Patricia Watson, Senior Staff Reporter
THE MORAL high ground taken by some groups and the unwillingness of the Jamaican Government to acknowledge the high number of men who have sex with men (MSM) prevents public acknowledgement of the spread of HIV among this group.
As noted last week, MSMs face contempt from the general public and 'sporadic harassment' from the police under the buggery law. Since the group is 'non-existent', estimating HIV among the group is like giving health workers baskets to carry water, that is, difficult. When presented with Ministry of Health data recently on HIV among MSMs, one gay man simply scoffed.
"Knowledge of HIV is very high among the community and safe sex is practised. It is an assumption and not necessarily true," he stated. "Too much energy is put into the issue of homosexuality we are imprisoned, we can't express ourselves, we can't express our freedom of choice."
Jamaica therefore seems to be groping in the dark in the area of HIV among homosexuals.
According to Antonio Miranda, an openly 'gay' man and member of the JFLAG (Jamaica Forum for Lesbians Allsexuals and Gays), since buggery is against the law in Jamaica, many homosexuals are forced into risky situations that can lead to the contracting of HIV.
"Men and women who have same sex relations may be fuelling the spread of HIV in Jamaica. Because of stigmatisation, you have several MSMs and lesbians who are having sex with both men and women," he noted.
As explained by Mr. Miranda, society appears to be pushing MSMs into heterosexual relations and in so doing are preventing them from practising healthy lifestyles.
The Behaviour Change and Communication Task Force report (2001) notes that one of the most serious barriers to intervention within the gay community is homophobia. Homophobia, according to renowned psychologist, George Weinberg in his book "Society and the Healthy Homosexual", is heterosexuals' fear of being in close quarters with homo-sexuals as well as homosexuals who hate themselves. http://psychology.ucdavis.edu/rainbow/html/sexual_prejudice.html also defines homo-phobia as an "aversion to gay or homosexual people or their lifestyle or culture" and "behaviour or an act based on this aversion." Homophobia is also seen as an irrational fear of homosexuality. Homophobia, the BCC report continued, like any other forms of bigotry, permeates all parts of the Jamaican society, from "the Prime Minister's Cabinet and Parliament to 3 - 6 year-olds at play in Jamaica's inner-city communities."
This ingrained homophobia poses many obstacles for those working with MSMs as well as the MSMs themselves.
"There is the problem of trust," Ian McKnight, executive director of the Jamaica AIDS Support said. "We know that the major aspect of this disease is about issues that affect the person infected and so even in a counselling situation, you need someone who can deal honestly with the situation. In the first instance, the person is positive and this is a social whammy and two, the person is a homosexual, and the psychosocial issues involved here is tremendous. They are unable to talk to their friends and relatives, and in some cases even their sex partners and this puts more people at risk."
G.M. Herek and J.P. Capitanio (1999) in an article entitled, 'AIDS Stigma and Sexual Prejudice,' in the American Behavioural Scientist, write that most people still link AIDS with homosexuality or bisexuality, and such association creates high levels of anti-gay attitudes. The writers also note that "people who contract AIDS sexually are assigned blame for their infection, but such blame is greater for a gay or bisexual man than for a heterosexual man or woman" and that "a sizable minority of the public equates all male-male sexual behaviour with AIDS, even sex between two uninfected men".
As a result of the above, Mr. McKnight and members of JFLAG who spoke to Outlook, claimed that MSMs even those without the HIV are prevented from accessing resources freely, be it educational or otherwise. As a result, he notes that a level of anger "looms in the com-munity as people treat them with disdain".
"Because of the homophobia, you find people are unable to go to public health institu-tions," Mr. McKnight stated.
He also added that caregivers experience discrimination across the board, which tends to handicap them in giving adequate and quality care. "There is a sort of institutionalised discrimination that prevents them from giving proper care."
In addition to the homophobia, the law as it pertains to buggery makes it difficult to speak openly about homosexuality in schools, prison or in the media.
Nickoy Jackson, another gay, echoed the same sentiments.
"Real sexual education is lacking in our schools. Chil-dren need to be aware of their sexuality and this will help in the reduction of HIV. Since buggery is against the law, we cannot speak about homosexuality in the schools.
"On the JFLAG hotline, we have got calls from a wide cross-section of the society on these issues. JFLAG needs to get out there, but there are financial constraints, which make it difficult to lobby. The main problem though is societal constraints. Even if we are trying to penetrate the society, it will be a difficult task. JLAG is not asking Jamaicans to accept homosexuality we are all human beings, we just need to be treated equally," he stated.
Many individuals in Jamaica, including the chief medical officer, the National AIDS Committee and some members of the Medical Association of Jamaica have been lobbying for the decriminalisation of buggery to make prevention efforts, a success. Some experts have even suggested that education on HIV transmission between MSMs be given to secondary school children and prisoners. This they note would give the individuals the tool needed to protect themselves from unwanted infections. This, however, cannot take place with any seriousness, unless the laws on buggery are revised.
Research has shown that where knowledge of HIV and AIDS is poor, HIV will spread more rapidly among such groups as MSMs. In North America and Western Europe prevention messages targeted at MSMs have resulted in a reduction of the number of HIV infections.
The United Nations Special Session on HIV/AIDS held in June 2001 also touched on the issue of homosexuality and HIV prevention. The session concluded that in order to 'get it right', countries need to involve marginalised groups in prevention programmes.
"In many societies, HIV is transmitted through practices and behaviour that may be illegal or taboo. In those instances, legal sanction and hostile public attitudes impede programmes aimed at reducing the danger of infection for stigmatised people. That need not be the case," the UN report noted.
It further stated that because of the illegality of certain sexual practices, "the scope of prevention programmes is often inadequate, creating situations where activities do not reach population groups that are most vulnerable to HIV infection. Marginalised groups (such as men who have sex with men, sex workers, injecting drug users or prisoners) are more likely to be ignored in prevention efforts." None of the prevention messages used in the campaign against HIV involves persons in same sex relations. The messages are instead directed to hetero-sexuals, even though the Ministry of Health 'suspects' that a large proportion of the AIDS cases recorded as 'unknown' is either bisexual or homosexual men. As shown last week, between 1982 and December 2001, the percentage of AIDS cases by mode of transmission listed unknown at 24.81 per cent, heterosexual at 61.54 and bisexual at 3.31.
