PLACING A FACE ON THE FACELESS: CHANGING SOCIAL AND CULTURAL PRACTICES IN THE FACE OF HIV/AIDS

Context

According to the World Health Organization, sexual identity or orientation is prohibited as grounds for discrimination and laws that criminalize homosexual acts between consenting adults violates the right to privacy. While many countries have recognized in some form or another same sex partnership amongst men, many countries – like Nigeria – still view it as a tabooed subject for discussion, not to mention it being legally and nationally criminalized.

It is important to recognize that despite the extent of the public’s acknowledgment of same sex partnership, this is a common act, though the figures vary across societal and cultural borders. Nigeria has no solid records for this population group because of the embarrassment and shame they have placed on same sex partnership. Yet, why is this an important topic to discuss and acknowledge in Nigeria despite the stigma and discrimination associated with it? In terms of HIV and the toil this disease has placed on Nigeria’s soil, the least that can be done is for the leaders of this country to acknowledge the consequences of refusing to provide treatment, care and support for same sex partnership.

It has been estimated by UNAIDS that at least 5% to 10% of HIV infections worldwide occur through same sex partnership. Further, same sex partnership amongst men does not only pose a risk to men but also to women that are involved in relationships with these men. Therefore, the general population is also at risk if initiatives are not taken amongst this vulnerable population group. It is also important to acknowledge that men who have sex with men are often married to women, especially where discriminatory laws or social stigma of male sexual relations exist.

In Nigeria, health care workers, other service providers, and employers often discriminate against men who have sex with men. The social stigma associated with this group makes it difficult and even dangerous for young men to disclose their sexuality openly. The worry of family and friends reacting negatively is a burden that lays heavy on the shoulders of these men. The concept that they are the reason the HIV epidemic exists is a myth that must be discarded and it should be viewed that they are not responsible for the epidemic but are affected by it – just like everyone else.

Unique cultural factors in Nigeria that place high values on masculinity coupled with the denial of the existence of such practices by government and individuals only heightens the ignorance when trying to mitigate the impact of HIV/AIDS. Lack of support with regards to HIV/AIDS treatment, care, and support simply means they will receive quarantine treatment by the general community - lack sufficient access to medical services which will them and the general population at risk. In this fight, it is important for implementers and HIV program designers to have a analytical and objective mind, putting aside cultural and religious sentiments with the aim of primarily reducing the negative impact HIV has placed on the Nigerian community and look forward to attaining the MDG by 2015.

Application of the Law and Policy Position

Discrimination occurs when a distinction is made against a person that results in his or her being treated unfairly and unjustly on the basis of their belonging, or being perceived to belong to a particular group. This discrimination may come in the disguise of laws which criminalize private same sex partnership between consenting adults, which violates their rights to protection of private life. This right accorded is by no way a special right. It is not special to be free from discrimination – it is an ordinary and universal entitlement of citizenship. The right not to be discriminated against is a common place claim we all should enjoy under the laws provided by our countries leaders.

It may be contended that the right to privacy flows from the effect of the right to respect ones life and the integrity of ones person and the right to respect the dignity inherent in a human being and to liberty and security of his/her personhood. If it is accepted that people regard their sexual attraction to others of the same sex as integral to their personality, it would follow that an encroachment of that aspect of their personhood would constitute a violation of their “integrity” as people and also to their inherent human dignity. Respect for this integrity and dignity requires that individuals be left free of state interference in the most intimate domain of sexual preference, especially with regards to the right of privacy.

It is also important to recognize that whenever a behavior is identified as a penalized crime, it gives police and law enforcement officers immense power to harass and victimize individuals, thereby making it extremely difficult when targeting such population groups when attempting to provide HIV treatment, care, and support. It should also be noted that there is no link between the continued criminalization of same sex partnership amongst males and the effective control of the spread of HIV. On the contrary, by criminalizing such group, the HIV/AIDS epidemic will continue to rise at a rate that may become uncontrollable. Sexual orientation should not be regarded as a disorder as is popularly held. To reduce the rate of the HIV/AIDS infection, prevention efforts must be designed with respect to sexual preferences and with recognition that stigmatization and discrimination that is taking place will only halt moving forward nationally.

Legislative Actions

Laws and legislations and the myriad of human right violations in Nigeria that makes same sex partnership more vulnerable to HIV/AIDS and exacerbates the impact of this
disease should be halted. Recognizing that men who have sex with men activities occur in Nigeria and funding programs that address it is a means forward that the government can take. This does not mean that the government supports the act of same sex partnership, but instead that the government supports providing HIV/AIDS treatment, and care for this group in order to fight the HIV epidemic in one spirit. Creating legislations that promote peer education and intervention strategies amongst men who have sex with men should be employed by policy makers as measures to curb the scourge. Such peer educators and advocates would help in educating people to adopt safe sexual practices in order to reduce or eliminate risk factors related to HIV infection.

