THE ELECTRONIC BULLETIN OF THE SWISS PLATFORM FOR HIV/AIDS AND INTERNATIONAL COOPERATION June/July 2009

I was recently asked whether I could contribute as a discussant to the topic of HIV/AIDS and homosexuality in South Africa at the Symposium on Sex, Gender and Politics organized by the Centre of Gender Studies at the University of Basel. Unfortunately I had to refuse the offer to speak as I have never seriously dealt with this issue. In addition, such questions have not yet been raised by partners of the aidsfocus.ch platform.

Yet, the request to share in the discussion started to challenge me: I was forced to deal with my own pictures – and especially with my omissions. In the global South, the HI-virus is primarily transmitted over heterosexual contacts. This fact had induced us to focus on this particular mode of transmission in the international response to AIDS. Besides, homosexuality is a taboo subject; even more so in Africa or in India than in our country. „In Africa, there are no homosexuals“, is a common phrase.

Notwithstanding, in every culture and society there are men who have sex with other men (MSM). Some identify themselves as „homosexuals“, others as bisexuals and numerous men see themselves as completely „normal“ men just having sex with men. In Dakar, the capital of Senegal, 88 per cent of men who have sex with men have also sexual contacts with women. Many MSM in the global South are married and have children – this is why they are not necessarily perceived as homosexuals.

In many countries, sex between men is socially ostracized, denied and often criminalized. Only a few days ago, on the 2nd of July 2009, India abolished criminalization of homosexuality in its penal code with a historic court decision. But still, in more than 80 countries worldwide homosexuality is still prohibited.

Also UNAIDS noted that MSM have been overlooked too long in HIV and Aids policies and programmes – with potentially fatal effects, as biological, socio-cultural and behavioural factors make MSM more vulnerable and contribute to the spread of the epidemic. In Latin America, sex between men is responsible for one fourth of the new HIV-infections. Even in Africa, the homosexual transmission has become a serious problem. In Senegal for example, the results of a study showed that 22 per cent of MSM live with HIV.

It is a question of human rights to fight against stigma and discrimination and to strengthen MSM (and other vulnerable groups such as transgender people, sex workers and drug users), to comprehensively inform them and to enable them access to prevention according to their specific needs as well as to treatment, care and support. It is also a question of reason and a medical and political necessity to promote and adjust HIV and Aids programmes and to the specific situation of MSM – also in the framework of international cooperation.

Helena Zweifel Coordinator aidsfocus.ch

1. July 2009 - The Delhi High Court declared section 377 of the Indian Penal Code which criminalised consensual sexual acts of adults in private as violative of the rights to privacy, liberty, health and equality enshrined in the Constitution of India. Though the decision was largely seen as a victory for the men who sex have with men and transgender people, it is a victory for all – regardless of sexual orientation and gender identity. The judgment is noteworthy and progressive in terms of its rejection of a hetero-normative and homogenous conception of sexuality. UNAIDS urges all governments to ensure full respect for the human rights of men who have sex with men, lesbians and transgender. (UNAIDS)

http://www.unaids.org

Sex between men happens in every part of the world. In the context of the global AIDS epidemic, sex between men is significant because it involves anal sex – a practice that, when no protection is used, carries a higher risk of HIV transmission than unprotected vaginal sex. In many countries, men who have sex with men (MSM) are not so visible. Sex between men is stigmatised, officially denied and criminalised in various parts of the world. This adds to the vulnerability of MSM and making it near impossible to carry out relevant HIV prevention campaigns in some countries. Many have wives, or have sex with women as well as men, and this means that they may transmit HIV to their female partners. The significant impact that HIV is having on MSM is therefore very much linked to countries’ wider HIV epidemics. The avert-Website provides an excellent introduction and the global picture as well as links and references for further reading (2009)

http://www.avert.org

UNAIDS and UNDP launched a plan to encourage new and better approaches to HIV, specifically focusing on men who have sex with men and on transgender populations. In many parts of the world HIV prevalence among men who have sex with men is more than 20 times higher than in the general population. Studies show that HIV prevention services reach only one tenth to one third of people who engage in male homosexual activity. The action framework outlines how UNAIDS will work towards achieving universal access through three main objectives: improving human rights; strengthening the evidence base through better data; and reinforcing capacity and promoting partnerships to ensure broader and better responses. (May 2009)

http://data.unaids.org

Sex between men occurs in every culture and society, though its extent and public acknowledgement vary from place to place. In terms of HIV, sex between men is significant because it can involve anal sex, which when unprotected carries a very high risk. At least 5–10% of HIV infections worldwide are estimated to occur through sex between men, though this figure varies considerably between countries and regions.

