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New Study Shows Grim Reality for Gay Men and HIV/AIDS in Africa
By L. K. Regan
Published Jul 21, 2009
Both research and press coverage of HIV/AIDS in sub-Saharan Africa have overwhelmingly focused on heterosexual transmissions. In effect, this focus replicates the prejudice that keeps gay men out of sight in African life in general. This month, the respected British medical journal The Lancet takes on this gap in public and scientific awareness with a report on gay men and HIV/AIDS in sub-Saharan Africa. Their review of the current state of affairs makes for grim reading.
As the study, authored by Dr. Adrian Smith et al. of Oxford University, succinctly points out, "Globally, men who have sex with men (MSM) continue to bear a high burden of HIV infection. In sub-Saharan Africa, same-sex behaviors have been largely neglected by HIV research up to now." There is, however, some recent research on gay men in sub-Saharan Africa, and the Lancet study is a comprehensive review of the results of that research, seeking to reach some basic conclusions. Here's what they found.
Overall, HIV rates among MSM in sub-Saharan Africa are 10 times higher than within the male population in general. In surveying the reasons for this wide gap, the researchers cited the various repercussions from a single, basic cause: homophobia. As Dr. Smith writes, the HIV rates in African gay men are "driven by cultural, religious and political unwillingness to accept [gay men] as equal members of society." This unwillingness is part of what Smith calls a "profound stigma and social hostility at every level of society concerning either same-sex behaviors amongst men, or homosexuality." As his study points out, "The HIV/AIDS community now has considerable challenges in clarifying and addressing the needs of MSM in sub-Saharan Africa; homosexuality is illegal in most countries, and political and social hostility are endemic."
Because of the intense homophobia in sub-Saharan Africa, gay men are driven underground, and engage in high risk practices (intravenous drug use, multiple partners, prostitution) that increase the rate of infection. "Unprotected anal sex is commonplace," the study says, "knowledge and access to inappropriate risk prevention measure are inadequate and... in some contexts, many MSM engage in transactional sex." Gay men stand at the meeting point between social prejudice and poor public resources, as Smith et al. point out: "High rates of HIV infection, HIV risk behavior, and evidence of behavioral links between MSM and heterosexual networks have been reported. Yet most African MSM have no safe access to relevant HIV/AIDS information and services, and many African states have not begun to recognise or address the needs of these men in the context of national HIV/AIDS prevention and control programs." As Smith told the BBC in an interview, "This has the consequence that this group becomes extremely hard to reach."
Clearly, a substantial cause of the ten-fold higher infection rate among gay men is governmental refusal to admit they even exist, and to educate them about their special risks and options. Smith also spoke to the BBC about "a desperate need for delivering a basic package of prevention for HIV", including ensuring supplies of condoms. "There is also a need to sensitize, educate and train those involved in HIV, the interface with men who have sex with men, to educate those involved in care and prevention activities," he said. "The belated response to MSM with HIV infection needs rapid and sustained national and international commitment to the development of appropriate interventions and action to reduce structural and social barriers to make these accessible."
The situation for gay men in sub-Saharan Africa is, in short, very grim. As the Lancet study says, "In the early 1980s, silence equals death became a rallying cry" for the gay community. "Nearly three decades later in sub-Saharan African the silence remains, driven by cultural, religious, and political unwillingness to accept MSM as equal members of society." At least now there is the beginning of research aimed at unveiling this long-shrouded crisis.
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I never said "blatant lies." I just said that vaginal sex is also high risk (when condoms are not used). It is definitely less risky than anal sex. I'd love to engage in a mature discussion with you after you have finished college, Ryan, as you are only 19. I am 43, and have degrees in social anthropology and human development (masters). You are misunderstanding my remarks. Good luck in college.
Vaginal sex is several orders safer than anal sex, that's a fact. And someone having vaginal sex is much more likely to wear a condom every time because of the threat of pregnancy, whereas anal has no such threat to enforce condom use even in a committed relationship. I could care less what you choose to do in the bedroom. Just don't tell blatant lies about how all sex acts are created equal.
Nobody can make you do anything you don't want to do so go crazy if you feel like it. The consequences of your actions should speak for themselves.
I've already said what I wanted to say so, caveat.
