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Jamaica: Gay men need HIV truth, not anti-gay distortions

 Chris Beyrer, director of the Johns Hopkins Fogarty AIDS International Training and Research Program (Photo courtesy of Johns Hopkins Global Health)
Dr. Chris Beyrer, director of the Johns Hopkins Fogarty AIDS International Training and Research Program (Photo courtesy of Johns Hopkins Global Health)

The religious anti-gay group, Jamaican Coalition for a Healthy Society (JCHS), has constantly misused data produced by Professor Chris Beyrer et. al., to claim that the country’s anti-sodomy law is necessary to control HIV among men who have sex with men.

JCHS makes this spurious claim because of a Lancet article which said that HIV was “out of control” among French MSM. Since France decriminalized sodomy in the 18th century, the illogical inference is that countries which recognize the human rights for gays cannot control the spread of HIV among gay men.

The JCHS has mounted an aggressive media campaign aimed at selling their lie about the public-health benefits of the anti-sodomy law. In this regard, they have published full-page colour ads and several newspaper op-eds written by various doctors (none of them epidemiologists). For example, see one such op-ed published on Sunday, July 21, 2013: “Tell men who have sex with men the truth.”

JCHS representatives have also appeared on national radio and television stations. The campaign is beginning to work as we have seen some articles appearing in the print media parroting the line about the public health risks of sodomy.

HOWEVER, the sad reality is that EVEN WITH the anti-sodomy law, UNAIDS and others have recorded that Jamaica has the highest HIV prevalence rate among MSM worldwide (32.9%). This inconvenient truth is, of course, NEVER mentioned by the JCHS.

Dr. Brendan Bain, professor of community health at the Mona Campus of the University of the West Indies in Kingston, Jamaica, (Photo courtesy of EverydayLeadership.org)
Dr. Brendan Bain, professor of community health at the Mona Campus of the University of the West Indies in Kingston, Jamaica, (Photo courtesy of EverydayLeadership.org)

The JCHS has applied to be an interested party in the domestic challenge to Jamaica’s anti-sodomy law, which will have its second hearing on October 4. One main argument they will be advancing is the claim that the law prevents HIV transmission among gay men. In this regard, they have applied to have Professor Brendan Bain admitted as an expert witness. Professor Bain is a deeply religious man who is in charge of the HIV response for the major university in the Caribbean, the University of the West Indies. Bain has received significant grant funding from Caribbean and International HIV prevention and control outfits. It is therefore shocking that he would turn against the considered wisdom of the HIV community to lend his expertise in support of JCHS. However, Bain’s fundamentalist religious beliefs clearly trump his commitment to science.

We have applied to have Chris Beyrer accepted as an expert witness to counter Bain and we will be advised on October 4 if this application is successful.

In the meantime, this op-ed by Chris (below) is one of our attempts to push back against the JCHS’ twisting of the truth. We have also had excellent letters and op-eds written by Jamaican HIV and AIDS activists (particularly Brian-Paul Welsh) published, and we have received invaluable support for our on-air media campaign from members of other civil society groups. Chris’ op-ed is, by far, the most credible because of his reputation as an international HIV specialist.

Yes, Do Tell Gay Men The Truth!

By Chris Beyrer, Guest Columnist
Jamaica Gleaner

As a public-health physician in residency training, I had the privilege of living and working in Kingston, Jamaica with the excellent Expanded Program on Immunisation on polio and measles eradication efforts, now more than 20 years ago. I have fond memories of the welcome and kindness of my Jamaican colleagues and also of the great traditions of public health and medicine in the country. So it has been with real concern and personal sadness that I’ve seen the recent work of myself and my colleagues on HIV among men who have sex with men (MSM) both misunderstood and misused by professionals in Jamaica. In the interest of scientific rigour and of the rights of all Jamaicans to benefit from the outcomes of scientific progress, I would like to clarify the findings of our work (published in The Lancet in 2012.)

HIGH RATE OF INFECTION

Perhaps most importantly we did find that HIV infection rates are high among gay, bisexual, and other MSM worldwide. But we also found a clear and compelling relationship between HIV risks among these men and stigma, discrimination, and criminalisation. The bad news here is that the Caribbean region has the highest rates of HIV among MSM of any region worldwide, and also, I am sorry to say, some of the most discriminatory laws and practices for sexual and gender minorities.

That is not a coincidence. We’ve documented these challenges in many countries, and the reasons why stigma, homophobia, and discrimination can drive HIV rates are quite clear. People who are afraid and feel threatened avoid health care, do not seek or get HIV testing or other services which can help reduce risks, and are less likely to be treated for HIV if they are living with the virus. Punitive and hostile policies do not reduce HIV risks – they increase them.

NOTHING TO DO WITH GENDER

There has also been a misuse of the biological argument we have made in our work. To say that HIV is spread efficiently through unprotected (condomless) anal sex is, simply, true. It is also true that this has nothing to do with gender – the risks are similar for women and men when they are the receptive partners, which we also reported. And data from a number of countries makes clear that heterosexual couples do commonly engage in this practice, sometimes to reduce pregnancy risks and sometimes for pleasure. To argue that because this practice can lead to HIV infection it is inherently ‘unnatural’ or should be subject to criminal penalty is the same as arguing that vaginal sex is ‘unnatural’ since it can efficiently transmit syphilis, gonorrhea, chlamydia or the human papilloma virus, the cause of most cervical cancers in women.

What matters, of course, is reducing risks for all sexually transmitted infections (STI) for men and women. And the science tells us how to do this. By making condoms and lubricants widely available and cheap, by treating STI in settings of dignity, safety, and quality of care, so that people at risk will seek and use the services they need. And by listening to patients, being non-judgemental, and helping them reduce their real risks – which they will not disclose if they are afraid.

We called for comprehensive services for MSM to reduce HIV risks, not discriminatory laws, policies, and practices which drive them underground and away from compassion and health care. That is true for sexual and gender minorities in Jamaica, as it is true anywhere else.

Chris Beyrer, MD, MPH, is a professor at Johns Hopkins Bloomberg School of Public Health.

Written by Colin Stewart

Colin Stewart is a 45-year journalism veteran living in Southern California. After his retirement from paid newspaper work in 2011, he launched Erasing 76 Crimes and helped with the Spirit of 76 campaign that assembled a multi-national team of 26 LGBTI rights activists to advocate for change during the International AIDS Conference in Washington, D.C., in July 2012. He is the president of the St. Paul’s Foundation for International Reconciliation, which supports LGBTQ+ rights advocacy journalism, including the Erasing 76 Crimes news site and the African Human Rights Media Network. Contact him via Twitter @76crimes or by email at info@76crimes.com. Mailing address: 21 Marseille, Laguna Niguel CA 92677 USA.

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