Concerns for HIV prevalence rate in MSM in Jamaica & connected matters

With the final day in November which is considered Parenting month (non LGBT mattered), LGBT Homeless Awareness and Transgender Awareness/Day of Remembrance month/day (the 20th) so I decided to combine some concerns on the eve of World AIDS Day as well with the theme locally Justice for All as espoused by the Minister of Health recently. See: Health Minister Ferguson on WAD '13 & FBOs fear of a Buggery repeal with future parachuted gay marriage

This year has been a difficult year in some respects for me as I have lost so many friends from AIDS related deaths despite the more sophisticated anti-retroviral drugs albeit they had the HIV infection for quite a while and were surviving but like all things there has to come an end. Why is there still a high prevalence rate of HIV infection in men who have sex with men in Jamaica? Especially the younger aged men who have sex with men whether they self identify as gay, from as early as 1986 the first study done with MSM in the height of the AIDS epidemic where the prevalence was 10% and then in 1995 it jumped to 32% with a similar figure in 2007. The last study done in September 2011 through to January 2012 covering some four parishes and four hundred and forty nine men when compared to the 2007 that only captured 201 showed that there was some minor increase in the infection rate to approximately 33% although the 07 study was a snowball one covering Kingston and Mandeville while the 2011/12 was a cross sectional.

Anal sex as we know is high risk for HIV transmission and the men who are captured in most of these studies are from lower socio economic backgrounds making them socially vulnerable, we know of the exploitation within the MSM community, the power imbalance or differentials and lifestyles issues such as no life planning, low risk assessment, homelessness, living for the moment and lack of disclosure of HIV status. The prevention obviously have been ineffective over the years it seems as we are told repeatedly that MSM are driven underground and do not have access to safer sex implements but how can this be when the very agencies that have direct access to the populations do not engage said groups consistently yet claim to represent marginalized groups? Two factors came up for mention in the 2007 study:

1) Ever having a sexually infection

2) Receptive anal intercourse

These two significant risk factors came up for mention again in the 2011 study; the study was done to find the following based on my understanding of it;

To estimate the prevalence of HIV and sexually transmitted infections among MSM

To monitor program coverage and effectiveness

To look at risk factors

To explore underlined determinants

To estimate HIV incidence post the study by following a cohort of men who tested negative in the 2007 study, other items known as proximate determinants were added to the 2011 survey such as cash for sex, type of sex, number of partners, receptive anal intercourse, risk perception, use of drugs and condom usage added to that were underlined determinants in terms of social vulnerability which make some MSM more at risk and carry out risk practices than others so demographic features, socio economic status, literacy and gender issues. Outcomes that were tested for therefore were HIV, Syphilis, and other STIs. An experienced female research nurse participated in the survey via contacts from the MSM populations and persons had to be 16 years and older with written informed consent to participate. Some characteristics and results coming through were:

61% were between the age of 16 and 34

38% were 25 years of age and older

1/5 of both groups identified as “female” (possible trangender) and nearly 60% were bisexual which was what were also found in the 2007 survey; 8% of those identifying as bisexual were married.

12% of persons surveyed were of low literacy

79% had a low comfort level admitting to someone they were men who have sex with men; about a quarter of the cohort had experienced violence or ever been to jail and a fifth had spent a night outdoors; 16% of the total had expressed hints that they had been “raped”

Between 2007 and 2011 there was some improvement in the access to HIV/treatment services rate amounting to 50% a major increase; 84% of these persons were satisfied with the services received which is a smack in the face of some who continue to use an old narrative that gay men do not have access t treatment and care in the public systems. 84% is no different of the client satisfaction found in the mainstream

79% of persons had ever had an HIV test most of them had received their results and 58% had a test in the past 12 months alongside seeing the risk card as disseminated by outreach officers, 76% of the men had seen the risk card.

Risk perception was way off nearly 60% of the men thought they had little or no chance of contracting HIV which really when one assesses it is quite ridiculous because one is involved in anal receptive sex especially the risk is higher. The feeling of the young that they are invincible needs to be broken and a mindset change is urgently needed.