Dear Brian,
Vaginal sex is also a high risk behavior. Sex is high risk by nature. That's how heterosexuals reproduce and also acquire HIV, as women of color are now in one of the highest risk groups. Your bias is that you come from an individualistic culture: anglo saxon - White USA folk. I come from South America: my bias is seeing the world from a collectivistic perspective. We are both right, but using only your perspective or mine will not address the problem appropriately: we have to use both to address the problem. Individuals and societies are responsible, not just one or the other.
However, I think your view of sex is extremely limited and judgmental. I am sorry to have to say it like that. You are not better than others because yo choose not to FUCK (that's anal and vaginal sex, by the way) I love to FUCK and also to get FUCKED up my ass, I feel blissful when i do it. So stop judging my pleasure. By the way, I ALWAYS wear condoms. God bless.
I Did everyone miss the point where as it stated there was not enough tools for prevention in Africa? Anal sex my friends is here to stay but you can reduce the odds of getting HIV if you always use a condom! However in many area's of Africa you can barely get food, or clean water some I would think a condom is hard to come by when you are about to have gay anal sex. In addition many Africa nation refused to believe that HIV was even real until recently. Men who got HIV was told to have sex with a virgin to get ride of it--that is still going on. Africa has some serious infrustrure issues histrically caused by emperialistic countries--which is why most first world nation give billions to African nations a year not out of charity, but mainly out of white guilt.
So, basically, you're laying the blame of rising HIV infection rates on everyone but the two people committing the high risk sex act (also known as anal sex)?
I'll bite, I admit that I have a personal bias. I don't care for anuses/anal and I never have and, quite frankly, I find the obsession with anal and anal fetishes to be bizarre. Regardless of my personal bias, the situation remains as is. There is a giant problem growing and laying the blame on everyone but the people physically involved doesn't help to solve the problem because it displaces the responsibility onto everyone who has nothing to do with what two men do in a bed room (are you really arguing that men have anal sex as a result of social condemnation?).
Read the other comments, that guy was in a committed relationship having anal sex for a year and his partner STILL caught HIV. Laying the blame on society or the current culture or on full moons does nothing to diminish the fact that anal sex is the actual cause of rising infection rates. Until this problem is owned up to, the problem with these crazy infection rates will never go away.
I understand that the choice of two adults to engage in high risk behaviors together is their choice alone. But don't expect people to hold back their criticism when those same consenting adults wind up diseased and dying and don't expect these people to accept the blame for that outcome either.
RyanReBoRn:
It is true that HIV is spread through specific behaviors, but behaviors take place within social and cultural contexts. A great researcher asked a brilliant questiononce: what differentially puts people at risk for risks? In other words, certain populations are more exposed to risks than others because of social conditions. The huge health disparities in the US are connected with the fact that minorities have been denied access to privileges historically. Studies also have shown how social oppression of any kind is connected with poor health outcomes, that are often mediated by the risky behaviors that you mentioned. Another thing: anal sex is not the problem, but UNPROTECTED anal sex with multiple partners is. There is a big difference. People, straight or gay, have diverse sexual preferences, and prescribing what is ok and what is not ok has never worked in human history. One more thing, HIV is a disease, being gay or having anal sex is not. An African American focus group participant recently said: "You cannot do HIV prevention without addresing poverty. You cannot do HIV prevention without addressing homophobia. You cannot do HIV prevention without addressing homelessness. You certainly cannot do it without addressing the dynamics of family relationships. It's just so deep. I keep saying that HIV is a social problem that manifests as a public health problem." By the way, from an individualistic perspective, the individual is responsible for everything. A collectivistic perspective places responsibility also in society as a whole. Our opinions are always biased by our perspectives. I acknoweledge my own bias. Are you ready to acknowledge yours?
Why not just say that gay men shouldn't have sex. Perhaps, instead of practicing safety, it could just be run past a committee. I just love when people within the gay community become judgmental. "I know what guys should and shouldn't do, because I know what is right and wrong and my judgment is sacrosanct."
If one particular thing makes you happy and something else doesn't, why is it that what you want to do is therefor what everyone should want. You are welcome to your catholic views (and I don't mean in the religious sense) but please refrain from projecting your ideas onto everyone. We don't need more segregation. We need to address the need for safety for those who prefer to do things differently than you.
The only truly safe sex, is no sex. However, that isn't realistic. So the next best thing is education. The worst thing is ignorance. The next worst thing is judgment.
I agree with Ryan.
Love between gay men should not involve anal sex.
It's a destructive and high-risk practice that needs to stop.
It's about time we put the focus on respect and safety for ourselves, and for each other.
That's pure bull crap. You experienced this first hand and you still feel that way?
