community;
2. “The negative economic impact on individuals and families,” families are forced to allocate
already limited resources to caring for the infected relatives. The income-generating capacity of
the family is diminished due to inability to work;
3. “Growing numbers of children orphaned by AIDS,” 15 million children are orphaned before the
age of 18, with12 million of those children living in sub-Saharan Africa; and
4. “Psychological impacts” include anxiety and depression. These forms of mental illness are
particularly severe in children.
There are number of ways in which HIV/AIDS can cause social disruption which may result in the
collapse of structural arrangements in a society. These are:
1. Human capacity shortfalls for sectors dependent on human capital, resulting from HIV/AIDS
related illnesses and deaths;
2. Increased number of orphans as infected members of the household die from AIDS;
3. Emergence of gender related obstacles in relation to treatment care and prevention of HIV/AIDS;
4. Psychological impacts on those infected with the disease and their families and
5. Increased burden on public health sector to provide treatment and care for those infected, who are
most times the most vulnerable in society.
39
International Federation of Red Cross and Red Crescent Societies, “World Disasters Report 2008: Focus on HIV
and AIDS,” http://www.ifrc.org/Docs/pubs/disasters/wdr2008/WDR2008-full.pdf (accessed July 3, 2008).
40
Ibid.
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The list provided above simply reflects some of the channels through which HIV/AIDS can affect the
normal functioning of a system and by no means exhaustive. In such a situation, where the system fails to
function normally, there is need for intervention to reinstate stability41. As with other disasters, disaster
management tools can be applied to HIV/AIDS to minimize and mitigate the threats that such a disaster
pose to society and the economy.
Burger and Brynard (2001) stated that the United Nations Disaster Management Team Programme
defined a disaster as
“a serious disruption of the functioning of a community causing widespread human,
material or environmental losses which exceed the ability of the affected community to
deal with the disaster by means of its own resources.”42
The authors highlighted that a key feature of the definition of a disaster is that communities are unable to
cope with the manifestations of the disaster. The HIV/AIDS epidemic has been referred to as a
‘catastrophe’, an ‘AIDS Disaster’ and even a ‘social disaster.’ Burger & Brynard (2001) postulated that
HIV/AIDS has all the characteristics of a disaster and should be categorized as a slow-onset disaster.
HIV/AIDS is regarded by the authors as a threat and a “silent” epidemic.
This categorization would then inform the manner in which disaster management principles can be
applied in order to control the disease. A slow on-set disaster takes place over a long period of time. A
disaster of this type ought to have identifiable phases in order to implement management strategies. The
authors suggested that a slow-onset disaster could have an early warning phase; emergency phase and a
rehabilitation phase to which management strategies could be applied.
The latter point referred to above was also put forward by Foster and Williamson (2000). The authors
suggested that children are subjected to recurrent psychological trauma which began with the death of
their parents and continues with persistent poverty, and sexual abuse. These children have the above
experiences without emotional support and education to overcome their circumstances. The children
become child care providers and engage in domestic duties, and income generating activities. The new
responsibilities result in school attendance decreasing significantly or altogether. Orphans were more
41
This statement is consistent with Porfiriev (1998) definition of disaster. See page 52
D. Burger and Petrus Brynard, “HIV/AIDS - The Slow-Onset Disaster: Disaster Management Perspectives and
Challenges into the New Millennium,” Journal of Public Administration 36, no. 2 (2001),
http://www.up.ac.za/dspace/bitstream/2263/5473/1/Burger_HIV(2001).pdf (accessed July 7, 2008).
42
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likely to be depressed at ages 10-14 years, more likely to die from malnutrition and poor health care and
more likely to have their sexual debut from an early age.
Hartman and Squires (2006) take the standpoint that “there is no such thing as a natural disaster.”43
Disasters are events that occur within a societal context. This context is shaped by class, race, gender and
other factors. Social underpinnings which exist before an event only widen the subsequent chasm.
43
Havidán Rodriguez (Reviewer), “There Is No Such Thing as a Natural Disaster: Race, Class, and Hurricane
Katrina,” Routledge, 2006.
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Chapter 5:
The Economic Significance of Sex Tourism
Lim (1998), when addressing the sex work industry in Southeast Asia, suggested that there is an interest
in the economic contributions of the sex sector due to sex-related tourism. Lim (1998) cited the following
economic data for other sex tourism destinations:
•
In 1995, Australia estimated that the sector generates $30 million a year.