60% of persons who were positive had not disclosed their status to their partner(s) this is a huge problem yet still even after my absence from outreach work and certainly helps to perpetuate the transmission; aside from HIV over 8% were positive for syphilis, 3% for gonorrhoea and 9% for Chlamydia but there were no rectal swabs done for that survey so maybe the rates could be higher.

Those who were aged under twenty five a quarter of them were already positive and among those over twenty five 42% were positive, so there is a strong relationship between positivity and age.

MSM who received or paid cash for sex otherwise known as commercial sex workers those who received cash for sex just about 50% of them were positive by twenty five; the other groups who were involved in transactional sex (without cash) 26% of those persons were positive while 40% of cash for sex only were also positive, among heterosexuals transactional sex in which gifts or non cash bargaining there is a higher risk among those, bearing in mind the hierarchy

Sex work or cash for sex

Transactional sex (non cash)

Neither

All three are different but among MSM there is not much difference maybe due to the high risk of anal sex and it obviates the hierarchy. Gender and sexual orientation in as far as cash for sex persons who identify as females as much as 56% of them were positive while non cash MSM were 40% on the other hand bisexuals who did not receive or paid cash for sex 17% of them were positive which is a bit puzzling as the rate among bisexuals significantly lower than the average rate. Risk behaviour with the bisexual group and cash/noncash MSM receptive anal intercourse and cash for sex is 48%; versatile (both receptive and dominant partnered sex) the prevalence is high for those receiving cash for sex, those who gave a history of five or more one night stands 67% of those Cash for sex and 44% of other MSM were positive.

Condom use – those MSM who say that they only use boots their prevalence was significantly lower while those who ticked if they were ever told by a doctor they had an sexually transmitted infection their prevalence rate is significantly higher.

Other underlying factors also make for interesting perusal such as those who suffered violence in both cash for sex and other MSM categories – 54% in the former were positive while those who were ever raped or slept in jail while also being involved in cash for sex were four times likely to be infected than the other categories.

The 125 men of the 449 surveyed of who accepted cash for sex only 34 of the men did not have an adverse life event which means low literacy, been to jail, slept outdoors or homeless. Those who had no cash for sex but with adverse life events the rate was 27%, taking only MSM who had adverse life events their prevalence was high as 39%; men who had no adverse life event or cash for sex their prevalence was 21% so it is important to separate the categories to get a better picture. The number of life events automatically pushes the rate upwards in MSM hence homelessness is a major issue here.

The 49 men who were negative in the 2007 study the incidence estimate showed an annual rate of 6% if it were linear over five years it means it would move from 0 – 30%

The proximate determinants are well known in the conceptual model used to conduct the survey for example condom use always was protected, most of the men as said previously were poor and unemployed, adverse life events were common, transactional sex was common, Risk perception very low, STI prevalence is very high, HIV prevalence is very high but these cannot be used to generalize the rate in the broader MSM populations. The high prevalence is associated with social vulnerability, sex work and other STIs HIV among MSM is an important factor driving the epidemic in Jamaica, more ways must be found to bring down the numbers with real meaningful interventions but with recent abandonment by LGBT organizations and the lack of interest from the national program in as far as social/welfare responses then how do we expect to see the rates go down?

Bearing in mind the ending of the last round of global fund in July of 2013 yet with more agencies including faith based managed NGOs also doing HIV prevention work with sometimes the same group of MSM yet the numbers are frightening. The homeless matter has taken a turn and myself and others are watching carefully the developments in certain quarters as the lgbt reporting goes into overdrive using the homeless men in New Kingston as bait while the other populations are overlooked completely. Donations are being solicited which is good but the motive one wonders:

homeless men sleeping in the drain by the old Superplus store and how late the response to this problem nationally.

Here is the page to donate, the details of the project is missing, the target amount(s) as most campaigns ought to have is not there, the essence of the project is not shown so what are persons being asked to donate to and those who do not have a paypal account how do they donate? see more HERE and A claim on How to help homeless LGBT Jamaicans ......