Why do you feel the only way you can share love with another man is if you have anal sex with him? Prior to the mid 70's, gay people who had anal sex were a fringe group, meaning that the majority of men were expressing their love for each in other ways.
The problem here is the notion that anal sex between gay men is an inevitable MUST when, clearly, it is not.
For your sake and for the sake of gay men who think in kind, I hope that realization eventually sinks in.
This is sad, the story and all. Then the comments read. Some of which are true in statement. I normally do not "bottom" for anyone, I usually top. And it's always protected. Until I met my partner, we started using condoms at first then decided after about 4 months or so to stop. I was tested months ago prior to the "exclusive relationship" and he had been monogamous from his recent ex. Figuring we were both healthy and that the trust was there we decided to have raw sex "unprotected." I topped mostly and bottomed at times. It wasn't until almost a year after we lived together that he started having symptoms of infection. Prolonged fever, fatigue, and constant headaches. He showed up positive after taking a HIV test prior to blood screening "which showed everything was (normal) up till the HIV test." Finding out, not only was I scared to death, but I got my ass checked. To my relief, all test were NEGATIVE, but will still have to go and get checked for follow ups. It was and still is a blessing from God above in the name of JESUS. After being with my boyfriend for a year and most of that being unprotected sex I can't explain how I was spared this horrible experience of infection and certain death "over time." I guess the point I was trying to make according to a comment I read is that for one, it's easy to say "oh just cut out the butt sex and all will be well." There are many different circumstances that play a role into why gays have unsafe butt sex or but sex in general. Like my testimony here, you can think and feel fine, even after being tested but still possibly have it and not know. And sleeping around? That only takes one in a two man relationship to ruin the future of it. It's just sad to me, that this disease was designed to destroy and divide people. Like most STD's we see. When the gift of love and sharing it with another physically is now threatened and the threat is leading to a certain demise
Are you guys serious? You don't catch HIV/AIDS because people treat you like a second class citizen, you catch HIV/AIDS from participating in high risk behaviors like anal sex. Anal sex is by a WIDE margin the greatest vector for the transfer of the HIV virus. THAT is why the infection rates of gay men is always ridiculously high, it's because anal sex is something gay men just can't seem to do without.
The heterosexual population has a lower HIV infection rate because why? Because when they have sex, they have no reason to play inside of their partners anus because females have the proper receptive GENITALIA. Among the only reasons that HIV affects the heterosexual population as much as it has is the recent widespread acceptance of anal sex as an alternative sex act.
And haven't you ever wondered where the lesbians are in all this? They're nowhere, just statistical background noise. They have an HIV infection rate that is even LOWER than heterosexuals. Yet, as homosexuals, are they not treated as second class citizens and "abominations"? The reason is because two women, both of which know there is no pleasure to be found in playing in their partners anus, will only engage in mutually satisfying genital stimulation.
If you guys can't see the connection between cultures that accept anal sex as an acceptable alternative and the rise of HIV infection rates in those populations then it's not because you CAN'T see the connection. It's because, and with willful ignorance, you won't.
if the infected gays stoped fucking around and spreading it it would die out, but nooooooooo... why? if i had aids/hiv I WOULD NEVER EVER EVER had sex and would monitor everything i do to spare anyone trouble. affrica- well different thing, education education education (but i guess that is not enough)- for modern world- dont have sex with people from africa (drastic? sure it is). safe? very...
And as usual, they'll go blame the infection rates to the Unhealthy Gay LifestyleŽ, not realizing it's a symptom of their ostracization.
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Firewithin wrote:
I never said "blatant lies." I just said that vaginal sex is also high risk (when condoms are not used). It is definitely less risky than anal sex. I'd love to engage in a mature discussion with you after you have finished college, Ryan, as you are only 19. I am 43, and have degrees in social anthropology and human development (masters). You are misunderstanding my remarks. Good luck in college.
Jul 29 9:31 PM
Dragoonxi wrote:
Vaginal sex is several orders safer than anal sex, that's a fact. And someone having vaginal sex is much more likely to wear a condom every time because of the threat of pregnancy, whereas anal has no such threat to enforce condom use even in a committed relationship. I could care less what you choose to do in the bedroom. Just don't tell blatant lies about how all sex acts are created equal.
Nobody can make you do anything you don't want to do so go crazy if you feel like it. The consequences of your actions should speak for themselves.
I've already said what I wanted to say so, caveat.
