Homophobia fueling HIV

Our society is too focused on arguing whether LGBT people belongs with others, whether their behavior is legal or not or finding ways to convert them to be ‘straight’ rather than seeking a way to minimize consequent mental and physical health issues.

We make it a taboo in discussions and deprive the younger generation of education. Entangled in all these negative attitudes and phobias against a human being’s sexual orientation, it seems like we have been overlooking more important consequences of that orientation. Health care officials say that in order to combat HIV/AIDs, we have to first combat homophobia.

In one hand, the relationship between HIV and gay and bisexual men has existed since the beginning of the epidemic, which is most clearly demonstrated by HIV’s former name, Gay-Related Immune Deficiency, or GRID.  On the other hand homophobia is often noted as one of the drivers of the epidemic for gay and bisexual men. In Sri Lanka, HIV health care providers identify that one of the major barriers in preventing HIV/AIDs from spreading in the society is the homophobic attitude present among people.

The American Heritage Dictionary (1992 edition) defines homophobia as ‘aversion to gay or homosexual people or their lifestyle or culture’ and ‘behavior or an act based on this aversion.’ In simpler terms, ‘homophobia’ is the hatred or fear of homosexuals – that is, lesbians and gay men – sometimes leading to acts of violence and expressions of hostility.

Creating awareness in order to eliminate the homophobic attitude and discrimination against the LGBT community are among the main goals of the International Day against Homophobia and Transphobia. This Day was introduced in May 17, 2004 as the International Day against Homophobia. In 2009, ‘Transphobia’ was added explicitly in the title of the name, in recognition of the very different issues at stake between sexual orientation and gender expression. Since 2015, ‘Biphobia’ is added to the title, to acknowledge the specific issues faced by bisexual people.

Homophobia is not limited to any one segment of society. It can be found in people from all walks of life. One of the most common notions among people with a homophobic attitude in Sri Lanka is that homosexuality is a western import and that it goes against the culture of our country. “Penal Code 365A by virtue of the fact that it is an old colonial anti sodomy law, is still used by many, particularly in law enforcement to discriminate against and violate the rights of LGBTIQ (lesbian, gay, bisexual, transgender, intersex, and questioning) persons in Sri Lanka,” said EQUAL GROUND Executive Director,  Rosanna Flamer-Caldera. EQUAL GROUND is a nonprofit organization seeking human and political rights for LGBTIQ.

She further said that this permeates into every section of society where the threat of this law and the misinformation about it is used to discriminate and subjugate the community.  As Flamer-Caldera explained what we call Sri Lankan culture today is based on Victorian morality depriving us of an open mind. “We hear many persons saying that Homosexuality is a western import and that it goes against the culture of this country.  In fact our culture is based on Victorian morality and our laws our based on Victorian laws – brought by the British!  So these are what are imported, not homosexuality which has been around way before the Colonizers came to our fair land.”

Flamer- Caldera rebuked media organizations for quoting prominent health officials stating that the rise in HIV in Sri Lanka is due to the rise of homosexuality. “This is not only erroneous but highly misleading,” she said.  “In fact it should be stated that homophobic attitudes in the health sector and their inability to reach members of the community due to their apathy and homophobia is the reason HIV is rising within this community,” she further said.

In addition she said that while HIV is indeed prevalent in the LGBTIQ community, it makes up only up to 15 percent of the total numbers infected – the rest (85 persons) being heterosexual persons. “Misguided notions about homosexuality and gender identity coupled with rampant homophobia and transphobia is hampering interventions in this area a hundred fold.”

As she explained, the Government should first and foremost repeal the laws that criminalize homosexuality. “The state has no business in our bedrooms and consensual sex between adults is of no concern to anyone other than the two people who are engaging,” she emphasized adding that strengthening the laws to protect women and children should be foremost on the government’s agenda but at the same time they must be certain to uphold democratic values and give everyone their rights as Human Beings including the LGBTIQ community.  The health sector must be sensitized to accept and understand the LGBTIQ community and the corporate sector must also follow suit and encourage diversity in the work place.

“EQUAL GROUND is the only LGBTIQ advocacy group focusing on the rights – Human Rights – of the LGBTIQ community, seeking equality for all sexual orientations and gender identities; human rights for everyone.  EQUAL GROUND holds sensitizing workshops all over the island and is currently conducting such programs with the corporate sector, the media and the public at large,” she mentioned.

“It will be most happy to be called upon to sensitize the government sector, the health sector and others to be better able to understand and accept LGBTIQ persons as human beings and productive citizens of this country,” she added.

Dr. Dayanath Ranatunge, UNAIDs (United Nations Programme on HIV/AIDS)  Country Manager for Sri Lanka, speaking to The Nation also admitted that the support of the government and society as a whole is needed in combating HIV in Sri Lanka. He lamented that the discrimination against the LGBTIQ community is found mostly in the grassroots level while speaking in the context of health care facilities and law enforcement agencies.  “Our advocacy programs in relation to homosexuality and HIV started 10 years ago. Comparatively, the situation is much improved now,” he said. “All senior ranking officers in law enforcement and health care settings are being educated about the importance in the involvement of MSM (Men who have sex with men) HIV awareness programs. Yet, the gap of awareness between the senior officers and grass-root officers is wide,” he said.

HIV epidemic is related to human sexual behaviors where people exchange bodily fluids in a form of sexual intercourse- anal or vaginal or oral sex. Ranatunge further explained how homophobic attitudes deprive LGBTIQ community of health care facilities.

“This homophobic attitude keeps them away from HIV testing and HIV care and support and this makes MSM more vulnerable to HIV,” he argued. “If somebody wants to stop the disease spreading, HIV testing must be given priority. The more number of people take the tests, the more it can be prevented,” he added.

Speaking specifically about MSM, Ranatunge emphasized the need of education on safe sex methods. If the test results come negative they should be encouraged to practice protective sexual behavior where bodily fluids will not be exchanged. “In simpler terms they should be encouraged to use a condom and a lubricant together,” he said.  “It’s more important that they use lubricant with the condom. “Usually condoms tend to break during anal sex. There are local health care services which provide this,” he said. “Education is available in health care services and this education should be freely available for everyone without any stigma or discrimination based on their sexual orientation,” he added.

Secondly, if the test results are positive, they should be encouraged to engage with the existing health care services for a longer period. Ranatunge explained that patients with a homosexual orientation withdraw from treatments because they fear discrimination and stigma against them. “It is evident that if an HIV infected person is put in to a proper treatment schedule, the ability to infect another -‘infectivity’- becomes almost zero meaning that if a person is undergoing proper treatment he or she is no longer a threat,” he iterated. Also, he expressed grief on how a lot of people drop out in the middle of treatment unable to face the stigma.

If we are to work towards taking prevalence of HIV infection down to zero in Sri Lanka, these homophobic attitudes should somehow change. Relevant authorities and stakeholders should be educated further about the situation. “There are cases reported where homosexual men were forced to pretend as straight men and get married to women. Sometimes they might have kids too. Unfortunately, through these forceful acts, the general community also becomes vulnerable to HIV,” he reiterated.