HIV/AIDS AND HEALTH RISKS AMONG GAY PEOPLE IN LOW INCOME COUNTRIES

Background:

HIV prevalence data suggest that men who have sex with men (MSM) in low-income are at increased risk of HIV. The aim of this article is to present information on HIV/AIDS and health risks among gay people in low income countries.

Key Words: HIV/AIDS, men who have sex with men (MSM), low income countries (LIC), HIV among gay, gay health diseases, condom use.


Gay youths and adults are recognized as being at high risk for HIV infections. They are 19 times more likely to be infected with HIV in low income countries around the world. Only 1 in 5 have access to the HIV prevention, care and treatment services they need and 5-10 % infections of HIV/AIDS is transmitted through gay sex. HIV epidemics and prevention needs among gay youths and adult in these countries have been relatively neglected. Compounded by limited resources, the quality and coverage of services and programs for gay youths and adults remain low, especially in contexts where the social stigma attached to male to male sex and the criminalization of this behavior is widespread as seen in Uganda today.

The urgency of adequately addressing HIV prevention needs among gay youths and adults in low income countries however has become most obvious in recent years. Gay sex behaviors have been documented in a variety of low income countries where these behaviors are most times been considered to be non-existent or illegal. Available data across LIC suggest that proportions of men who engaged in gay sex in the past year may reach 7%–8% in parts of some regions. In addition, HIV prevalence data suggest that many gay youths and adults are at markedly at increased risk for HIV infection in low income countries there fore; HIV epidemic among gay youths and adults is increasing at a higher rate. “HIV/AIDS is a disaster not only for the countries hardest hit but also for men who have sex with men wherever they live”. (World disaster report 2008)

Several studies suggest that HIV knowledge and the self-perceived risk for HIV infection is very low among gay youths and adults in low income countries. The availability of data concerning the frequency of unprotected and protected “anal intercourse” is very limited.

There are also several gay diseases apart from HIV/AIDS which affect gay youths and adults in LIC countries; these infections need greater attention because there infection rate is growing a lot in minority groups of young and adult homosexuals.


Anal genital

(Anal cancer);
Anal cancer is the result of infection with some subtypes of human papilloma virus (HPV), which are known viral carcinogens, (John R.Diggs). Anal cancer arises from the following diseases;
Chlamydia trachomatis Cryptosporidium Giardia lamblia Herpes simplex virus Human immunodeficiency virus Human papilloma virus Isospora belli Microsporidia Gonorrhea
Gay youths and adults in LIC are at greater risks of the above disease because they are not well sensitized about such infections (STDS), how to control the spread of infections and seeking treatment measures for affected individuals. Since GLBT people exists in low income countries and the number still growing, programs and treatment centers should be set up to help gay and Lesbian minority groups because they have rights for treatment and care.

If programs aren’t set up to help gay groups, the spread of such diseases above and HIV/AID epidemic will remain on a higher rate. On addition to that, gay youths and adults engage in sex out side their relationship hence getting re-infected and infecting others with new infections

METHODS OF PREVENTION AND LIVING HEATHY

Gay and Lesbian people in low income countries have a right to live health lives, getting sensitized on HIV/AIDS epidemic and access of treatment and care. The methods which can be advice for gay and lesbians minorities groups to follow are as follows;

Getting tested and have your partner tested
Gay and Lesbian youths and adults should be advised to go for HIV and other STDs tests with their partners. Testing is more important because many gay people don’t know if they are infected or not. Testing can help a couple to know ones status and getting treatment, care if found infected.


Use a condom

Many gay youths are found not to use condoms especially in low developing countries where by a big percentage of these individuals don’t have money and access to lubricants and or, some time fear going to health centers to pick condoms. In many cases, these minority groups don’t get enough sensitization on safer sex. If condoms are used careful with out using petroleum jelly, cold creams or oil, condoms can’t be weakened.
On the side of Lesbians, sex toys should be kept safe either by protecting them with a condom or cleaning them before and after every sex. Experts believe that syphilis is on the rise among gay and bisexual men because they are engaging in unprotected sex with multiple partners.

Be monogamous

Stay with one sex partner who has tested negative for HIV and other STDs and who won't have sex with anyone but you. Monthly testing should be carried out among the partners in order to get updates on each ones status. ABCD (Abstinence, Be faithful, condom use and Disclosure) methods should be also be adopted in gay communities in low income countries.

Limit alcohol and don't use drugs

Drug and alcohol abuse is common among gay youths and adults. In many cases, substance abuse is a way to cope with shame and overcome fear, denial, anxiety or even revulsion about gay sex.
A given percentage of gay people take alcohol and use drugs. Those who are under influence are more likely to take sexual risks which leads to infections of HIV and STDs. Young men and women should limit alcohol they take and those using injections for drugs should not share because there is a high risk of getting infections from one another.

