Even with high levels of sexually transmitted infections (STIs) and risky sexual behavior, men who have sex with men (MSM) in Jamaica are reluctant to seek medical help due to fear of discrimination and stigma, The Jamaica Gleaner reports.

According to the article, a 2008 survey by the island’s Ministry of Health found that 31.8 percent of MSM in Jamaica are living with HIV, 8.5 percent had chlamydia, 5.5 percent had syphilis and 2.5 percent had gonorrhea. Additionally, 27.7 percent of the men surveyed reported having two or more sexual partners in the past four weeks and 33.8 percent admitting to having two or more female partners in the past 12 months.

The study indicates that the high number of STIs among the country’s MSM is linked to discriminatory laws—such as the Jamaican government’s legislation against sodomy—and mistreatment by the general population and those in the health sector, which all make it difficult to seek care.