•
Indonesia’s sex sector earned between US$1.27 million and US$3.6 billion.
•
The Japanese sex industry contributed approximately 1% to GDP.
•
It was found that for the period 1993-1995, prostitution was Thailand’s biggest underground
business and contributed for two-thirds of total illegal income.
In 1998 a report “The Economic and Social Bases of Prostitution in Southeast Asia”, the ILO supported a
call for the recognition of the sex sector. The report suggested that the sex sector now has the
characteristics of an industry and, therefore, contributes to employment, national income and economic
growth of countries. Despite its growth, the sex sector has inherent hazards such as the transmission of
HIV/AIDS. Interest in the economic contributions of the sex sector has gained popularity due to sexrelated tourism.
A major challenge which has been identified, is that attempts to deal with the sex sector is dominated by
moral issues, religious perspectives, human rights and criminal issues rather than an economic approach.
Further, in some countries the focus is on macroeconomic policies which promote tourism and revenue
receipts as opposed to sex work. Policies which tackle sex work need to account for adults who
voluntarily engage in this line of work and need to address the possibility of looking at it as legal
profession which is regulated by law, health regulations and social security. Those policies must differ
from those which address child prostitution.
As indicated above, sex sector establishments may be ‘organized’ or ‘unorganized.’ Organized
establishments have managers or proprietors. Defined relations are laid out for the sex workers and
‘pimps’ (female or male) may also act as the intermediary between the sex workers and clients. Organized
sex work can take the form of massage parlours, call-girl establishments, official brothels and nightclubs.
Conversely, in less organized circumstances, there are no intermediaries although the sex workers may
have someone to protect them from harm.
Page- 104 -
The report reiterated that income is not only generated directly but indirectly through redistribution in the
form of remittances. Income from this sector is used by some of its participants as a means to compensate
for the lack of access to public services such as social security and to combat poverty. It was found that
for the period 1993-1995, commercial sex trade was Thailand’s biggest underground business and
contributed to two-thirds of total illegal income. The lack of effective enforcement of laws and ballooning
profits were contributing factors to the success of the business. It is possible to capture revenue from the
sex sector in the form of licenses which are issued to entertainment establishments, as well as through
liquor and cigarettes taxes.
In the section to follow we will explore the potential economic significance of sex tourism within the
Caribbean context using two of our case countries, Jamaica and the Dominican Republic, as the basis of
our analysis.
Page- 105 -
5.0 Economic significance of sex tourism- The Case of Jamaica and the
Dominican Republic
It is important to explore the motives for engaging in commercial sex work as identified by the sex
workers. Economic independence, high levels of unemployment and lack of “qualifications” were cited
among the main reasons why CSWs continue to engage in high risk sexual activity. This is not surprising
given the high levels of unemployment in some of the parishes from which CSWs migrate or originate.
Over half of the CSWs interviewed in Jamaica did not live in the parishes in which the tourist hubs are
located. The respondents lived in the St. Catherine, Westmoreland and Kingston/St. Andrew parishes
where the unemployment rates in those parishes in 2003 were 23%, 11%, 35% respectively.
Economic independence has differing underpinnings for women and men. FSWs cited that they do not
have to rely entirely on a man or be taken advantage of. Their reasons for engaging in sex work include
the need to meet their needs such as paying the bills and taking care of their family. Sex work was the
only form of economic activity in which all the interviewed FSWs engaged - thus making the activity
their only source of income. The MSWs, on the other hand, did not mention that taking care of family or
meeting their economic needs were their main reasons for engaging in sex work. Their motives were
vastly different from FSWs. The MSWs, in addition to wanting to make quick and easy money, took
pleasure in sex work, found it fun and, in one case - a distraction from a previous career. Many of the
MSWs were also otherwise employed as an accountant; entertainment coordinator; a bus driver;
construction worker; chef; masseuse and a boat operator. Even when asked about what are the measures
in place to help with expenses if they were to fall ill, insurance was cited. Some of the MSWs were
already part of the formal work force. This was not the case for the FSWs.
However, both MSWs and FSWs noted that sex work helps them to do a number of things such as make
money quickly without working too hard or for long hours; facilitates working for themselves; and
provides the option to not work in professional jobs that do not pay as well. Economic independence is an
important factor when deciding whether to continue to engage in sex work. All of the respondents noted
that they do not have to depend on anyone for money.