Peace and tolerance 

H

Health Minister Ferguson on WAD '13 & FBOs fear of a Buggery repeal with future parachuted gay marriage rights

In an interview on local radio station Love 101FM on the upcoming World AIDS Day observance and the activities Health Minister Dr Fenton Ferguson used the opportunity to somewhat appeal to the faith based organizations to also participate in the response to HIV via the national program. The theme for this year is "Justice for All" and he mentioned the concern with the infections rates in certain groups such as men who have sex with men. He highlighted one of the issues with regards to the human rights aspects of the response that faith based organizations have concluded that it is an attempt to decriminalize buggery and somehow parachute same sex marriage as we have seen from voices such as Fellowship Tabernacle's Reverend Al Miller aligned to the Lawyers' Christian Fellowship and the Jamaica Coalition for a Healthy Society, JCHS.

He said ".....that is not the intent why there is the need to review these laws many of them appear to be punitive; there is also the fact that we now need to get to faith based leaders and others to say this is not about Buggery, this not about same sex marriage, this is about how do you as a Christian see, uhm, persons who need care having access to that care; once you shut them out as a group because you might have certain moral views about them then what you are now doing is spreading, setting up the possibility with that high prevalence setting up the possibility for spread of HIV"

He also mentioned that the rate was 32% in MSM but my last workshop with the national program some time ago the 2010 study has moved that to near 34% but the silence is deafening in as far as the new figures as 32% is from the 2007 study. Political bi-partisan support has helped the response to become so robust and he mentioned civil society and the country program under global fund is led by same. 

The last grant from GF of some forty million US dollars ended in July 2013 with ten million dollars from the world bank which ended in March of this year. Therefore the thrust in as far as the millennium development goals due 2015 as HIV is goal number six strategies must be found to push ahead to achieve the target and a partnership with FBOs. 

How does this new thrust however plays into the recent change in direction by the administration on the suggested (turned promise) conscience vote on buggery to now having a debate/possible amendment to the Sexual Offences Bill even as the upcoming case in the constitutional court by Javed Jaghai slated for November 2014 is unclear. Is the amendment a pre-cursor to the case so as to nullify the trial?

Here is the audio from the interview:

This interview also comes on the heels of news that:

 

World Council of Churches Supports Gay and Intersex People

Peace and tolerance

H

UWI Sociologist on Buggery And AIDS: A Lot Of Bull

There goes Dr Orville Taylor again as he tries to present a cloudy perspective on HIV, LGBT and related matters as usual on the pretext of the (mis)labelling of Jamaica as the most homophobic place on earth according to the old Time Magazine article; let us remember that the title of the piece was a question not a statement of fact based on incidents at the time that were reported.

Now comes the swipe by Dr Taylor as published in the Gleaner:

Yesterday was World AIDS Day. In school, we were taught that you can't have your cake and eat it too. Those who are pushing for the decriminalising of male-to-male homosexuality should focus on that agenda and not try to mix it inordinately with the issues relating to HIV/AIDS, unless they are arguing that the two are coterminous. Such an association, if ingrained in the media, will not help the struggle against stigma and discrimination.

Activists, including, apparently, Health Minister Fenton Ferguson, want to see the buggery law repealed. Indeed, Prime Minister Portia Simpson Miller definitively said she felt that it should be revisited. One should note, however, that the anti-buggery statute has not been applied in cases of private consensual male-male sexual activity in almost four decades, before most of the population was born. Like the laws which outlaw Sunday openings of supermarkets and women working more than 10-hour shifts, it is not enforced.

Nevertheless, the campaigners have to decide whether they are saying that consistent with the original lore, HIV/AIDS is the scourge of gay men, or it is simply not a gay disease. It is plain logic, and the persons pushing the anti-buggery law stance need to have in their camp more people who are less concerned with overworking their grey matter. By now, the standard knowledge in Jamaica is that HIV is not peculiar to Batman and Robin, but is seen more often among agent 'Ho-ho' seven and Daredevil. Most Jamaicans surveyed in studies conducted by universities, as well as governmental and non-governmental organisations, know that HIV affects all categories and does not reside solely in the gay community.

homophobic 'dis'-association

So then, why is it that the pro-gay groups keep on making the association between the repealing of the buggery law and HIV/AIDS? The premise is that homophobia drives the disease underground, because HIV-positive persons are not willing to seek treatment because of the fear of being labelled homosexual. That is simply not true.

