Of particular concern in many parts of Asia are men who cannot be openly gay for fear of the authorities and who simultaneously have female partners in deference to social mores.
Sex between men is illegal in 14 out of 19 countries in the region.
Last week, a state-owned, 5-star hotel in the heart of Delhi’s diplomatic enclave played host to community groups working with MSM from 22 countries across the Asia Pacific regions.
For three days, behind closed doors, the groups deliberated alongside senior government officials, NGOs and international civil servants on how best to reach out to the MSM community across the region despite the limitations of the law. The discussions revolved around one overarching theme: the risks and responsibilities around male sexual health.
The tripartite regional consultation in Delhi was hosted by India’s National AIDS Control Organisation (NACO) and Naz Foundation International, an international NGO working with MSM communities in Asia.
The gathering took place at a time of increasing pressure on governments to legalise same sex relations. Recently, several well-known Indians - including Nobel Laureate Amartya Sen and writer Vikram Seth - wrote an open letter to the Indian government and members of the judiciary, supporting the “overturning of Section 377 of the Indian Penal Code, a colonial-era law dating to 1861, which punitively criminalises romantic love and private, consensual sexual acts between adults of the same sex”.
One observer commented on how the punitive law around same sex relations was feeding the HIV/AIDS epidemic in India.
"If the law allowed MSMs to go public, they would not perhaps get married. But in the current situation, there is a threat to married women who are being told to be faithful and have one partner. The woman will have the one partner but a man who has sex with other men has more than one partner," observed one of the key speakers Dr Nafis Sadiq, Special Adviser to the UN Secretary-General and Special Envoy for HIV/AIDS in Asia Pacific, in an interview with IRIN/PlusNews.
Numbers give an idea of the dimension of the problem. "The most conservative estimates for 2006 show there are at least 10 million men having sex with men in Asia Pacific who are several times more infectous than the general adult population. Data in Asia show that without interventions, male to male sex will become one of the main sources of new HIV infections in the region. We are facing a public health crisis, but you would never know it from the region’s almost invisible response so far," said J V R Prasada Rao, director of the Bangkok-based UNAIDS Regional Support Team.
Health services for MSMs and transgender people are almost non-existent in the region. "A very recent UNAIDS survey shows that most countries in the region do not include any interventions for MSM and transgender people in their National Strategic Plans on HIV. Only eight countries identified MSM as a priority group, and included interventions for them, in their strategic plans," Rao pointed out.
He added that in Thailand, where 20 percent of new HIV infections are among MSM, they account for just over one percent of national spending. "In some other countries like India, there is a budget for MSM interventions but implementing them is obstructed by the law," Rao added.
Community workers in many parts of India say the authorities make it difficult for them to work with MSM on HIV/AIDS.
"Our biggest problems are the police and doctors. Many [MSM] people we work with are poor - daily wage-earners - and cannot afford expensive private doctors. When they go to a government health clinic, the doctors taunt them about their sexual preferences. Many prefer to remain untreated rather than suffer discrimination and humiliation," said Christopher Jayakumar, head of the Andhra Pradesh Male Minorities Association - a network of 22 grassroots organisations working among and with MSMs in the southern Indian state of Andhra.
Despite this, Sujatha Rao, Director-General of NACO, assured the Delhi meeting that the Indian government was taking steps towards a better response towards MSM. Indeed, the home ministry and the health ministry were currently in consultation to better understand the emerging epidemiological situation and the law on male to male sex was being re-examined.
//This article is part of an IRIN/PlusNews series on HIV/AIDS and communities of humanitarian concern. Visit: PlusNews. //
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