Old school fags might find it hard to believe. Young fags may not care (which is part of the problem). But one of the starkest truths to come out of the International AIDS Conference, held in Toronto this month, is that gay men aren’t really part of the plans to eradicate the disease worldwide.
The people who once were at the front of the fight against what used to be called “gay cancer” are now bringing up the rear — despite increasing infection rates amongst gay men in countries from Thailand to Canada. Celeb leaders like Bill and Melinda Gates, Bill Clinton and Richard Gere don’t seem to care for us.
So one of the most interesting initiatives coming out of the conference also makes one wonder, “Is this 1988 or what?” It was the launch of a global forum on men who have sex with men (MSM) and HIV/AIDS, a loose coalition of international groups that will try to get gay issues back on the world HIV/AIDS agenda.
Yes, that means it’s fallen off the world agenda.
For example, very little of the science at the conference included strategies that would be effective with homosexual men. Microbicides was the buzz word and right now they’re only talking about using them for women.
In many conference presentations, gay men were lucky to hear mention of “vulnerable groups” or “high-risk groups.” Most delegates know what these phrases are code for — MSM, sex workers and intravenous drug users. But it’s becoming increasingly unlikely the general public knows what it means. The mainstream media, chasing after the next big scientific breakthrough and the next celebrity, mostly played along.
“When Bill Gates and others neglect to mention us in their speeches, it contributes to our invisibility,” says New Zealander Joseph O’Reilly, of the International AIDS Alliance. “In a world committed to universal access to HIV prevention, treatment and care, fewer than one in 10 men who have sex with men have access to that. The gap is huge.”
This gap may be hard to believe for gay men living in western urban centres like Toronto, San Francisco or Amsterdam. In cities where gay men and lesbians led the fight in the 1980s and ’90s, it’s impossible to contemplate an AIDS organizations not being dominated by queers — as clients and staff.
In developing countries, though, getting money for HIV/AIDS often means purposely excluding “vulnerable communities” like gay men. Most US government money, for example, now comes with strings attached, strings that restrict talk of safer sex — abstinence must be option number one — homosexuality, sex work and drug use. In 2005 Brazil refused US$40 million because it would not sign a Bush government pledge opposing commercialized sex work. For Brazil, an emerging world power, the freedom to fight the disease as it saw fit was more important than the money. But that’s not the case for poorer countries.
That means prevention programs in most developing countries don’t mention that, oh, unprotected anal sex between men remains one of the highest infection risks. That means no condoms are being made available to these men. That means that gay men must stay closeted to access services, and that they get second-class treatment.
Of course, that’s assuming that MSM in poorer countries even bother to try to access services at all. One of the reasons AIDS workers use the phrase MSM instead of “gay men” is that in many countries, MSM don’t consider themselves gay or even bisexual and are not tied into a shared MSM culture where they can support one another. In China, for example, it’s estimated that 80 percent of men who have sex with men are married to women.
There are cultural reasons for this and also legal ones. In countries where homosexuality is illegal — Angola, Nigeria, Yemen, India, Bhutan and Jamaica are ready examples — an MSM asking for information or condoms, getting an HIV test or asking for other HIV/AIDS services is inviting arrest, if not harassment and violence.
For gay activists in developing countries, they are left with the chicken-and-egg conundrum of where to start. They need rights in order to access services. But several delegates reported that AIDS organizations, even those with their hands tied by homophobic US policies, were more helpful than many of their own national human rights organizations. Nigeria’s gay group recently invited 70 human rights organizations to a daylong orientation meeting. Only 10 attended; four left after lunch.
Said Keith Goddard of Gays And Lesbians Of Zimbabwe (GALZ): “Many organizations think of sex as GALZ’s issue and are uncomfortable with it.”
Ignored internationally, criminalized nationally and abused locally, some gay activists consider themselves lucky to be alive.
“The situation is shitty in many countries,” said Shivandanda Khan of India’s Naz Foundation International. “Sitting here, you’re listening to a lot of shit.”
The global forum, which was initiated at a mini-conference for MSM organizers before the main conference, aims to help civil society groups, AIDS organizations, MSM/gay groups and other agencies connect in order to improve the situation going into the next AIDS conference in Mexico in 2008. Its general goals are to increase awareness, provide opportunities for networking and information sharing, to innovate and experiment and to celebrate victories. In particular, they want to develop an international policy agenda for MSM and HIV/AIDS.
“I’m tired of coming to events like this all over the world where, despite the fact that MSM are disproportionately affected by the epidemic, we are not front and centre,” said forum member George Ayala of AIDS Project LA.