The 2001 UN General Assembly Special Session (UNGASS) Declaration of Commitment on HIV/ AIDS adopted by all UN Member States emphasized the importance of “addressing the needs of those at the greatest risk of, and most vulnerable to, new infection as indicated by such factors as […] sexual practices.” (2006)

http://data.unaids.org

HIV & AIDS Treatment in Practice (HATIP) 138, June 9, 2009, covers the need to address the large epidemics of HIV occurring among men who have sex with men (MSM) and transgender people in resource-limited settings. As an example of the large and overlooked epidemics occurring in MSM, this edition examines recent studies from South Africa, where HIV prevalence among MSM is almost twice the level recorded among men in the general population. It also looks at models of appropriate services now being developed, and discusses how to address the barriers to providing services.

http://www.aidsmap.com
http://www.aidsfocus.ch

1. June 2009 - This issue of HIV and AIDS Treatment in Practice (HATIP) looks at the future sustainability of HIV prevention, treatment and care programmes in the face of a global economic recession and increasing pressure for de-prioritisation of expenditure on the HIV epidemic – a focus at the 2009 HIV Implementers’ meeting, held earlier this month in Windhoek, Namibia. It discusses the ongoing debate about the wisdom of disease-specific aid (e.g. for HIV/AIDS) versus funding for general health systems strengthening and other issues.

http://www.aidsmap.com
http://www.aidsfocus.ch

Johannesburg, 25 June 2009 - Two HIV-positive Namibian women who allege they were sterilised against their will in public hospitals are seeking redress through the courts, the first of more than 20 known cases, according to the International Community for Women Living with HIV/AIDS (ICW). ICW has conducted fact-finding missions to document stories from women who have been sterilised, some of whom said they signed consent forms to undergo what was simply listed on their health documents as a "BTL" without fully understanding its implications. (PlusNews)

http://www.plusnews.org

Nairobi, 18 June 2009 - An initiative that uses music and dance to convey HIV prevention messages to young people, dance4life, has won an award for Excellence in HIV/AIDS Communication in Africa from the African Network for Strategic Communication in Health and Development (AfriComNet) "Adults are still guessing but dance4life has already taken a giant step," their press release quotes one young man, Mugalu, from Uganda, as saying. People younger than 25 account for half of all new HIV infections worldwide, according to UNAIDS. (PlusNews)

http://www.plusnews.org

New York, 16 June – Ahead of this year’s World AIDS Day, the United Nations Secretary-General Ban Ki-moon, the World AIDS Campaign and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have come together to announce the theme of “Universal Access and Human Rights”. The theme has been chosen to address the critical need to protect human rights and attain access for all to HIV prevention, treatment, care and support. It also acts as a call to countries to remove laws that discriminate against people living with HIV, women and marginalized groups.

http://www.worldaidscampaign.org

1. June 2009 - In the conservative city of San Luis Potosi, central Mexico, a pioneering community organisation is striving to change attitudes to one of society’s most stigmatised groups. FID (Fortaleciendo la Diversidad) was the city’s first transgender organisation. The group’s innovative work was recognised last year when it won the Red Ribbon award at the International AIDS Conference. This includes running workshops for the local police to raise awareness of transgender issues and reduce aggressive behaviour.