Given that Jamaicans now know that the infection is passed by any type of sex, why should anyone with the virus feel that he would be labelled gay? Most infected persons are recorded by the health ministry to be male heterosexuals. In plain language, the largest group of people who are said to be HIV-positive in Jamaica are 'gyallis'.

Are the anti-buggery law advocates telling us, or more important, not telling us, something? Perhaps, there are some inconvenient facts. Strangely, my lazy colleagues in Jamaican media cut and paste from the standard UNAIDS documents and run the relatively useless information that the Caribbean is the region with the second-highest prevalence of the disease in the world. Yes, colleagues! We are behind only sub-Saharan Africa. So what? How does this help us? We also have the second-largest concentration of black people and the second-hottest climate. So, are we saying that hot temperatures and melanin that render us more prone?

Well, no, because again my indolent associates don't even bother to look nearer to home and examine our African American friends. Indeed, HIV prevalence among African Americans is scary and is much higher than among ours. For example, 45 per cent of all new infections among Americans in 2011 were black people. A similar number of all HIV-related deaths represent victims of African descent.

In Washington, DC, where the Obama residence is one of the few things which are white, three per cent of the population is HIV-positive. In Obamatown, with one of the greatest concentrations of black people in America, 75 per cent of those infected with HIV are African American. The American National HIV/AIDS Strategy reports that blacks "comprise the greatest proportion of HIV/AIDS cases across many transmission categories ... women, heterosexual men, injection drug users, and infants".

Yet, digging deeper into the statistics, we get to the bottom of the phenomenon, where subgroups within the category show greater risk. Intravenous drug users and sex workers are on the front line of the data. However, African American men who have sex with men (MSMs) accounted for around 73 per cent of new infections among men of colour. Black gays with HIV comprise 37 per cent of MSMs who are seropositive. Furthermore, young black MSMs have the fastest-growing infection rates, with new infections in the sub-30 age group racing up a frightening 48 per cent between 2006 and 2009.

'anal' attitude to data

Among the 'blacktivists' and 'blackademics' such as the (American) Association of Black Sociologists, we have long accepted that AIDS in America is a black disease and target our strategies accordingly. There is no pretence because the data do not lie. Nonetheless, we know that all social problems seem to affect black people more; we live shorter, are more unemployed, die violently more often, drop out of college more frequently, are less literate, have more unplanned babies and a slew of other 'crosses'. Poverty, marginality and ignorance all combine to exacerbate the problem, which is one of the main reasons that black people, globally, are more susceptible to the vagaries of HIV/AIDS.

Yet, there is one indisputable fact, and with all the pussyfooting around it, one can't turn one's back on this. The most common and highest behavioural risk in passing on HIV is anal penetrative sex, a.k.a. buggery. It is no bull: that is the truth that God loves. Last year, in America, 77 per cent of new infections were recorded among MSMs. Only 12 per cent of the men who have HIV 'say' they got it from vaginal sex. Given the number of persons who are on the 'down-low', it is reasonable to believe that the former is higher.

Back on 'The Rock', although the majority of infections ostensibly cover male heterosexuals, gay and bisexual men are disproportionately affected. Some 32 per cent of Jamaican MSMs are HIV-positive. We can speak of homophobia until the bulls come home, but nature 'himself' has already conspired against MSMs by designing the vagina as more receptive to penetration than the rectal orifice.

The real problem is not that HIV |stigma prevents people from making a living. Treating HIV/AIDS as another chronic disease makes sense. However, it is discrimination which is the concern. I am not sure that there is a problem with discrimination in the workplace based on sexuality. Typically, there is a 'don't ask, don't tell' policy in the world of work, and more important, most persons who gain employment do so because of contacts and recommendations. However, much of the AIDS/gay-rights coalition ironically enforce workplace policies which violate our international treaties and force aspirant workers to test before being appointed.

