|Jim Pickett (at right) stands with with Brian Kanyemba of the Desmond Tutu HIV Foundation in Cape Town, South Africa, in October 2011. (AFC Photo)
The dream of the AIDS-free generation will never be realized as long as there remain countries in the world that kill and imprison people for being gay.
Same goes for countries that won’t even acknowledge homosexuality exists within their national boundaries and therefore fail to provide targeted HIV prevention and treatment services. Such are the realities underscored by a new report, “Achieving an AIDS-free Generation for Gay Men and Other MSM,” released by amfAR and Johns Hopkins University on Wednesday.
The report studied the funding and implementation of HIV services targeted for MSM (men who have sex with men) in eight countries where same-sex intercourse is criminalized or heavily stigmatized: China, Vietnam, Ethiopia, Guyana, Mozambique, India, Nigeria and Ukraine. Among other findings, the study concluded that MSM are “deprioritized and marginalized by national HIV programs.”
In the report’s own words: “It will be impossible to achieve an ‘AIDS-Free Generation’ if MSM are left behind.”
(For those who may not know, the phrase “AIDS-free generation” has been a sort of battle cry for people and organizations involved in the ongoing efforts to stop the 30-year-old AIDS epidemic, gaining momentum since Secretary of State Hillary Clinton used it in her historic November 2011 speech.)
The report rings true for Jim Pickett, director of prevention advocacy and gay men’s health for the AIDS Foundation of Chicago (AFC). Pickett is also chair of the International Rectal Microbicides Advocates, a group that does what its name suggests. His work takes him all over the world to advocate for microbicide research and other HIV prevention strategies.
“Sadly, it’s not new. It’s what we know. But … it’s really important for us to continue to put that message out there. It’s another way to have this discussion, to shine a light on these disparities and to move forward in the right direction,” Pickett said. “(This report) is a really important document.”
Pickett was in Addis Ababa, Ethiopia, just last month for a meeting with advocates for the launch of Project ARM (stands for Africa for Rectal Microbicides). Project ARM is an IRMA initiative. The conference coincided with the 2011 International Conference on AIDS and STDs in Africa.
It was wrought with tension from the get-go, as anti-gay religious groups caught wind of an African gay men’s health pre-conference satellite and began mounting a protest. Eventually, they were silenced by the Ethiopian government, Pickett said. But it was an uncomfortable learning experience: IRMA and Project ARM kept their own agendas low-profile and encountered no problems.
At the Project ARM meeting, advocates from Malawi, Uganda and other countries talked about the fear of being discovered gay after receiving threats of bodily harm and death.
“We acknowledge that in our quest for developing these new HIV prevention strategies like rectal microbicides, they are for naught if people aren’t safe, if they can’t be who they are wherever they are,” Pickett said. “If you are so deeply stigmatized or demonized that you have to be hidden, you’re not going to come up and go to the counter and get a rectal microbicide. You’re not going to get any services.”
As an example, Pickett pointed to the arrests of nine gay men in Senegal following the 2008 ICASA. Word quickly rippled through the gay community in Senegal.
“It had a terrible chilling effect on their services,” Pickett said. “They had all these different programs and services – no one came anymore. … When those big public things happen, people go underground and they don’t show up, don’t get what they need, and they hide.”
One strategy is to try to change the laws and reverse the tide of public opinion. But in countries where homosexuality is either criminalized or heavily stigmatized, HIV services for gay men and other MSM can be offered while making an argument based on science, epidemiology and the public’s health, Pickett said. For example, some organizations do outreach and services for gay/bi men as part of their “youth” or “sex worker” programs.
“It’s almost better to say ‘sex workers’ and fold in gay/MSM there,” he said.
Despite the overwhelming challenges that gay/bi men in these countries face, Pickett said, there are reasons for hope. The Internet has served as a conduit for community all over the world. The HIV advocates in these difficult countries are resilient, lively people, Pickett said. And they are organizing and making changes.
“I’m hopeful,” Pickett said. “We’re in a terrible situation, but I feel like there’s more energy addressing it, more reports coming out like this one, giving your advocates in Vietnam or Ethiopia tools to advocate to their public health authorities and funders to say hey you can’t ignore this.”
Progress is not linear. But Pickett said he became emotional as he looked around the room with the Project ARM advocates in Ethiopia last month. He was surrounded by 40 or so people who had traveled from various African countries, enduring hellish visa problems in addition to the typical discrimination in their homelands, just to be there.
“They were there to talk about rectal microbicides and talk about new prevention technologies and hope and the future,” Pickett said. “And they were energized, inspired and engaged. I just thought, my God, they have all these other things, but they still have that. And they’re organizing. They’re the most inspiring people.”