http://www.aidsalliance.org

In 22 countries in Africa, the Caribbean, Europe and Central Asia, and Asia and Pacific, disruption of HIV prevention and treatment programs is expected as a result of the global economic crisis, according to a new report from UNAIDS and the World Bank. Eight countries are already facing shortages of antiretroviral drugs or other disruptions to AIDS treatment. Together, these countries are home to more than 60% of people worldwide receiving AIDS treatment. HIV prevention programs are also in jeopardy. In 34 countries, representing 75% of people living with HIV, there is already an impact on HIV prevention programmes focusing on high-risk groups such as sex workers, people who inject drugs and men who have sex with men. (July 2009)

http://www.unaids.org

International groups, nations and donors should give increased attention to the protection of human rights and the HIV-prevention and treatment needs of migrants, Human Rights Watch said in his new report. It describes how discrimination and human rights abuses faced by migrant populations result in increased vulnerability to HIV infection and barriers to care and treatment. Human Rights Watch called on nations, international agencies and donors, and nongovernmental organizations to work jointly on law reform and provision of services to ensure freedom from discrimination and continuity of treatment for HIV-positive migrant populations worldwide. (2009)

http://www.hrw.org

This report by Médecins Sans Frontières (MSF) outlines the community-based approach to the decentralisation of HIV and AIDS services. The Wellspring of Hope was the first programme in Lesotho to provide HIV and AIDS treatment and care through an entire health service area as a result of this initiative. The report discusses the delivery of HIV and AIDS services, specifically testing and counselling, prevention of mother to child transmission and antiretroviral therapy and a nurse driven approach to the provision of antiretroviral therapy at the community level (2009)

http://www.msf.org.za

Rape of a woman or girl had been perpetrated by 27.6% of the men interviewed and 4.6% of men had raped in the past year, according the new report published Medical Research Council (MRC) on the correlation between rape, physical intimate partner violence and HIV. South Africa has one of the highest rates of rape reported to the police in the world and the largest number of people living with HIV. The aim of this research was to understand the prevalence of rape perpetration to understand factors associated with rape perpetration, and to describe intersections between rape, physical intimate partner violence and HIV. (June 2009)

http://www.mrc.ac.za

This resource was developed for World Vision (WV) staff to provide an overview of key HIV and AIDS programming considerations within the African context. The resource documents lessons learned, including successes and shortcomings, and provides recommendations for future HIV programming. The key findings and lessons learned from these studies are organised according to six themes: Linkages, partners and networks; Community mobilisation; Volunteerism; Capacity building; Sector integration; Child protection and sexual abuse. (2009)

http://www.aidsfocus.ch

Africa | This E-Learning course hosted by InWEnt provides a starting-point for developing a clear understanding of the global epidemic, as well as an opportunity for participants to examine their own beliefs and attitudes towards HIV and AIDS and those affected by the disease. The online course is designed for non medical professionals who deal with HIV and AIDS issues in various contexts. Participants from Cameroon, Kenya, Malawi, Namibia, Rwanda, South Africa and Tanzania are especially invited. The online course consists of 4 modules. A 1 day start-up seminar will precede the start of the course. Duration: 09 October 2009 - 31 January 2010

http://www.inwent.org
http://www.aidsfocus.ch

Biel | HIV and AIDS are a sad reality in a number of countries involved in International Cooperation (IC). It affects not only every aspect of the lives of the people concerned, but also considerably impacts the life and work of IC expatriate personnel. This seminar has the objective of working with participants so that they can better manage this challenge. Intended audience: Those working in International Cooperation organizations and their accompanying partners. Contents: Impact of HIV / AIDS on personal life and impact of HIV / AIDS on professional life. Date: 20 October 2009

http://www.cinfo.ch

Partners: Afro-European Medical and Research Network, AIDS & Child, Bethlehem Mission Immensee, Caritas Switzerland, cinfo, CO-OPERAID, Déclaration de Berne, Doctors without Borders, Esperanza Medicines Foundation, FEPA, Fédération Genevoise de Coopération, Gemeinschaft St. Anna-Schwestern, HEKS, IAMANEH Switzerland, INTERTEAM, Kindernothilfe Schweiz, Kwa Wazee, medico international Switzerland, mediCuba-Suisse, missio, REPSSI, SolidarMed, Swiss Aids Care International, Swiss Aids Federation, missio, mission 21, Swiss Aids Care International, Swiss Catholic Lenten Fund, Swiss MIVA, Swiss Red Cross, Swiss Tropical Institute, Tear Fund, Terre des hommes Foundation, terre des hommes schweiz, and World Vision Switzerland.