Interestingly, a point which I made while chairing an HIV Workplace Policy Workshop in 2009 is that no data are available regarding women who have sex with women. Given the copious amounts of vaginal fluids which are passed in female-to-female cunnilingus, it is amazing that the researchers have kept their mouths closed on the risks involved with this.

Nonetheless, the fact that MSM sexual activity is high-risk must not be hidden. People who are exploring their gay sexuality must understand their risk and take measures accordingly. It is very dangerous ground for the media spin doctors to simply normalise anal sex. No evidence exists that anti-buggery laws make MSMs have more unprotected sex. Anti-ganja laws don't lead to lung disease from smoking.

Of note is the 'just get on with your life' campaign of 2005-2006. Ironically, when the surveys were done in 2009, it was discovered that risky behaviour had increased despite the media blitz. Conclusion? The normalising of the disease made it less frightening and, thus, some persons threw caution, and latex, to the wind.

These are serious times, and we must advise our young people, especially those who are gay, that they must know themselves and be smart. True, my opinion, as expressed on March 4, 2012, is that the horse went through the gate last year when Parliament enacted the Charter of Rights, making the buggery laws unconstitutional.

However, instead of trying to piggyback on the AIDS issue and mate it with the anti-buggery law campaign, zealots must separate them and teach their community using a 1980s USA slogan to boost their message; unless protected, "don't bend for a friend".

Dr Orville Taylor is senior lecturer in sociology at the UWI and a radio talk-show host. Email feedback to columns@gleanerjm.com and tayloronblackline@hotmail.com.

World AIDS Day 2011

'Getting to Zero', the world commemorates World AIDS Day. An event that was inaugurated 23 years ago today by the World Health Organisation, World AIDS Day focuses on raising money, increasing awareness, fighting prejudice, and improving education on the issue of the AIDS pandemic caused by the HIV infection.

Observed on December 1st each year, the World AIDS Campaign is the leading international organisation which plans and implements the observance of the day and provides governments, national AIDS programmes, faith organisations, community organisations, and individuals with an opportunity to raise awareness and focus attention on the AIDS pandemic worldwide.

The red ribbon used is the global symbol for solidarity with HIV-positive people and those living with AIDS.

This year's theme marks the commitment of the global community to focus on the achievement of the following three targets: zero new HIV infections, zero discrimination and zero AIDS-related deaths. World AIDS Day is important for reminding people that HIV has not gone away, and that there are many things still to be done. It also provides all of us with the opportunity — on an individual, community and political level — to take on the challenge of getting to zero.

According to UNAIDS estimates, there are now 34 million people living with HIV, including approximately 2.5 million children. During 2010, some 2.7 million people became newly infected with the virus, including an estimated 390,000 children.

Despite a significant decline in the estimated number of AIDS-related deaths over the last five years due to improved access to antiretroviral treatment and care in many regions of the world, the AIDS epidemic still claimed an estimated 1.8 million lives in 2010.

The vast majority of people with HIV and AIDS live in lower- and middle-income countries. But HIV today is a threat to men, women and children around the world. In low- and middle-income countries, less than half of those in need of antiretroviral therapy are receiving it, and too many do not have access to adequate care services.

The Caribbean, one of the regions of the world that is most affected by the HIV/AIDS pandemic, reduced the number of new HIV infections by a third from 2001 levels and by more than 25 per cent in Dominican Republic and Jamaica.

However, we are still ranked amongst the highest in the world with an estimated 240,000 people living with HIV and AIDS in the Caribbean at the end of 2009 and an estimated 17,000 newly affected and 12,000 new deaths.

In two countries in this region — The Bahamas and Haiti — more than two per cent of the adult population is living with HIV. These statistics are only rivalled by those of sub-Saharan Africa, making the Caribbean the second most affected region in the world.

