UNAIDS : Stigma and discrimination against anal penetration, fisting, felching, rimming etc cause of high HIV in MSM ?

A)

UNAIDS are a group of United Nations agencies which are working to eliminate HIV worldwide..

On Page 123 of the document ” UNAIDS OUTLOOK 2010″ homophobia is defined as follows :

“What is homophobia?

UNAIDS describes   homophobia as intolerance and contempt for those who have identities and orientations other than heterosexual ones. It is an aversion, hatred,
fear, prejudice or discrimination against homosexual men, bisexual people, transgender
people, transvestites, lesbians and transsexuals. Homophobia confers a monopoly of normality on heterosexuality, thus generating and encouraging contempt for those who diverge from the  reference  model.”

B)

If  UNAIDS  is  to  be  believed    a significant  cause  for   the high  rates  of  HIV  among  MSM  in the  Caribbean  is  stigma  and  discrimination against  the homosexual  lifestyle  and  by  extension  the  activities  of  the Hard  Cell  Playroom  such  as  anal penetration, fisting, felching, rimming, brown showers, watersports, scat  and  “farming”.

See  :http://www.hardcell.org.uk/playroom.htm

According  to  UNAIDS  the stigma  and  discrimination  associated  with  being  homosexual  cause   MSM  to shun  or  be denied  adequate health  services .  Studies  have  confirmed  this fact  but  studies  also  show  that  there  are  also  other  considerations  why  MSM  do  not  utilize  health care  services.

Caribbean  UNAIDS  director  Dr. Ernest Massiah,

What’s the score on regional HIV/AIDS?

Published: Thursday | September 16, 2010 1 Comment

http://jamaica-gleaner.com/gleaner/20100916/cleisure/cleisure4.html

The stigma associated with HIV is a relic of the early 1990s, when fear informed ignorance. This is also linked to prejudice and rejection of what is perceived and judged as abnormal sexual beha-viour and wrongful sexual orientation. It is precisely these stigmas that threaten the public’s health: they prevent people from getting tested, getting and sharing their test result with others and from seeking treatment, if needed. Unrecognised and untreated HIV can spread. In 2010, stigma and prejudice should have no place in Caribbean societies.

AIDS Behav. 2011 Aug;15(6):1088-97.

Stigma, health care access, and HIV knowledge among men who have sex with men in Malawi, Namibia, and Botswana.

Source

Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health, E7146, 615 N. Wolfe Street, Baltimore, MD 21205, USA.

Abstract

Same-sex practices are stigmatized in much of sub-Saharan Africa. Cross-sectional relationships between discrimination, access to and use of health care services, and HIV knowledge among men who have sex with men (MSM) were assessed in Malawi, Namibia, and Botswana. A survey and HIV screening were used to explore these variables and the prevalence of HIV. Overall, 19% of men screened positive for HIV infection. Ninety-three percent knew HIV is transmitted through anal sex with men, however, only 67% had ever received information of how to prevent this transmission. Few (17%) reported ever disclosing same sex practices to a health professional and 19% reported ever being afraid to seek health care. Men reported ever been denied health care services (5%) and 21% had ever been blackmailed because of their sexuality. Strong associations were observed between experiences of discrimination and fear of seeking health care services. Characterizing the relationship between stigma and health care seeking practices and attitudes can inform the development and implementation of HIV interventions for African MSM.

AIDS Patient Care STDS. 2009 Oct;23(10):825-35.

Health system and personal barriers resulting in decreased utilization of HIV and STD testing services among at-risk black men who have sex with men in Massachusetts.