Jul 26 5:21 AM
Firewithin wrote:
Dear Brian,
Vaginal sex is also a high risk behavior. Sex is high risk by nature. That's how heterosexuals reproduce and also acquire HIV, as women of color are now in one of the highest risk groups. Your bias is that you come from an individualistic culture: anglo saxon - White USA folk. I come from South America: my bias is seeing the world from a collectivistic perspective. We are both right, but using only your perspective or mine will not address the problem appropriately: we have to use both to address the problem. Individuals and societies are responsible, not just one or the other.
However, I think your view of sex is extremely limited and judgmental. I am sorry to have to say it like that. You are not better than others because yo choose not to FUCK (that's anal and vaginal sex, by the way) I love to FUCK and also to get FUCKED up my ass, I feel blissful when i do it. So stop judging my pleasure. By the way, I ALWAYS wear condoms. God bless.
Jul 25 3:33 AM
spartanrda wrote:
I Did everyone miss the point where as it stated there was not enough tools for prevention in Africa? Anal sex my friends is here to stay but you can reduce the odds of getting HIV if you always use a condom! However in many area's of Africa you can barely get food, or clean water some I would think a condom is hard to come by when you are about to have gay anal sex. In addition many Africa nation refused to believe that HIV was even real until recently. Men who got HIV was told to have sex with a virgin to get ride of it--that is still going on. Africa has some serious infrustrure issues histrically caused by emperialistic countries--which is why most first world nation give billions to African nations a year not out of charity, but mainly out of white guilt.
Jul 24 12:55 AM
Dragoonxi wrote:
So, basically, you're laying the blame of rising HIV infection rates on everyone but the two people committing the high risk sex act (also known as anal sex)?
I'll bite, I admit that I have a personal bias. I don't care for anuses/anal and I never have and, quite frankly, I find the obsession with anal and anal fetishes to be bizarre. Regardless of my personal bias, the situation remains as is. There is a giant problem growing and laying the blame on everyone but the people physically involved doesn't help to solve the problem because it displaces the responsibility onto everyone who has nothing to do with what two men do in a bed room (are you really arguing that men have anal sex as a result of social condemnation?).
Read the other comments, that guy was in a committed relationship having anal sex for a year and his partner STILL caught HIV. Laying the blame on society or the current culture or on full moons does nothing to diminish the fact that anal sex is the actual cause of rising infection rates. Until this problem is owned up to, the problem with these crazy infection rates will never go away.
I understand that the choice of two adults to engage in high risk behaviors together is their choice alone. But don't expect people to hold back their criticism when those same consenting adults wind up diseased and dying and don't expect these people to accept the blame for that outcome either.
Jul 23 11:49 PM
Firewithin wrote:
RyanReBoRn:
It is true that HIV is spread through specific behaviors, but behaviors take place within social and cultural contexts. A great researcher asked a brilliant questiononce: what differentially puts people at risk for risks? In other words, certain populations are more exposed to risks than others because of social conditions. The huge health disparities in the US are connected with the fact that minorities have been denied access to privileges historically. Studies also have shown how social oppression of any kind is connected with poor health outcomes, that are often mediated by the risky behaviors that you mentioned. Another thing: anal sex is not the problem, but UNPROTECTED anal sex with multiple partners is. There is a big difference. People, straight or gay, have diverse sexual preferences, and prescribing what is ok and what is not ok has never worked in human history. One more thing, HIV is a disease, being gay or having anal sex is not. An African American focus group participant recently said: "You cannot do HIV prevention without addresing poverty. You cannot do HIV prevention without addressing homophobia. You cannot do HIV prevention without addressing homelessness. You certainly cannot do it without addressing the dynamics of family relationships. It's just so deep. I keep saying that HIV is a social problem that manifests as a public health problem." By the way, from an individualistic perspective, the individual is responsible for everything. A collectivistic perspective places responsibility also in society as a whole. Our opinions are always biased by our perspectives. I acknoweledge my own bias. Are you ready to acknowledge yours?
Jul 23 9:45 PM
bgcat57 wrote:
Why not just say that gay men shouldn't have sex. Perhaps, instead of practicing safety, it could just be run past a committee. I just love when people within the gay community become judgmental. "I know what guys should and shouldn't do, because I know what is right and wrong and my judgment is sacrosanct."
If one particular thing makes you happy and something else doesn't, why is it that what you want to do is therefor what everyone should want. You are welcome to your catholic views (and I don't mean in the religious sense) but please refrain from projecting your ideas onto everyone. We don't need more segregation. We need to address the need for safety for those who prefer to do things differently than you.