Overall, the main route of HIV transmission in the Caribbean is through sexual intercourse. Much of this transmission is associated with commercial sex, but the virus is also spreading in the general population. Cultural and behavioural patterns (such as early initiation of sexual acts and taboos related to sex and sexuality), gender inequalities, lack of confidentiality, stigmatisation, and economic need are some of the factors influencing vulnerability to HIV and AIDS in the Caribbean. As a result, AIDS is now one of the leading causes of death in some of these countries, with Haiti being the worst affected. An estimated 7,500 lives are lost each year to AIDS in Haiti, and thousands of children have been orphaned by the epidemic.

This year, we are asking you to Be Aware. Being aware means finding out the facts about HIV and using this knowledge to protect yourself and others. Promote awareness amongst friends, family members and loved ones; take part in AIDS awareness initiatives and ensure that the message is passed on to all, so that we may be one step closer to reaching zero.

A recent survey in the men who have sex with men population by the Ministry of Health already however suggests we have cause for some serious concerns as preliminary estimates suggest the infection rate will pass the 2007 31% figure despite the presence of a national program that was expected to impact behaviour change overall but what seems to be very little targeted work on the ground by the advocacy structure that being Jamaica AIDS Support and its offspring Jamaica Forum for Lesbians Allsexuals and Gays with very little presence in the community in terms of front line and beat foot patrols then it is no wonder we may see these high figures and to think both organizations are headed by gay men, what does that say about interest and reasons for existence? Is it possible to get to zero or let alone just reduced rates with this kind of aloofness? I think not, we need to get real.

 World AIDS Day 2011 Concerns by glbtqja4 

Meanwhile a full paged ad appeared in the Gleaner (partially scanned seen below) today from an organization I presume named The Isaachar Foundation of whom we know very little about so far except it is chaired by Dr Wayne West who is aligned to the Lawyers' Christian Fellowship and The Coalition for the Defence of Life, Isaachar with their motto "Confronting The Culture ... one mind at a time" of course here seems to be sizing up the high infection rates in the men who have sex with men populations as their fault, they also made reference to France having no sodomy laws since 1791 while having staggering rates of infection.

If one is to be honest and so righteous as these religious pundits claim to be then why not contextualize the points, there must be some cultural as well as other specific factors that contribute to such rises, not just a broad brush of msms simply because they want to impose a theocratic way of doing business and dictating how others should live. This surprise ad had no contact information provided or any logo or reference as to who they really are. Clearly as we have been seeing with the posturings of the leading voices of the religious right they now have new allies coming to their aid or are they consolidating? then what about freedom of choice? Nuff tings lie ahead people.


also see: 

More effective HIV/AIDS prevention message needed

Peace and tolerance

H 

(pamphlet photos from the MOH National Program)

Ten Things You Can Do to Enhance Your Emotional Well-Being for the HIV+ individual

1. Build a strong, supportive, trusting relationship with an HIV/AIDS doctor. You should be able to freely discuss everything and anything and, if needed, to challenge your doctor's advice.
2. Develop consistent contact with a health care case manager who can help to make the rocky road to benefits and services easier for you. One mold does not fit all, so try to find a case manager that you trust, even if you have to switch to a new one.

3. Join an HIV/AIDS support group. Find out if they use an ongoing, drop-in format or if they are time-limited and require pre-enrollment. Also find out about the training and qualifications of the group leaders.

4. Get a therapist, preferably a good licensed psychologist or certified social worker. Remember anyone can state they are a "therapist"; request more information about their background and experience. Keep looking until your instincts tell you that you have found a good match.

5. Attend workshops or other HIV/AIDS events so that you can find out as much as you can about HIV/AIDS. You must be the expert on this disease and be on top of any new developments and programs.

6. Stay informed about your HIV/AIDS medications by seeking out information from any and all sources, including people, Web sites, and periodicals. The more you know about the medication you are taking and its potential side effects, the more you know what to expect about your emotions and mental well-being.

7. Address any substance use issues you may have by looking into substance use programs and groups. Consider working towards being clean and sober.