Government and policy makes should also aid in coordinating and harmonizing the activities of governmental and nongovernmental agencies that have the same goal of reducing the effects of the HIV epidemic, which will ensure effectiveness in the effort to control the epidemic and provide care for infected individuals – regardless of their sexual preference.

Preventive Measures and Control:

Measures adopted at controlling the spread of the HIV/AIDS epidemic should be multi-sectoral, multi-dimensional, and multi-disciplinary in approach. Therefore, control measures that have targeted urban areas with regards to men who have sex with men, should gradually be extended to cover the rural areas. Effective prevention measures should also include the following:
Prioritize strategies and budgets to address HIV prevention, care, and treatment needs of men who have sex with men in national health and AIDS plan
Engage men who have sex with men, especially those living with HIV, in the design, implementation, and monitoring of programs
Tailor national, state, and local HIV strategies for men having sex with men to epidemiological and social data, taking into account the diversity of men who have sex with men and specific sociocultural circumstances and risks that they face
Promote programs for men who have sex with men who may be especially vulnerable to HIV infection, such as sex workers, injection drug users, and those in settings such as military facilities and prisons where violence and sexual coercion may take place
Support nongovernmental and community based organizations, including organizations of people living with HIV, addressing issues related to sex between men
Deliver programs that promote access to HIV prevention, treatment, and care for men who have sex with men
Challenge stigma and discrimination against men who have sex with men and advocate legal and policy reforms to promote their human rights and access to health services
Increase networking and information exchange with organizations working on behalf of men who have sex with men
We should look forward to a world free of HIV/AIDS...

HIV and AIDS Epidemic in Africa [Men who have sex with Men] MSM perspective

Sub- Saharan Africa is more heavily affected by HIV&AIDS than any other region of the world. Quoting from a reliable research, an estimated 24.5million people were living with HIV at the end of 2005 and approximately 2.7million additional people were infected with HIV during that year. In just the past year, the AIDS epidemic in Africa has claimed the lives of an estimated 2million people in this region. AIDS has orphaned more than 12million children.The extent of the AIDS crisis is only now becoming clear in many African countries as increasing numbers of people with HIV are becoming ill. In the absence of massively expanded prevention, treatment and care efforts, it is expected that the AIDS death toll in Sub-Saharan Africa will continue to rise. This implies that the impact of the AIDS epidemic on these societies will be felt most strongly in the course of the next ten years and beyond. It social and economic consequences are already widely felt, not only in the health sector but also in education, industry, agriculture, transport, human resources and economy in general.Despite the continuing impact of HIV&AIDS there are signs that awareness is waning among young people especially young men who have sex with other men (MSM). For instance, recent HIV/STI prevalence study targeted towards young MSM in Nigeria has shown decreasing awareness of HIV&AIDS among sexual minorities (MSM). The same pattern of increasing prevalence and decreasing awareness exist for STIs as a whole and many young people, mostly young gay men (or men who have sex with men as some identified) may under-estimate how likely they are to be exposed to sexually transmitted infections (STIs) including HIV&AIDS, young people do not believe that they are vulnerable to contracting them.The data on HIV infection among sexual minorities in Africa need both to expand (current) prevention work and to develop new strategies in a way that will address young MSM. It is important to do both, so that young gay men (MSM) have information about HIV&AIDS, how it affects them and do not forget messages about HIV&AIDS or start to think that they are no longer relevant to them. This is also important to meet the needs which arise as circumstances change over time. For instance, young gay men many need to get updated information about new testing arrangements in their area or new types of condoms. At the same time basic information need to be provided all the time because new gay men are beginning their sexual careers and may never have been reached with the information support and advice about HIV&AIDS or thought it was relevant to them.Effective and result-driven prevention work with young gay men (MSM) has the same basic elements as prevention work with any group or community. It involves;• Raising awareness about HIV/AIDS, challenging myths and assumption and reducing stigma by providing people with accurate, up-to-date information and opportunities to clarify their attitudes and values.• Providing opportunities for people to develop their personal and social skills in order to enable and empower them to make decision and carry them through in terms of protecting and promoting their sexual health.• Providing accessible and appropriate sexual health services and advice including access to condoms.• Providing access to treatment and care.Finally, it is advisable that organizations working in the area of HIV&AIDS target young MSM in their prevention work henceforth. This is mostly important to many of the organization in African countries who have through culture and religion marginalize this particular group of sexual minorities and have prevented them from acquiring necessary information about HIV&AIDS.