Page- 106 -
An interesting dimension of the commercial sex trade among CSWs in both the Dominican Republic and
Jamaica is that some sex workers “export” their services and work in other Caribbean countries –
primarily the Bahamas, St. Lucia, Antigua, Saint Martin, The Turks and Caicos and Barbados.
From an economic standpoint, specifically in terms of the potential economic significance of Commercial
Sex to the economies of Jamaica and Dominican Republic, it should be noted that earnings obtained from
sex workers are not directly captured by the State via income taxes. However, the CSWs as consumers of
goods and services, contribute to the national income via payment of Government Consumption Tax
(GCT) spent procuring goods for themselves or any one of their dependents or children identified earlier.
A multiplier effect is therefore created when their earnings are spent on goods and services.
5.0.1 Estimations of potential fiscal gains from CSWs via GCT
Based on the findings of focus groups and key informant interviews in Jamaica, the following information
is known:
• FSWs earn as little as US$15 (JA$1000) or as much as US$140 (JA$10,000) a night. Tips which
can add an additional US$23 (JA$ 1500).
• FSWs might provide services for between 5 to 6 clients per night or on a “good” weekend.
The results of the survey of CSWs in Jamaica show average weekly income can range from US$45 –
US$600 (US$2340 – US$31,200 per year). 44 . They can earn as much as US$2,000 45.
Recent data were not available for the Dominican Republic46 but a 1995 study showed that “selfemployed” female sex workers, after paying a hotel employee to enter the resort, can earn between US$4US$28 per episode for a limited period of time. In some cases sex workers can earn US$28 a week –
44
Annual Salary and Benefits Survey (2007) received from the Jamaica Employers’ Federation was used to compare
the yearly salaries of formal tourism employees in low paying jobs with that of earnings of CSWs. The former
earned approximately US$20,000 less than CSWs in a year.
45
The MSWs indicated that in addition to cash, they also received clothing and gifts. Two MSWs indicated that
they only received gifts and clothing, no cash.
46
An economic significance survey comparable to what was done in Jamaica was not conducted for the Dominican
Republic
Page- 107 -
which is considered to be decent earnings. Most sex workers, however, earn between US$8-US$14. 47 In
2001, a male sex worker (MSW) may have earned US$117 a month or from one episode.48
If we consider that the economic “benefits” to be derived from CSWs can be picked up through
contributions made via the payment of consumption taxes. An estimate of this figure for a typical
commercial sex worker is presented below.
The following assumptions can therefore be made as it relates to the application of this indirect tax to the
group:
1) The Consumption Tax is 16.5% 49;
2) CSWs are considered to have consumption patterns similar to that of the average household in
Jamaica and the DR;
Based on the literature as well as from the interviews conducted the following information is known about
the commercial sex workers:
1. The average price of an episode is $75 US 50;
2. A CSW has between 2-10 episodes per week; and
3. The CSW population ranges from 852-2500 persons in Jamaica and 70,000 to 100,000 for the
Dominican Republic.
If the above assumptions are taken into account, the following were concluded for Jamaica:
•
Given that a CSW spends 10% of his/her income on goods and services their contribution to
government’s revenue can range between an estimated US$109,000 per annum to US$1.6m per
annum.
•
If a CSW spends 20% of his/her income on goods and services their contribution to
government’s revenue from GCT can range from an estimated US$220,000 per annum to
US$3.2 million per annum.
47
Julia O'Connell Davidson and Jacqueline Sanchez Taylor . “Child Prostitution and Sex Tourism: Dominican
Republic,” http://www.childtrafficking.com/Docs/o_connell_1996__child_prost3.pdf (accessed November 19,
2008).
48
Mark Padilla, Caribbean Pleasure Industry: Tourism, Sexuality and AIDS in the Dominican Republic (Chicago:
University of Chicago, 2007), 31and 43.
49
The value of this tax varies depending on the sector or the good/service under consideration. It is applied on the
value added to goods and services. It is a tax on consumption and is included in the final price the consumer pays for
goods and services
50
This represents an average of the fees charged across both countries and across the various price ranges.
Page- 108 -
•
If the percentage of income spent on goods and services is increased to 30% then the contribution
of a CSW to the GOJ would range from an estimated US$330,000 per annum to US$4.8 million
per annum.
•
government’s revenue can range between an estimated US$ 550,000 per annum to US$8 million
per annum.
If the above assumptions are taken into account, the following were concluded for The Dominican
Republic:
•
government’s revenue can range between an estimated US$9.288m per annum to US$64.4
million per annum.