8. Exercise regularly and maintain good nutrition because the mind and the body are closely linked, and physical health enhances mental health.

9. Work if you can for income but also work for the structure and well being that employment can provide. Everyone can benefit from structure, and we all need to feel we are productive members of this world.

10. Seek a sense of belonging outside of HIV/AIDS such as by starting a hobby, traveling and exploring, getting a pet, starting or finishing school, or volunteering. The bottom line is to keep your stress low; keeping your stress low will help you to keep your immune system high.

J. Buzz von Ornsteiner, Ph.D., is a New York State-licensed psychologist and author of the "Psychologically Speaking" column in Body Positive Magazine.

I am always amazed how the fan fare dies down after World AIDS Day passes and we don't see much in the media continuing on the heightened public awareness especially for persons who are HIV positive or who have just been found via the testing methods to be so. Public awareness and social marketing shouldn't just die off like that because the day has passed.

Please highlight and share in some way information and writings about HIV all year round folks not just for WAD.

Peace and tolerance.

H

Tearing Down The Walls Of Stigma

Nadisha Hunter

Several years ago, infected persons would not willingly admit to having HIV infection, as the stigma surrounding the disease was high.

But today, while there is still some degree of reservation about publicly declaring the illness, some people feel comfortable discussing the issue.

One such person is Jason Richards, who has been living with HIV/AIDS for the past seven years. He has seen the need to use his illness to educate the public about the disease.

However, it was only four years ago that he felt comfortable to do so because of the stigma that had existed in society.

The 24-year-old said after years of facing discrimination in society, he opted to contribute to breaking the walls of stigma through various educational strategies.

"I started out, first of all, by giving a speech on the disease for a friend who is also infected, but was scared to make the public talk," he said.

"I wasn't scared because by then I went through all the criticisms in society and persons were beginning to love and care for me," he added.

Richards is now participating in the Ministry of Health campaigns in breaking the stigma.

Pledge to continue

He said he was positive that he had made a difference in the lives of several persons living with the illness, and pledged to continue.

"My work don't stop here. I will continue to educate the people of Jamaica so that they know that AIDS is not a death sentence and we are people who live normal lives just the same," he said.

Richards encouraged other infected persons to speak up about the disease, which could change the way persons view them in society.

According to Roshane Reid, behaviour change communication officer in the National HIV/STI programme at the Ministry of Health, while the stigma still exists, the ministry has made significant strides through various educational strategies with the partnership of several key partners.

Among these are the Ministry of Education, non-governmental and faith-based organisations, as well as United Nations partners and funders.

The 2008 Knowledge, Attitude, Behaviour and Practice survey done by the ministry indicated that Jamaicans are displaying increasing acceptance of persons living with HIV, with 82 per cent being willing to care for an infected family member.

It showed, however, that persons remain reluctant to purchase fresh vegetables from HIV-positive vendors, with less than a quarter endorsing this measure.

Reid said the programme reaped much reward in breaking down the stigma in society as a result of several campaign strategies, such as mass media campaign featuring persons living with HIV, prevention interventions at health centres, public education in workplaces and education in schools, primarily through the implementation of the Health and Family Life Education curriculum.

The Jamaica Red Cross also played a major role in breaking down the barriers in society.

Programmes director for HIV and Youths, Stacy-Ann Tomlinson, said the institution was heavily involved in educating the public about the disease at various forums and events.

MSM Global Forum - GLOBAL SURVEY INDICATES MOST GAY MEN WORLDWIDE CANNOT ACCESS MOST BASIC HIV PREVENTION & SERVICES

Media Contact:

Jack Beck

510.271.1956 (o)

jbeck@msmgf.org

Groundbreaking Global Survey Indicates Most Gay Men Worldwide Cannot Access Most Basic HIV Prevention and Services

As the world looks toward new prevention technologies, majority of men who have sex with men report no easy access to condoms and lubricants.

