Homophobia threatens HIV prevention

Gay and bisexual men in a number of African countries are too afraid of discrimination to seek help or advice about HIV/AIDS.

Speaking on the 2010 International Day Against Homophobia in May this year, UNAIDS executive director Michel Sidibé urged all governments to take steps to eliminate stigma and discrimination faced by men who have sex with men.

“They must create social and legal environments that ensure respect for human rights and enable universal access to HIV prevention, treatment, care and support,” he said.

According to UNAIDS figures, between 5-10 per cent of HIV infections worldwide are estimated to occur through sex between men, although this figure varies considerably from country to country.

Yet men who have sex with men (MSM) continue to face discrimination from healthcare workers, other service providers, employers and police.

The difficulties that such men currently face in countries across Africa have recently been reported by amfAR, The Foundation for AIDS Research.

The amfAR MSM Initiative has highlighted the wave of homophobic rhetoric and violence that is undermining efforts to combat high rates of HIV/AIDS among the MSM sector of the population.

Human rights activists, AIDS advocates and grassroots MSM organisations say that progress made over the past several years is being threatened by a new climate of fear and repression.

This has particularly been seen in countries such as Uganda, where although same-sex sexual behaviour has long been outlawed, the ‘war’ against homosexuality has taken on a new dimension.

A new law proposed in Uganda is aimed at bringing in the death penalty for “aggravated homosexuality”, which includes any same-sex sexual activity by HIV-positive people.

It not only mandates up to life imprisonment for anyone convicted of such acts, but would also imprison anyone who knows of homosexual conduct and fails to report it – which would effectively criminalise the efforts of those providing HIV/AIDS services to members of the MSM community.

Pepe Julian Onziema, the HIV/AIDS programme coordinator at Sexual Minorities Uganda (SMUG), explained that providing HIV services has become nearly impossible.

“We are referring our clients to doctors who had agreed to help us, but they’re finding it difficult to continue because they are afraid something will happen to their jobs,” he told the MSM Initiative.

“One doctor still manages to get us condoms, which we are able to distribute through our men’s organisation. But we are limited in the number of people we are able to reach.”

If the new law is passed, Onziema acknowledges that his organisation will be unable to continue working openly with members of the gay community. “We will be forced underground, and that will only increase cases of abuse and HIV infection.”

Similar problems are reported in Kenya, where a mob of several hundred men attacked an HIV/AIDS clinic run by the Kenya Medical Research Institute (KEMRI) in the coastal town of Mtwapa, near Mombasa. This had followed a rumour that two local men were planning to hold a wedding ceremony there.

HIV/AIDS services in the area have since ground to a halt, said Peter Njane, director of the amfAR-funded group Ishtar MSM. “People used to get their antiretrovirals at KEMRI. While it’s been closed, there is no provision of condoms and lubricant; no medical services for this community.

“Some of the men who were attacked are not sure they will be able to go back to work as peer educators. And we are hearing from other AIDS organisations in the area that people are afraid to come to their office for meetings.”

One of UNAIDS’ ten priority areas in the Joint Outcome Framework for 2009-2011 is the removal of punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS.

Another key priority of the Framework is to empower men who have sex with men, sex workers and transgender people to protect themselves from HIV infection and to fully access antiretroviral therapy.

Unfortunately, as the amfAR MSM Initiative reports, there is a still a long way to go to meet these priorities.

And it is not only in African countries that such homophobia is affecting HIV/AIDS services to those in need.

Although many Latin American countries boast socially advanced legislation when it comes to defending sexual freedom and orientation, the lingering “machismo” which breeds prejudice and discrimination is continuing to flourish across Central and South America.

The stigma attached to same-sex relations in the region is complicating the task of slowing the spread of HIV, made worse by the fact that sex between men is a leading mode of HIV transmission.

In its 2008 report to the UN General Assembly on the state of the HIV epidemic, Brazil stated that men who have sex with men are eleven-times more likely to be HIV positive than the population as a whole.

And the impacts of these high rates extend beyond the men themselves. A Health Ministry study in Peru, for example, found that most women who get infected by the virus get it from men who have had a gay relationship.

Yet spending on HIV prevention among MSM in Latin America is proportionally very low. According to UNAIDS, less than ten per cent of the money spent on prevention goes into campaigns specifically aimed at MSM.

MSM is not something that governments in the region choose to make a lot of noise about. In most countries and by many institutions, it is just not seen as a political gain.

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