•
If a CSW spends 20% of his/her income on goods and services their contribution to
government’s revenue from GCT can range from an estimated US$18.5m per annum to
US$128.7 million per annum.
•
If the percentage of income spent on goods and services is increased to 30% then the contribution
of a CSW to the GOJ would range from an estimated US$27.8m per annum to US$193.1
million per annum.
•
government’s revenue can range between an estimated US$46.3m per annum to US$321.8
million per annum.
From the above estimations it is clear that the sex industry is contributing significantly to government
revenues in their respective countries. These contributions are also significant when one explores the
likely areas of expenditure by the CSWs in these territories. In the case of Jamaica a series of eight focus
groups were held with CSWs in the tourist hubs of Ocho Rios, Montego Bay and Negril on the north
coast of Jamaica. From these groups sixty percent (60%) of the sex workers interviewed had children.
Typically they have between 1 to 4 children with ages ranging from 1 year old to 16 years of age.
Additionally most Female Sex Workers also had dependants which included mothers, sisters, etc.
Page- 109 -
Chapter 6:
Recommendations for Sustainable tourism
development given slow-onset disasters
6.0
Policy Conclusions and Recommendations
It is recognized that prostitution and sex work is illegal in the Caribbean and the degree to which it is
generally accepted that sex tourism is part of the tourism product varies across territories, from Tobago on
one hand, where commercial sex workers are less conspicuous, to the Dominican Republic on the other.
Here, there is a greater sense of openness about the existence of sex tourism, even though it is not an
advertised component of the country’s tourism product. Sex tourism is “normal” and “profitable” in the
Dominican Republic as sex workers in establishments have health cards and are required to undertake
periodic health checks including checks for sexually transmitted diseases. Tourist hubs such as Punta
Cana, Puerto Plata, Bavarro and Juan Dulio which promote the all-inclusive product often include
transactional sex as part of the holiday package.
The reality is however that a significant, potential source of economic benefit and cost to region’s tourism
sector lies in the sex dimension of the tourism product. Festivals and cultural events that constitute part
of the tourism sector and which explicitly promote “freeing up” including all the sexual innuendo, do
little to diminish the perception of the 4Ss of the Caribbean tourism industry.
In light of the foregoing, the challenges of dealing with and internalizing the threat of HIV/AIDS in these
tourism-dependent countries will require different approaches at the policy-making/governmental level in
line with the degree of maturity of the sex tourism industry and the level of acceptance that exists in the
respective local settings.
At the centre of these approaches must be a move away from the urge to adopt punitive measure towards
those who ply their trade in the commercial sex industry as a first option. This is based on human rights
principles supporting the right of people to make informed choices about their lives, in a supportive
environment that empowers them to make such choices free from coercion, violence and fear. (UNAIDS,
2009) Any attempt at these punitive measures, it has been proven, will only result in this group going
underground and proving more difficult to reach. This will also manifest itself in a reluctance to access
medical services, and more importantly to be the recipients of key intervention that will ensure the sex
worker continues to live safely. Given the significant contribution that has been highlighted above by this
group toward the real economy, any attempt to curtail this flow can have serious ramifications on the well
Page- 110 -
being of the families and children of these CSWs, thereby putting additional burden on the state to treat
with their economic and social needs.
On the other hand programmes and policies that seek to provide key health and social services to this
group and a supportive environment that facilitates the provision of these services will achieve the
success of minimizing the risk and vulnerability that is associated with this group. Additionally such
approaches will provide the opportunity for key interventions that are geared towards treating with some
of the negative social spin offs that are associated with and impact on commercial sex work, these include
trafficking, violence and exploitation of women and children, forced sex work and drug abuse. Instead
attempts at ensuring that this group remains accessible to programme interventions will make for a more
efficient use of national resources in addressing the HIV/AIDS epidemic in these territories.
Page- 111 -
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http://proquest.umi.com/pqdweb?did=1153139721&sid=2&Fmt=6&clientId=31897&RQT=309&VName
=PQD (accessed July 17, 2008).
World Travel and Tourism Council. “The 2008 Travel and Tourism Economic Research: Jamaica.”
World Travel Tourism Council. The 2008 Travel and Tourism Economic Research.
World Bank: www.worldbank.org
World Travel and Tourism Council: http://www .wttc.org
World Travel and Tourism Council Travel and Tourism Economic Impact, Barbados: 2009
World Travel and Tourism Council Travel and Tourism Economic Impact, St. Lucia: 2009
Page- 119 -
Appendix I
Table 1 - Assuming that CSW’s spend 10% of their income on goods and services that have the GCT component:
No
of
Episodes per
week
per
CSW
Avg.
