Globe and Mail

Global AIDS researchers renew focus on gay men

BY ANDRÉ PICARD
August 6, 2008

MEXICO CITY — When the epidemic of HIV-AIDS began, it hit first and hardest in the gay community in Canada and the United States, a byproduct of promiscuous sexual activity in bathhouses and sex tourism in countries like Haiti.

A quarter of a century later, much has changed, but men who have sex with men continue to be, by far, the hardest hit by the virus. And the disease continues to spread most rapidly where homosexual sex is taboo, or criminalized.

In the Americas, men who have sex with men (MSM) are 33 times more likely to be infected with HIV than are people in the general population. In Asia, the rate is 19 times higher. And, even in Africa, where women account for the majority of new cases, MSM are four times more likely to have HIV.

“HIV disproportionately affects men who have sex with men in every region of the world, but we are ignoring this reality,” said Jorge Saavedra, director of CENSIDA, the national HIV-AIDS program of Mexico.

He said that is the case because man-to-man sex is hidden, stigmatized and often situational. In fact, researchers now use the term “men who have sex with men,” because many of the men do not consider themselves homosexual or bisexual; rather, they have same-sex encounters to make money (usually in tourist areas), or because they spend long stretches in isolated, all-male settings such as prison, the military and work camps. “We have failed to bring down the incidence of HIV-AIDS in MSM because we have not tried,” Dr. Saavedra told delegates attending the 17th International AIDS Conference in Mexico City.

“We are ignoring reality. We are ignoring scientific evidence.”

Craig McClure, executive director of the International AIDS Society and long-time Canadian AIDS activist, put it bluntly: “Homophobia continues to fuel the spread of HIV.”

He said ensuring human-rights protections for men who have sex with men and confronting the stigma of same-sex relationships are a prerequisite for stemming the epidemic of HIV-AIDS.

While gay men in North America have made tremendous gains in legal protections – an offshoot of their AIDS-related activism – that does not reflect the state of affairs globally.

In 86 countries, consensual same-sex activity is a criminal offence. In 21 of those countries, male-to-male sex is punishable by prison sentences or more, and in seven other countries it is punishable by death, according to a report by the Global Forum on MSM and HIV.

“Gay, bisexual and other MSM are largely invisible in many parts of the developing world, and in the majority of cases, subject to varying degrees of discrimination, violence and human-rights abuses,” said Robert Carr, the forum's co-chair.

The Mexico City conference began with a massive anti-homophobia march, one that was, in large part, a celebration of new legislation that bars discrimination based on sexual orientation, a striking change for a machismo society like Mexico. And days before the AIDS conference began, Panama, the only country in Latin America where male-to-male sex was a criminal offence, repealed the legislation.

Peter Piot, executive director of UNAIDS, said this sort of action is essential and called on other countries to drop policies that discriminate against men who have sex with men, saying they discourage them from getting care and from protecting themselves and partners against HIV-AIDS.

“Homophobia kills. We must kill homophobia,” Mr. Piot said.