Source

The Fenway Institute, Fenway Health, Boston, MA 02119 , USA. mmimiaga@fenwayhealth.org

Abstract

Testing for HIV and other sexually transmitted diseases (STD) remains a cornerstone of public health prevention interventions. This analysis was designed to explore the frequency of testing, as well as health system and personal barriers to testing, among a community-recruited sample of Black men who have sex with men (MSM) at risk for HIV and STDs. Black MSM (n = 197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered assessment, with optional voluntary HIV counseling and testing. Logistic regression procedures examined factors associated with not having tested in the 2 years prior to study enrollment for: (1) HIV (among HIV-uninfected participants, n = 145) and (2) STDs (among the entire mixed serostatus sample, n = 197). The odds ratios and their 95% confidence intervals obtained from this analysis were converted to relative risks. (1) HIV: Overall, 33% of HIV-uninfected Black MSM had not been tested for HIV in the 2 years prior to study enrollment. Factors uniquely associated with not having a recent HIV test included: being less educated; engaging in serodiscordant unprotected sex; and never having been HIV tested at a community health clinic, STD clinic, or jail. (2) STDs: Sixty percent had not been tested for STDs in the 2 years prior to study enrollment, and 24% of the sample had never been tested for STDs. Factors uniquely associated with not having a recent STD test included: older age; having had a prior STD; and never having been tested at an emergency department or urgent care clinic. Overlapping factors associated with both not having had a recent HIV or STD test included: substance use during sex; feeling that using a condom during sex is “very difficult”; less frequent contact with other MSM; not visiting a health care provider (HCP) in the past 12 months; having a HCP not recommend HIV or STD testing at their last visit; not having a primary care provider (PCP); current PCP never recommending they get tested for HIV or STDs. In multivariable models adjusting for relevant demographic and behavioral factors, Black MSM who reported that a HCP recommended getting an HIV test (adjusted relative risk [ARR] = 0.26; p = 0.01) or STD test (ARR = 0.11; p = 0.0004) at their last visit in the past 12 months were significantly less likely to have not been tested for HIV or STDs in the past 2 years. Many sexually active Black MSM do not regularly test for HIV or STDs. HCPs play a pivotal role in encouraging testing for Black MSM. Additional provider training is warranted to educate HCPs about the specific health care needs of Black MSM, in order to facilitate access to timely, culturally competent HIV and STD testing and treatment services for this population.

C)

To  achieve  lower  rates  of  infection  UNAIDS  is  lobbying  Caribbean Governments  to  remove  those  sections  of  their  law  which criminalize  the  above  activities  but  the  following  remains  true.

HIV-related sexual risk behaviour between 1996 and 2008, according to age, among men who have sex with men (Scotland).

Knussen C, Flowers P, McDaid LM, Hart GJ.

Source

Department of Psychology, Glasgow Caledonian University, Glasgow G4 0BA, UK. c.knussen@gcu.ac.uk

Abstract

OBJECTIVE:

To examine changes in the proportions of those reporting 2+ unprotected anal intercourse (UAI) partners in the previous 12 months among men who have sex with men (MSM) in Scotland between 1996 and 2008. Differences according to age group were also examined.

METHODS:

Logistic regression was used with data from eight cross-sectional anonymous, self-report surveys in commercial gay venues in Glasgow and Edinburgh (N=10,223). Data were stratified according to survey and age group (<25 years vs ≥25 years).

RESULTS:

The percentage of 2+ UAI partners reported in the previous 12 months increased significantly between 2000 and 2002, adjusted for age group. When the surveys were divided into two time periods (1996-2000 and 2002-2008), no significant differences were found within each time period in the percentage of 2+ UAI partners reported (adjusted for age group). However, a significant increase was found when the aggregated figures for 2002-2008 were compared with those for 1996-2000. At the aggregate level, those aged <25 years were significantly more likely than those aged ≥25 years to report 2+ UAI partners in the previous 12 months (adjusted for survey).

CONCLUSIONS:

HIV-related sexual risk behaviour did not change significantly between 2002 and 2008 among MSM in Scotland, after the increases noted between 2000 and 2002. A significant minority of MSM continue to engage in relatively high levels of sexual risk, and younger generations appear to be at particular risk. This represents a public health concern and highlights the need for targeted age-specific interventions.

PMID:

21071563

[PubMed – indexed for MEDLINE]

UNAIDS   apparently  accepts  without  question  the   slogan  ” Gay  is  good”  but   where is  the evidence  that  Gay  is  in  fact  good   and  Men having  sex  with  Men  is  not  inevitably  a  source  of  serious  disease  ?

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