Buggery laws choking HIV control

Lower prevalence rate in men in countries without restrictions

By INGRID BROWN Observer senior reporter browni@jamaicaobserver.com

Monday, November 21, 2011

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NASSAU, The Bahamas — Michel de Groulard, regional programme adviser of UNAIDS Caribbean Regional Support Team said that data has shown a significantly lower HIV prevalence rate among gay men in Caribbean countries without buggery laws.

According to de Groulard, the HIV prevalence rate among men who have sex with men (MSM) in three Caribbean countries without buggery laws namely Bahamas, Haiti and Suriname was less than 10 per cent in all cases.

This he said is in comparison to Jamaica, Trinidad & Tobago and Guyana where the prevalence rate is more than 20 per cent for these countries with buggery laws.

Pointing to The Bahamas which repealed its buggery laws inn 1991, de Groulard said that the prevalence rate now stands at 8 per cent among gay men. This is despite Bahamas having the highest prevalence rate in the Caribbean.

However in Jamaica, where the buggery laws remain firmly on the books, de Groulard said that the prevalence rate among gay men is a whopping 32 per cent.

"We see correlation for countries which have decriminalised because when you compare them to those who continue to criminalise there is a significant difference," Groulard told the Observer.

He was however unable to say how, if any, decriminalising of homosexuality has impacted the incidents of HIV in countries like The Bahamas, since there are no available data.

Groulard said that while it is easy to determine what per centage of a population is infected, it is more challenging to determine when they were infected, thus determining if this would have been before or after buggeery laws are repealed.

"There are methods to do it but it is expensive and complicated so most countries do not do it," he said.

Dr Peter Figueroa, the former head of Jamaica's national HIV programme said that the HIV prevalence rate among Jamaican men who have sex with men continues to be unacceptably high.

Dr Figueroa was addressing delegates at the 2011 Caribbean HIV Conference now underway at the Atlantis, Paradise Island, The Bahamas where delegates from more than 30 Caribbean countries have come together to chart the way forward in the fight against the disease.

Pointing to a Jamaican study conducted in 2007 with 201 men who have sex with men and another conducted this year with 453 men, the epidemiologist said that only 75 per cent of these men reported using condom at last anal sex.

According to Dr Figueroa, the study further revealed that 34 per cent of MSM had two or more female partners in the last 12 months while 56 per cent of them said they were bisexuals.

The homeless, victims of violence and those of lower socio economic status were twice as likely to become infected with the disease.

"What was worrying in 2011 survey was that 18 per cent said they had no chance of getting HIV and 40 per cent said they had little chance of getting the disease," he said.

HIV prevalence remains high among persons engaging in sex for money with 11 per cent reporting that they had paid for sex and 21 per cent saying they were paid for sex.

Pointing to reasons why the HIV prevalence rate was so high, Dr Figueroa chalked it down to high rate of commercial and transactional sex.

"Many of them are vulnerable, homeless, poor and have no family support and limited education," he said.

Dr Figueroa said that there is a need to empower and support these men to take more responsibility for safe sex.

"We need to provide a much more supportive environment starting from policies to actual programmes, and dealing with discrimination when it takes place," he said.

He said that he purpose of the research is to get closer contact with MSM in order to better improve prevention efforts and to get persons to seek treament earlier.

Meanwhile, policy and advocacy coordinator of the Caribbean Vulnerbale Communities Coalition (CVC) Ivan Cruickshank said that despite the rising levels of infections among vulnerable groups such as sex workers, MSM, prisoners and socially excluded youth, Caribbean states have chosen to focus almost exclusively on targetting the wider population. Such countries, he said continues to develop generalised responses rather than tailored programming.

"Moreover while Caribbean governments often commit on paper and in rhetoric to working with marginalised groups, in private government officials and ministers continue to express resentment to working with these populations," he said

He added that while most governments of the region have committed to report to the United Nations against targets, they fail to report 70 per cent of all data on sex workers and men who have sex with men.

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