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Early Lessons Forgotten, AIDS Conference Told
French AIDS activists protest their country's policies on the disease at the international conference in Mexico City.
(Eduardo Verdugo -- Associated Press)
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"The same kinds of stigma and discrimination and institutionalized homophobia that failed gay men in America is now failing men who have sex with men in the rest of the world," said Kevin Robert Frost, chief executive of Amfar, the Foundation for AIDS Research.
An Amfar survey of 128 countries found that men who engage in sex with other men are at greater risk of contracting HIV than others in the population. The term "men who have sex with men" emerged a decade ago to account for men who do not identify themselves as gay or bisexual but nevertheless have sex with other men.
In Asia, these men are 18 times as likely to contract HIV as the general population, while in Africa they are four times as likely to be infected, according to Amfar.
"We were surprised how extreme it was," said Chris Beyrer, an epidemiologist at Johns Hopkins University who helped prepare the report. "It is dramatically higher across all regions."
In many cases, AIDS rates among gay and bisexual men are "directly related to the institutionalization of homophobia," Frost said.
Eighty-five countries, including Jamaica, Belize, India and Egypt, have laws criminalizing sex between men. It is punishable by death in seven countries, including Nigeria and Saudi Arabia, and by imprisonment in 76, according to the International Lesbian and Gay Association.
"It's difficult to provide services to men who have sex with men in countries where they don't acknowledge they exist," said Craig McClure, executive director of the conference sponsor, the International AIDS Society. Even if they do not face criminal penalties, gay men can experience stigma and discrimination that lead to low self-esteem and risky behavior such as unprotected sex.
"We live in an environment where nobody likes us," said Shivananda Khan, an activist who works with gay rights groups throughout East Asia. "We are told every day that we are horrible. Very few people love us. How do we cope with the constant, daily stigma? We drown our sorrows."
One of the hardest-hit regions is Latin America, which for the first time this week is hosting the biennial AIDS conference. Men who have sex with men in the region are 33 times as likely as others to be infected with HIV, the highest ratio found in the Amfar study.
"It is mostly the issue of machismo and homophobia," said Jorge Saavedra, head of Mexico's AIDS office.
Saavedra has emerged as one of the stars of the Mexico City conference and is credited with helping spotlight the issue of HIV in gay men this week.
His speech to delegates Tuesday was the first time since 1993 that the topic of men who have sex with men was featured in a plenary session. Though he has not concealed his sexual orientation, Saavedra made a point of spotlighting it, announcing to the crowd that he is gay, married and HIV-positive.
"It is not wrong to be gay," he said. "What is wrong is the need to be hidden."