Know the risks associated with sexual venues
Sexual venues such as bathhouses, sex parties and the Internet can facilitate multiple sexual partnerships and anonymous sexual encounters, as well as higher risk sexual behaviors.
Example;
A gay man named Vince, who had never before had anal intercourse without a condom, went to a sex club on the spur of the moment when he got depressed, and had unprotected sex:
"I was definitely in a period of depression . . . . And there was just something about that particular circumstance and that particular person. I don't know how to describe it. It just appealed to me; it made it seem like it was all right”, said Vince.

Get vaccinated

Gay youths and adults should be advised to go for vaccination which can protect them from serious liver infections and hepatitis A and B which can be spread through Un-protected sexual acts. Hepatitis B is on a wide spread in low income countries there fore treatment and prevention measures should be emphasized to minority groups in LIC.


Remain vigilant

Gay people should know that anti-retroviral medications have reduced the number of AIDS death, but AIDS is still an illness which has no vaccine and cure. Also there is no cure for some STDS like Human papilloma virus or genital herpes; the only best way of living a health life is to protect them selves by use of condoms and getting proper treatment for curable STDs.


What should be done to maintain gay health and reduce HIV infections among gay people in Low income countries?

Human rights NGOs and other LGBT organizations in countries where homosexuality is illegal, should insist that the rights of the minorities are upheld. They need not accept the tyranny of the majority. If it’s not done, the epidemic will grow again especially in low income countries.

Leaders from low income countries where homosexuality is illegal, should support more HIV prevention targeted toward men who have sex with men and research on the extent of the epidemic among gay people. A recent study of gay sex in low income countries found that African gays are 3.8 times more likely to be HIV-positive. There is no way HIV epidemic infections could be pulled down if gay people are left un-sensitized.


Current HIV prevention efforts should be effective in reaching gay individuals. Limited research efforts in Kenya and Ghana showed that men who have sex with men do not consider themselves at risk of contracting HIV, because all of the prevention messages thus far have focused on heterosexual couples. Many MSM also have sex with women thus contributing to the risk women face. Low income countries should encourage prevention efforts among the minority groups.

Many researchers and NGO, whether publicly or privately funded should be encourage to inquire about same sex practices, their health and any other useful information which can help in building up prevention, care and treatment plans for gay youths and adults, especially most of African countries, where homosexuality is illegal.

Gay and bisexual youths and adults are more likely to smoke than are heterosexuals because of increased stress and depression due to social alienation. Smokers face many health risks, including cancer. There should be programs set up to help teach about smoking and health risks among gay people.

NGO should set up programs to carry out vaccination exercise among gay communities in a simplified way because so many gays in low income countries fear coming out due to the laws in their countries.



There is a need for printed reading materials which can be distributed to gay communities which teach on gay health, HIV/AIDS and prevention measures which can be followed to prevent or reduce infections among gay people.

Figure 1.
Comprehensive Model for HIV and Health report: Health risks and HIV/AIDS.



Form projects
with other
Organizations
to work on gay
Health and HIV/
AIDS in LIC








Fight off drug use
and smoking in
Gay communities
in LIC



NGOS in LIC,
research on
HIV rate in
Homosexuals




HIV prevention
efforts reach
Gay individuals



Leaders in LIC
Support
HIV prevention
In Gay people







GAY HEALTH &
HIV/AIDS

LOW DEVELOPED
COUNTRIES (Uganda)

“Act NOW”

NGOS Insist on
Human rights
(Gay rights)




Develop
Innovative Ideas
to fight the
Epidemic
In homosexuals

Conclusions:
Several researchers have tried to show the HIV epidemic among gay people in Low income countries and the response towards HIV, and Gay health by the governments and NGOs. Although reporting is incomplete and does not always conform to requirements, findings confirm that, in many low income countries, HIV prevention responses and Gay health in MSM need substantial strengthening.

Recommendation

The governments in low income countries should continue fighting end the epidemic and also providing the needed leadership (gay rights, access to treatment and sensitization in gay communities on gay health and HIV/AIDS) in order to free their countries off the epidemic in gay adults and youths. Prevention measures are required to lead the raising rate of HIV epidemic in Gay people.


Reference books,

a) Supplementary article by Lippincott Williams & Wilkins 2009

b) The health risk of gay sex by John R.Diggs Jr.MD

c) The report, securing Our Future: Report of the Commission on HIV/AIDS and Governance in Africa.
d) UNDP 2009. Human Development report for Africa 2009. UNDP, New York 2009