The only truly safe sex, is no sex. However, that isn't realistic. So the next best thing is education. The worst thing is ignorance. The next worst thing is judgment.
Jul 23 8:19 PM
WildPrince wrote:
I agree with Ryan.
Love between gay men should not involve anal sex.
It's a destructive and high-risk practice that needs to stop.
It's about time we put the focus on respect and safety for ourselves, and for each other.
Jul 23 5:59 AM
Dragoonxi wrote:
That's pure bull crap. You experienced this first hand and you still feel that way?
Why do you feel the only way you can share love with another man is if you have anal sex with him? Prior to the mid 70's, gay people who had anal sex were a fringe group, meaning that the majority of men were expressing their love for each in other ways.
The problem here is the notion that anal sex between gay men is an inevitable MUST when, clearly, it is not.
For your sake and for the sake of gay men who think in kind, I hope that realization eventually sinks in.
Jul 22 5:14 PM
UnifiedAron04 wrote:
This is sad, the story and all. Then the comments read. Some of which are true in statement. I normally do not "bottom" for anyone, I usually top. And it's always protected. Until I met my partner, we started using condoms at first then decided after about 4 months or so to stop. I was tested months ago prior to the "exclusive relationship" and he had been monogamous from his recent ex. Figuring we were both healthy and that the trust was there we decided to have raw sex "unprotected." I topped mostly and bottomed at times. It wasn't until almost a year after we lived together that he started having symptoms of infection. Prolonged fever, fatigue, and constant headaches. He showed up positive after taking a HIV test prior to blood screening "which showed everything was (normal) up till the HIV test." Finding out, not only was I scared to death, but I got my ass checked. To my relief, all test were NEGATIVE, but will still have to go and get checked for follow ups. It was and still is a blessing from God above in the name of JESUS. After being with my boyfriend for a year and most of that being unprotected sex I can't explain how I was spared this horrible experience of infection and certain death "over time." I guess the point I was trying to make according to a comment I read is that for one, it's easy to say "oh just cut out the butt sex and all will be well." There are many different circumstances that play a role into why gays have unsafe butt sex or but sex in general. Like my testimony here, you can think and feel fine, even after being tested but still possibly have it and not know. And sleeping around? That only takes one in a two man relationship to ruin the future of it. It's just sad to me, that this disease was designed to destroy and divide people. Like most STD's we see. When the gift of love and sharing it with another physically is now threatened and the threat is leading to a certain demise
Jul 22 4:35 PM
Dragoonxi wrote:
Are you guys serious? You don't catch HIV/AIDS because people treat you like a second class citizen, you catch HIV/AIDS from participating in high risk behaviors like anal sex. Anal sex is by a WIDE margin the greatest vector for the transfer of the HIV virus. THAT is why the infection rates of gay men is always ridiculously high, it's because anal sex is something gay men just can't seem to do without.
The heterosexual population has a lower HIV infection rate because why? Because when they have sex, they have no reason to play inside of their partners anus because females have the proper receptive GENITALIA. Among the only reasons that HIV affects the heterosexual population as much as it has is the recent widespread acceptance of anal sex as an alternative sex act.
And haven't you ever wondered where the lesbians are in all this? They're nowhere, just statistical background noise. They have an HIV infection rate that is even LOWER than heterosexuals. Yet, as homosexuals, are they not treated as second class citizens and "abominations"? The reason is because two women, both of which know there is no pleasure to be found in playing in their partners anus, will only engage in mutually satisfying genital stimulation.
If you guys can't see the connection between cultures that accept anal sex as an acceptable alternative and the rise of HIV infection rates in those populations then it's not because you CAN'T see the connection. It's because, and with willful ignorance, you won't.
Jul 22 3:15 PM
WhatIsUp wrote:
if the infected gays stoped fucking around and spreading it it would die out, but nooooooooo... why? if i had aids/hiv I WOULD NEVER EVER EVER had sex and would monitor everything i do to spare anyone trouble. affrica- well different thing, education education education (but i guess that is not enough)- for modern world- dont have sex with people from africa (drastic? sure it is). safe? very...
Jul 22 1:49 PM
Sedative wrote:
And as usual, they'll go blame the infection rates to the Unhealthy Gay LifestyleŽ, not realizing it's a symptom of their ostracization.
Jul 22 8:09 AM