A law criminalising "unnatural" sex is reinforcing the stigma that leaves gay men in Burma hidden, silenced and shamed, hindering efforts to contain HIV/Aids, claim experts and activists.
Monks, lawyers and the police are calling for the rarely enforced law – section 377 of the penal code, which dates from the British colonial era – to be used to imprison a gay couple who marked their 10th anniversary this month with a wedding-style event.
The ceremony made front-page news on 3 March, and the backlash was swift. The next day, Burma's largest newspaper, Eleven Daily, equated sex between men with bestiality and asked why the couple were not being investigated for violating section 377, which carries a 10-year prison term.
Aung Myo Min, director of rights group Equality Myanmar, which is leading the campaign to repeal section 377, said Eleven Media was using hate speech to stoke homophobia.
Increased hostility against homosexuality could make it harder to reach the community's most hidden members, said Nay Oo Lwin, programme manager with Population Services International (PSI), which operates the largest HIV/Aids outreach programme in Yangon.
Aids experts here say it is difficult to provide gay men with safe-sex information, counselling and testing services because intense stigma keeps them hidden. Gay men were "hard to reach in the most extreme sense" as stigma keeps them hidden, said the UNAids country representative, Eamonn Murphy.
Anne Lancelot, director of PSI's targeted outreach programme, said: "We know there is a large population of [gay men] who do not identify themselves that way, but we don't even know how large that population is."
Murphy said, however, that homosexuality had become more visible over the past decade, particularly in cities.
Burma's National Aids Programme (Nap) puts the number of gay men at less than 0.5% of the population: 240,000 of an estimated 60 million people. Fewer than 30% of them have received HIV prevention services.
This low level of outreach to a group that may also be vastly underestimated alarms experts. Concerns are compounded by the lack of sex education in Burma.
Nap conducted its first surveillance of HIV prevalence among gay men in 2007 and uncovered a 29% infection rate. The rate is now about 7-8%, compared with less than 0.6% for the overall population.
The decline is often attributed to increased condom usage, but it is possible, too, that some gay men are hiding their identity to escape the stigma, Murphy said.
Nearly half of the estimated 200,000 people with HIV/Aids in Burma live in Rangoon or Mandalay, the two largest cities, according to a draft report by regional Aids experts.
Cities offer gay men freedom, but the risk of HIV infection rises when awareness of safe sex is scant, discrimination rife and services frail, the report noted.
If Burma wants to avoid the fate of other Asian cities, it needs to reduce stigma and expand services for gay men in cities, said the report, which stressed the need to repeal section 377. Doctors need to become less hostile to gay men, who are often treated with contempt by medical professionals, according to the study's authors. As a result, "most gay men are terrified of going to a doctor for a sexually transmitted infection", Lancelot said.
Gay men in Burma have a unique set of terms for describing themselves, partly based on the degree to which masculinity and femininity are experienced and displayed. Transgender people are less likely to be hidden and thus more likely to experience harassment, especially from police, according to complaints to the Human Rights Commission set up by Burma's nominally civilian government.
Gay men who identify themselves as heterosexual, however, are more likely to be hidden, married and susceptible to bribery, according to the UNDP report. Expanding internet access in Burma is providing a new way for gay men to connect anonymously, as well as more opportunities for risky sex.
PSI is expanding its outreach programme online. "We're going on the cruising websites and Apps, such as Grinder and Jack D," Lancelot said. "This might help us reach people who do not come to our [18] drop-in centres. We are watching very carefully what is happening in Thailand, where there seems to be quite a rebound of the HIV epidemic among [gay men]. We need to be ahead of the curve."
HIV prevalence among gay men in Bangkok surged from 17.3% to 28.3% between 2003 and 2005, and remains at nearly 30%, according to a 2013 report by Thailand's public health ministry and the US Centres for Disease Control and Prevention.
• This article was amended on 28 March 2014 to clarify that a report by regional experts was a draft and not the final version.
http://www.information.myanmaronlinecentre.com/burmas-homosexuality-law-undermining-hiv-and-aids-fight/
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