Tutu calls for end to gay stigma to help tackle HIV
Archbishop Desmond Tutu has called for homosexuality to be decriminalised to help tackle HIV.
His comments come in an analysis in The Lancet journal of why incidence of the virus continues to grow among men who have sex with men.
Dr Tutu said anti-homosexuality laws would in the future be seen as “wrong” as apartheid laws are now.
Campaigners said it was important for community leaders to speak out.
The archbishop is patron of the Desmond Tutu HIV Foundation, based in Cape Town, which provides treatment for HIV and carries out research.
Writing in The Lancet, he said: “In the future, the laws that criminalise so many forms of human love and commitment will look the way apartheid laws do to us now – so obviously wrong.
“Never let anyone make you feel inferior for being who you are. When you live the life you were meant to live, in freedom and dignity”.
Also writing in The Lancet, an international team of researchers, led by Prof Chris Beyrer of the Johns Hopkins Bloomberg School of Public Health in the US, said men who have sex with men (MSM) bore a “disproportionate burden” of HIV.
The fact HIV was first identified in gay men has “indelibly marked the global response” and “stigmatised those living with the virus”, they said.
The researchers’ paper said there was optimism among HIV specialists about the potential to use prevention, such as the drug Truvada, to reduce levels of HIV in men who have sex with men.
Earlier this week, the US Food and Drug Administration approved Truvada for preventative use in those at high risk of infection and who may engage in sexual activity with HIV-infected partners, the first time it has approved a drug to prevent HIV infection.
‘Struggle for equity’
But the international team said the picture was very different in many other countries.
“In too many settings in 2012, MSM still do not have access to the most basic of HIV services and technologies such as affordable and accessible condoms, appropriate lubricants and safe HIV testing and counselling,” they said.
We’ve got to have community leaders and people with influence speaking out.”
End Quote Terrence Higgins Trust
“The struggle for equity in HIV services is likely to be inseparably linked to the struggle for sexual minority rights—and hence to be both a human rights struggle, and in many countries, a civil rights one.”
The paper, published on the eve of the international Aids 2012 conference, adds that by the end of 2011, only 87 countries had reported prevalence of HIV in MSM.
Data is most sparse in the Middle East and Africa, where homosexual activity is a criminal offence.
The researchers call for same-sex relations to be decriminalised in all countries, so that a true picture of the scale of HIV in men who have sex with men can be ascertained.
A spokeswoman for the UK’s Terrence Higgins Trust said: “We’ve got to have community leaders and people with influence speaking out.
“That’s why what Desmond Tutu is saying is so important.”
And she said it was right to focus efforts on men who have sex with men, in all countries.
She added: “In London, one in seven gay men has HIV.”
The Terrence Higgins Trust discusses barebacking at :http://www.hardcell.org.uk/playroom01.htm its Hard Cell website.
1. Among other information the site states :
1.the meaning of the term bare backing varies but Hard Cell uses it to mean sex without a condom
2. Some men describe themselves as barebackers as part of an identity they’re proud of.
3. The Gay Men’s Sex Survey shows in the UK around nine out of 10 men who have anal sex use condoms some or all of the time*. But it also shows half of us had anal sex without a condom at least once in the last 12 months.** Much of this is men in couples not using condoms with each other.
Most of the rest are men barebacking with guys they know (or at least believe) have the same HIV status as themselves, either both HIV positive or both negative. For this reason they don’t believe there’s a risk of HIV being passed on, although they may be wrong to assume that. We often make inaccurate assumptions about our or his HIV status. Only a small minority report barebacking with men whose HIV status they know is different to their own.***
*Gay Men’s Sex Survey 2006, Sigma Research; 86% of men who had anal sex in the previous 12 months had used a condom at least once **Gay Men’s Sex Survey 2008, Sigma Research; 54% of men had some unprotected anal sex in the previous 12 months with at least one man *** Gay Men’s Sex Survey 2008, Sigma Research; 3.5% of men whose last test was negative report unprotected anal sex with someone who they knew had HIV. Of men diagnosed with HIV 15.6% reported unprotected anal sex with someone they knew was HIV negative.
Int J Epidemiol. 2010 Aug;39(4):1048-63. Epub 2010 Apr 20.
HIV transmission risk through anal intercourse: systematic review, meta-analysis and implications for HIV prevention.
Department of Infectious Disease Epidemiology, MRC Centre for Outbreak Analysis and Modelling, Faculty of Medicine, Imperial College London, Paddington, London, UK. firstname.lastname@example.org
The human immunodeficiency virus (HIV) infectiousness of anal intercourse (AI) has not been systematically reviewed, despite its role driving HIV epidemics among men who have sex with men (MSM) and its potential contribution to heterosexual spread. We assessed the per-act and per-partner HIV transmission risk from AI exposure for heterosexuals and MSM and its implications for HIV prevention.
Systematic review and meta-analysis of the literature on HIV-1 infectiousness through AI was conducted. PubMed was searched to September 2008. A binomial model explored the individual risk of HIV infection with and without highly active antiretroviral therapy (HAART).
A total of 62,643 titles were searched; four publications reporting per-act and 12 reporting per-partner transmission estimates were included. Overall, random effects model summary estimates were 1.4% [95% confidence interval (CI) 0.2-2.5)] and 40.4% (95% CI 6.0-74.9) for per-act and per-partner unprotected receptive AI (URAI), respectively. There was no significant difference between per-act risks of URAI for heterosexuals and MSM. Per-partner unprotected insertive AI (UIAI) and combined URAI-UIAI risk were 21.7% (95% CI 0.2-43.3) and 39.9% (95% CI 22.5-57.4), respectively, with no available per-act estimates. Per-partner combined URAI-UIAI summary estimates, which adjusted for additional exposures other than AI with a ‘main’ partner [7.9% (95% CI 1.2-14.5)], were lower than crude (unadjusted) estimates [48.1% (95% CI 35.3-60.8)]. Our modelling demonstrated that it would require unreasonably low numbers of AI HIV exposures per partnership to reconcile the summary per-act and per-partner estimates, suggesting considerable variability in AI infectiousness between and within partnerships over time. AI may substantially increase HIV transmission risk even if the infected partner is receiving HAART; however, predictions are highly sensitive to infectiousness assumptions based on viral load.
Unprotected AI is a high-risk practice for HIV transmission, probably with substantial variation in infectiousness. The significant heterogeneity between infectiousness estimates means that pooled AI HIV transmission probabilities should be used with caution. Recent reported rises in AI among heterosexuals suggest a greater understanding of the role AI plays in heterosexual sex lives may be increasingly important for HIV prevention.