The paradox of HIV infection

Dear Sir,

I write with reference to a letter by W. West published October 13, 2010.

In it he asks a very poignant question which I have also pondered from the other side of the political fence. That is, given advances in technology, medicine, and economics, why do Men who have Sex with Men (MSM) continue to be disproportionately affected by HIV and AIDS?

The human rights approach to advocacy marries increased infection rates to prohibitive laws and non-supportive social environments. In countries such as Jamaica where the gay man is often interpreted in law as essentially an un-apprehended criminal, this pariah status is said to increase vulnerability and risk-taking behaviour. The gay man is typified as a disenfranchised, wandering spirit, flitting from place to place, and bed to bed, in search of the stability that neither church, state, nor family is willing to offer.

The panacea as proffered by most socially progressive agents of change is to repeal these prohibitive laws, such as the Buggery Law as it exists in Jamaica.

The existence of the law is in itself archaic and repugnant and is a reflection of one of our many societal odes to the dark-ages. The belief is that if such laws are removed then work can begin outside of the veil of secrecy and risk of prosecution, to empower and inevitably save the lives of this vulnerable community. That is a reasonable cause and effect assumption that has caused the ire of the faith-based community which feels entitled to its hatred of sexual minorities and the support of such laws that perpetuate their alienation, demonization, and social exclusion.

I am an advocate for the repealing of the buggery law from a public health perspective, but moreso from a human-rights point of view. Just as Lawrence v Texas demonstrated in the USA, buggery/sodomy laws cannot be supported in constitutional law as they unfairly isolate particular citizens and place them in harm's way by virtue of who such laws affect.

I feel in this politically correct world, for fear of offending those affected, we have softened the sting in the message that the practice of unsafe anal sex with multiple partners places participants at great risk for HIV infection, and that gay men that engage in such practices are at higher risk of contracting the disease. The problem was that this admission in the early days of the discovery of the disease led to the unfortunate moniker G.R.I.D.S. (Gay Related Immuno Difficiency Syndrome) that politicized the issue and served to reinforce the notion that the disease was divinely inspired as punishment for gay men's hedonistic lifestyles and that their suffering and death was just recompense to a displeased god. This prejudice has apparently influenced the medical response to this issue among gay men in Jamaica. At present, there are very few places that can and do offer a safe space and medical care for MSMs and as a result many are walking around oblivious to the danger coursing through their veins.

The reality, in my mind, is that we must mature as a people to be able to separate the political football that is "homosexuality" from the fact that there is a ticking time-bomb that is being pushed further and further under the carpet on which we are all standing. That is, the rate of infection among Jamaica's MSM and what is being done to address it.

I refuse to adopt the cynical perspective one can infer from W. West's letter, past ones included, that creates the impression that gay men are infectious disease vectors that are hell-bent on self-destruction. I believe that curbing the spread of the disease is a two-way street with the state recognizing and protecting sexual minorities' rights to exist freely in society and have unbiased access to medical care, and also the sexual minority groups taking responsibility for themselves and the risk they place themselves in by being sexually irresponsible.

In this instance I believe we must look within, at our own unique variables, and not necessarily to the outside for answers. Each country that is grappling with the paradox of increased infections in the midst of increased prosperity has underlying factors that need to be explored in order to come to a better understanding, while not demonizing those who become infected.

I am sincerely,

Brian-Paul Welsh

Another letter I submitted to the editor today. I've been having a dry spell in terms of publication with the local papers but fingers crossed.

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