Earning
per
Episode
Est. Earning
per week per
CSW
Est.
Earning
per year per
CSW
Contribution
to
Total Gov’t Rev
from GCT per year
per CSW
Contribution
to
Total Govt. Rev.
from GCT per year
Contribution
to
Total Govt. Rev.
from GCT per year
CSW’s = 852
CSW’s = 2500
2
75
150
7, 800
129
109, 652
321, 750
5
75
375
19, 500
322
274, 131
804, 375
7
75
525
27, 300
450.
383, 783
1.123 M
10
75
750
39, 000
644
548, 262
1.609 M
Note: Figures are in US$
Table 2- Assuming that CSW’s spend 20% of their income on goods and services that have the GCT component:
No
of
Episodes per
week
per
CSW
Avg.
Earning
per
Episode
Est. Earning
per week per
CSW
Est.
Earning
per year per
CSW
Contribution
to
Total Gov’t Rev
from GCT per year
per CSW
Contribution
to
Total Govt. Rev.
from GCT per year
Contribution
to
Total Govt. Rev.
from GCT per year
CSW’s = 852
CSW’s =2500
2
75
150
7, 800
257
219, 305
642, 500
5
75
375
19, 500
644
548, 262
1.610 M
7
75
525
27, 300
901
767, 567
2.252 M
10
75
750
39, 000
1, 287
1. 097 m
3.218 M
Page- 121 -
No
of
Episodes per
week
per
CSW
Avg.
Earning
per
Episode
Est. Earning
per week per
CSW
Est.
Earning
per year per
CSW
Contribution
to
Total Gov’t Rev
from GCT per year
per CSW
Contribution
to
Total Govt. Rev.
from GCT per year
Contribution
to
Total Govt. Rev.
from GCT per year
CSW’s = 852
CSW’s = 2500
2
75
150
7, 800
322
274, 344
805, 000
5
75
375
19, 500
804
685, 008
2.01 M
7
75
525
27, 300
1, 126
959, 352
2.815 M
10
75
750
39, 000
1, 609
1.371 m
4.023 M
Page- 122 -
No
of
Episodes per
week
per
CSW
Avg.
Earning
per
Episode
Est. Earning
per week per
CSW
Est.
Earning
per year per
CSW
Contribution
to
Total Gov’t Rev
from GCT per year
per CSW
Contribution
to
Total Govt. Rev.
from GCT per year
Contribution
to
Total Govt. Rev.
from GCT per year
CSW’s = 852
CSW’s = 2500
2
75
150
7, 800
386
328, 872
965, 000
5
75
375
19, 500
965
822, 180
2.413 M
7
75
525
27, 300
1, 351
1.151 m
3.378 M
10
75
750
39, 000
1, 931
1.645 m
4.827 M
Page- 123 -
No
of
Avg.
Est. Earning
Est.
Episodes per
Earning
per week per
per
week
per
CSW
CSW
per
CSW
Earning
year
per
Contribution
Total
Gov’t
to
Rev
from GCT per year
Contribution
Total
Govt.
to
Rev.
Contribution
Total
Govt.
from GCT per year
CSW’s = 852
CSW’s = 2500
2
75
150
7, 800
644
548,262
1.61 M
5
75
375
19, 500
1609
1.370 m
4.023 M
7
75
525
27, 300
2252
1.917 m
5.63 M
10
75
750
39, 000
3218
2.741 m
8.045 M
Rev.
from GCT per year
per CSW
Episode
to
Page- 124 -
Table 6- Assuming that CSW’s spend 75 % their income on goods and services that have the GCT component:
No
of
Episodes per
week
per
CSW
Avg.
Earning
per
Episode
Est. Earning
per week per
CSW
Est.
Earning
per year per
CSW
Contribution
to
Total Gov’t Rev
from GCT per year
per CSW
Contribution
to
Total Govt. Rev.
from GCT per year
Contribution
to
Total Govt. Rev.
from GCT per year
CSW’s = 852
CSW’s = 2500
2
75
150
7, 800
965
822, 180
2.413 M
5
75
375
19, 500
2, 413
2.056 m
6.034 M
7
75
525
27, 300
3, 378
2.878 m
8.445 M
10
75
750
39, 000
4, 826
4.112 m
12.065 M
Page- 125 -

hiv and tourism study

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