Blaming gay sex, rather than homophobia, for AIDS

Colin Stewart is a 45-year journalism veteran. He is the…

First of two posts on Roman Catholic responses to issues of HIV and LGBT rights in Uganda and elsewhere.

Stefano Gennarini of the Catholic Family and Human Rights Institute

Catholics are divided in their response to the AIDS crisis among men who have sex with men (MSM).

Some reach out to “love your neighbor as yourself,” seeking to provide balm for the sick and education for the uninformed.

Stefano Gennarini, director of the Center for Legal Studies at the gay-wary Catholic Family and Human Rights Institute, isn’t one of those.

He blames MSM themselves for the high rates of HIV infection in MSM communities.

Providing MSM with improved health services would have minimal impact on the AIDS epidemic, Gennarini claims in a response to a recent Lancet medical journal article that called homophobia a “key driver” in the epidemic and advocated decriminalization and removal of stigma against homosexuality as a strategy for fighting AIDS.

The special issue of The Lancet noted that, in African and Caribbean countries where homosexual activity is illegal, HIV infection rates for black MSM are nearly two times greater than the rate for the general population.

It noted that “black MSM across the African diaspora share common experiences such as discrimination, cultural norms valuing masculinity, concerns about confidentiality during HIV testing or treatment, low access to HIV drugs, threats of violence or incarceration, and few targeted HIV prevention resources.”

But Gennarini doesn’t think that providing, rather than denying, AIDS education and health services to MSM would help much.

“Even if all active homosexuals were provided the best health services available today their infection rates would only go down 25% over the next 10 yrs,” he says.

He cites “the biological risk associated with anal sex” and “the propensity of homosexuals to lead a promiscuous lifestyle that exposes them to further risks.”

He seems to believe that MSM behavior could not be changed by AIDS education.

He says, “While the experts cite data showing how laws and culture can be barriers to access HIV services and information, there is no data showing that the expansion of special rights to persons on the basis of their sexual and identity preferences has had any effect on their HIV infection rate, or overall health.”

“Special rights” is apparently how Gennarini refers to allowing gay men to receive health services without fear of rejection or imprisonment.

Gennarini makes his pessimistic analysis despite evidence in the Lancet that AIDS education can change MSM behavior. For example:

“Inadequate access to HIV prevention materials and non-participation in HIV prevention programmes were associated with unprotected anal intercourse in MSM in investigations in Cameroon, Senegal, and Kenya.”
“Kenyan male sex workers who reported sex with men and who did not know that unprotected anal intercourse was a risk factor for HIV transmission were more likely to have such intercourse than were those who were aware of this risk.”

If that weren’t enough to be convincing, the Lancet also reported a link between stigma and risky behaviors among MSM:

“In Kenya, black MSM who experienced anti-gay stigma were more likely to have unprotected anal intercourse and be HIV positive than were black MSM who hadn’t experienced anti-gay stigma.
“In the USA, experience of homophobia by HIV-positive black MSM doubled the odds of unprotected anal intercourse with male partners who were HIV negative or of unknown HIV status.”
“In another US study, low social support -— a possible consequence of homophobia -— reduced the likelihood of HIV testing and increased the likelihood of undiagnosed HIV infection in black and Hispanic MSM.”
”The investigators of a study of Jamaican MSM reported that participants were reluctant to obtain lubricants even when freely available because of pervasive stigma associating lubricant use with homosexual anal sex.”