Homophobia fuels the spread of HIV

Sometimes the hardest blog posts to write are the ones that feel like they should be the easiest. The simple no-brainer issues that seem instinctive to me – Uganda’s proposed anti-gay legislation is bad.  Duh!  What is there to say beyond that?  I have a gut level negative response when any government takes violent or repressive steps against a group of people, because of their gender, ethnicity, sexual orientation …  You probably do too.  Perhaps what I can offer is some information beyond the instinctive, painful and highly personal response.  Heterosexism (especially state-sanctioned hate and the criminalization of homosexuality) has been shown again and again to hinder HIV prevention efforts, and if left unchecked, plays an instrumental role in spreading the epidemic.

Whether spurred by cultural or societal prejudices, or formally enshrined in state laws, anything that drives risk behaviour underground is bad for HIV prevention.   If the highest risk behaviours (sex between men or injection drug use, for example) are unspeakable, then how can we educate about doing them safely (using condoms and clean needles, for example)?  If these behaviours are criminal offenses, even punishable by death as is being proposed for anal sex between men in Uganda, then they are definitely not going to be talked about.  We know this from our experience with state-sponsored homophobia in the Caribbean and elsewhere.  In Canada, we are currently fighting ideology-driven laws preventing safe injecting sites and other harm reduction efforts that we know can curb the spread of HIV among injecting drug users.  Our response to HIV must be an open, intelligent and mature one.  It must acknowledge first that all kinds of people (even good people) have all kinds of sex and need easy and confidential access to the tools to do it safely.

Of course, we are learning more and more that HIV treatment is not just about improving the health well-being of people living with HIV, but is also a crucial component of successful prevention (see Treatment as Prevention).  In a country where having sex with another man is illegal (never mind punishable by death …), men are obviously going to avoid getting tested for HIV, whether they have been having anal sex with another man or not.  Certainly, treatment is not going to be an option – again creating an enabling environment for the rapid spread of HIV, not just in the gay community but to female lovers too.  Homophobia is also bad for HIV prevention because it discourages testing and treatment.

There’s yet another piece to the “homophobia spreads HIV” puzzle too.  On the individual level, studies (like the one mentioned in this POZ magazine post) that internalized homophobia in men who have sex with men is linked to poorer health outcomes – particularly depression which contributes to higher rates of risky behaviour.  This is one of those cases of “people take care of themselves as much as they value themselves” that is all too common for people in disenfranchised communities.  If all the messages around you tell you that you’re worthless or evil or not going to succeed, then you might start to believe it.  On the flipside, “positive attitudes towards homosexuality are associated with better mental and sexual health” says Dr. Rosser, quoted in the POZ post above.

The social and cultural attitudes, as well as the legal response of a nation to sexuality and HIV can create an enabling environment for successful HIV prevention and treatment, or it can create an enabling environment for the spread of HIV itself.  That’s a choice the government and its electors have the power to make.

-Miriam
 

This was posted on Friday, May 13th, 2011 at 10:00 am and is filed under HIV and the Law, HIV Prevention, Homophobia, News, Risk factor, Spiritual and Emotional Health, transphobia . Feel free to respond, or trackback. Read our comments policy.

• Name

  Email

  Website

  Cancel reply