Tourism, Hotel Concentration and HIV in Jamaica: A Parish-Level Mathematical Comparison of HIV Burden in Tourism and Non-Tourism Belts
Paul Andrew Bourne, PhD, DrPH
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Published: Oct 12, 2026
DOI: 10.58806/ijsshmr.2026.v5i10n02
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Background: Tourism is a major component of the Jamaican economy, with substantial hotel and visitor activity concentrated in Montego Bay, Ocho Rios and Negril and the surrounding north and north-western parishes. At the same time, Jamaica has experienced a geographically heterogeneous HIV epidemic, raising an important question concerning whether communities located in major tourism belts experience different HIV burdens from non-tourism areas. Objective: This study examines the ecological association between tourism/hotel concentration and reported HIV burden across Jamaica and develops a mathematical framework for assessing the tourism–HIV relationship. Methods: Secondary parish-level HIV surveillance data from Jamaica’s Ministry of Health were integrated conceptually with Jamaica Tourist Board accommodation statistics. The principal tourism belt comprised St Ann, Trelawny, St James, Hanover and Westmoreland, while the remaining reported parish units constituted the comparison group. Results: Ministry of Health data for 1982–2015 showed cumulative reported HIV case rates of 1,403.5 per 100,000 in St Ann, 1,237.4 in Trelawny, 2,465.4 in St James, 1,264.2 in Hanover and 1,324.9 in Westmoreland. The unweighted mean was approximately 1,539.1 per 100,000 in the tourism belt compared with approximately 889.9 per 100,000 in the non-tourism group, representing an ecological rate ratio of approximately 1.73. St James exhibited the highest cumulative reported HIV rate nationally, while Kingston and St Andrew demonstrated that elevated HIV burden was not unique to tourism-intensive areas. The findings suggest a geographic association between tourism concentration and historical HIV burden but do not establish that hotels or tourism cause HIV infection. Conclusion: Tourism intensity should be investigated as part of a broader system involving population mobility, sexual networks, urbanisation, transactional relationships, employment structures, testing intensity and socioeconomic conditions.
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