Whilst health authorities continue to blame “stigma and discrimination” and the buggery law for persistently high HIV rates among MSM research indicates that the substantial cause of the problem is the practice of buggery itself.
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Global epidemiology of HIV infection in men who have sex with men
Chris Beyrer et al.
– The disproportionate HIV disease burden in MSM is explained largely by the high per-act and per-partner transmission probability of HIV transmission in receptive anal sex.
Modeling suggests that If the transmission probably of receptive anal sex was similar to that associated with unprotected vaginal sex, five year cumulative HIV incidence in MSM would be reduced by 80-90%.
– Many MSM practice both insertive and receptive roles in sexual intercourse,which helps HIV spread in this population. Were MSM limited to one role, HIV incidence in this population over five years would be reduced 19-55% in high-prevalence epidemics.
– Taking both factors (per act transmission probability and role versatility) into account explains 98% of the difference between HIV epidemics among MSM and heterosexual populations—behavioral differences account for 2% of the difference.
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Buggery Law Affects HIV/AIDS Fight – Paper
Published: Monday | December 1, 2014
Ellyn Daniel-Ross, with Friends for Life, hammers AIDS markers in front of First Baptist Church on East Parkway in Memphis, Tennessee. First Baptist joins with Greater Lewis Missionary Baptist Church every year to cover the corners at Poplar and East Parkway with more than 3,000 ribbons to honour local aids victims. – AP
A CONCEPT paper prepared for the Ministry of Health said Jamaica’s buggery law “negatively impacts policy implementation” in the fight against HIV/AIDS as it “makes it difficult for reporting and treatment and prevention programmes for the MSM (men who have sex with men) population”.
Jamaica’s buggery law, which is contained in the Offences Against the Person Act, prohibits anal sex between men, in public or in private. It is punishable by 10 years in prison with hard labour.
The paper, which is part of the revision of the National HIV Policy, argues that there are gaps in Jamaica’s Charter of Rights, and that the protection against discrimination is not being afforded to homosexual males as a result of the buggery law.
“The pace of legislative reform and policy adoption in Jamaica is generally slow, and even more so since many parliamentarians and other persons of influence do not see HIV as a priority and many are uncomfortable with HIV-related issues. Many legal and legislative gaps remain that will significantly impact the HIV response in years to come,” the paper said.
It further argued that the absence of a general or comprehensive anti-discrimination legislative and policy framework is hampering efforts to redress incidents of stigma and discrimination against people living with HIV.
A joint select committee of Parliament is currently reviewing several pieces of legislation, including the Sexual Offences Act. The matter of the buggery law has also been raised at the committee, even though the focus is not in line with a review of the law which Prime Minister Portia Simpson Miller promised in the run-up to the 2011 general election.
The review of the National HIV Policy, however, could influence the discussions on the buggery law. After completing its review, the Ministry of Health will submit a final policy to the Cabinet for consideration.
Not Guided by Policy
Meanwhile, the Patricia Watson-authored concept paper argued that the National HIV-Related Discrimination Reporting and Redress System is not guided by any policy. It also said there is no legislation to support the reports submitted to the system. The paper also said the system has limited human resources and technical capacity.
“Stigma and discrimination, both in the general population and within the health sector, continue to pose a significant barrier. This is strongly related to the cultural norms, values and attitudes. Moreover, there is no law to protect PLHIV (persons living with HIV) and their households from stigmatising, discriminatory and violent actions,” the paper said.
It further argued that stigma associated with socially marginalised groups, especially MSM, remains very high, and acts of discrimination are commonplace.
“The impact of stigma and discrimination in the health sector prevents many from getting tested, accessing regular care and/or disclosing their status to their partners. PLHIV often do not want to receive treatment in their community because of concern that others may learn about their status,” the paper said.
“Stigma and discrimination is especially harmful to key populations who have to negotiate different stigmatised identities (sexual orientation or practices, poverty, mental illness, HIV status, etc). Key population groups have limited access to services for prevention, treatment and care. Because of criminalisation of sex work, access to services is affected. Where sex workers feel unable to disclose their profession to health-care workers due to stigma and/or discrimination, quality of care is compromised because their risk is not properly assessed,” it added.