November 29, 2010 (Oakland, Calif.) – A new survey of more than 5,000 participants worldwide indicates that the majority of men who have sex with men (MSM) globally find it difficult or impossible to access HIV testing, HIV counseling, free condoms and free lubricant. Released to coincide with World AIDS Day, the preliminary findings underscored the importance of universal access to HIV prevention and treatment, a central theme of this year’s World AIDS Day observance.

Initial analysis of the survey’s results indicates that fewer than half of MSM worldwide have access to even the most basic HIV prevention and services. Of all respondents, only 39 percent reported easy access to free condoms and barely one in four reported easy access to free lubricant. A full 25 percent said free lubricant was completely unavailable. Large percentages of men reported that it was difficult or impossible to access other essential services as well, including HIV testing (57 percent), HIV education materials (66 percent) and HIV treatment (70 percent).

Conducted by the Global Forum on MSM & HIV (MSMGF) in collaboration with Dr. Patrick Wilson, Assistant Professor at Columbia University's Mailman School of Public Health, the survey was carried out online in Chinese, English, French, Russian, and Spanish. Circulated through the MSMGF’s global networks and those of its partner Fridae.com, the survey closed with a total of 3,875 MSM and 1,009 MSM service providers participating – another 375 participants did not identify themselves as MSM or provider. Nearly three quarters of all study participants were from low or middle income countries.

“Since the beginning of the epidemic, it has been widely recognized that condoms, lubricant, testing and treatment, when combined with community-led behavior change and support programs, are the most reliable tools available in the fight against HIV among MSM,” said Dr. George Ayala, Executive Officer of the MSMGF. “More than 25 years in, it is inexcusable that MSM around the world continue to have such restricted access to these basic lifesaving resources.”

“With the excitement surrounding the promise of pre-exposure prophylaxis (PrEP), it can be easy to forget that we already have a rich selection of prevention measures that we know work right now,” said Patrick Hebert, Senior Education Associate at the MSMGF. “Today’s findings reinforce the fact that we can’t even get condoms and lube to more than half of MSM around the world. We must look seriously at barriers that prevent MSM in different country contexts from accessing these proven prevention tools.”

While reporting on levels of access to currently available HIV prevention tools and services, the survey also explored knowledge about emerging technologies like PrEP, which involves taking antiretroviral drugs before exposure to HIV in order to prevent infection. While men in North America, Western Europe and Australia reported more knowledge about emerging prevention strategies than men in Africa, Asia, the Caribbean, Eastern Europe, and Latin America, large numbers of men in all regions of the world expressed confusion about these technologies. When asked whether MSM should use PrEP to prevent HIV infection, 40% of respondents said “I don’t know.” This suggests a need for stronger communication and education efforts targeting MSM worldwide regarding these new potential options.

Regional differences also emerged regarding experiences of stigma and discrimination. On every measure of stigma related to homophobia, men in Africa, Asia, the Caribbean, Eastern Europe, and Latin America reported higher levels and harsher forms of stigma and discrimination than men in North America, Western Europe and Australia.

“Stigma and discrimination fuel the HIV epidemic among MSM and other high-risk populations,” said Othman Mellouk, Co-Chair of the MSMGF and Advocacy Coordinator of the International Treatment Preparedness Coalition (ITPC) for North Africa. “Stigma and discrimination undermine access to prevention and treatment programs by forcing MSM underground and away from services they may need. Without addressing the bigger issue of homophobia, we will have no hope of ending AIDS.”

The MSMGF is currently working with Dr. Wilson to complete analysis of the full data set and is expecting to release a comprehensive report in early 2011. This project is supported by a generous grant from the Bill & Melinda Gates Foundation.

The Global Forum on MSM & HIV (MSMGF) is an expanding network of AIDS organizations, MSM networks, and advocates committed to ensuring robust coverage of and equitable access to effective HIV prevention, care, treatment, and support services tailored to the needs of gay men and other MSM. Guided by a Steering Committee of 20 members from 17 countries situated mainly in the Global South, and with administrative and fiscal support from AIDS Project Los Angeles (APLA), the MSMGF works to promote MSM health and human rights worldwide through advocacy, information exchange, knowledge production, networking, and capacity building.

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