‘They say we are worms’ – Fear of violence keeps sex workers and homosexuals

January 15, 2010 at 6:29 pm (Uncategorized)

 

http://www.ottawacitizen.com/health/They+worms/2425589/story.html
Canwest News ServiceJanuary 10, 2010
Three gay Senegalese men huddle just after midnight in the
corner of a restaurant, wolfing down chicken dinners after agreeing to have
their photographs taken on the condition their faces are hidden from
view.
All three who, like two-thirds of gay Senegalese men maintain conjugal
relationships with wives or girlfriends as part of their public façade, say they
live each day fearing that exposure of their homosexuality would provoke
contempt, family rejection and possible violence in this poor, predominantly
Muslim country on West Africa’s coast.
“We face verbal and physical aggression in the streets if people know we are
MSM (men who have sex with men),” says Lamine, secretary general of a 95-member
group called Xam Xamle (“teaching knowledge”), which was organized three years
ago to convince men, often unsuccessfully, to come out of the shadows to attend
meetings on the importance of safe sex and regular HIV testing.
“They call us perverts, they say we are worms.”
Dr. Bara Ndiaye, project leader for the non-governmental organization
Enda-Santé, said anti-AIDS initiatives led by government and non-government
organizations are often viewed suspiciously.
“This society is very hostile toward homosexuals,” said Ndiaye, whose
organization works closely with MSM and sex workers on issues like safe sex,
testing, treatment and nutrition.
Any pretence of a tolerant society was shattered after two recent events. In
early 2008, five men were arrested, and later released, after their photos
appeared in a magazine celebrating a symbolic gay marriage.
The following December, police burst into the private residence of an HIV
outreach worker and arrested nine men, charging them with violation of the
country’s law against gay sex prohibiting “unnatural” acts.
They were allegedly beaten in prison and then sentenced to eight years in
jail, but were released on appeal in April amid international protests from
rights groups. Some fled the country as refugees due to threats from outraged
citizens who said in public forums that the men should be beaten or even
lynched.
Gay men, and male and female sex workers, are by far the two groups most
devastated by the HIV/AIDS epidemic — which has infected 33 million people
around the world, two-thirds of whom live in sub-Saharan Africa.
Roughly one in five members of each group is HIV-positive in Senegal, which
otherwise has a relatively low infection rate of just under one per cent,
according to government estimates.
“We are sometimes rejected by our own kids,” said Ndeye, an HIV-positive
female prostitute and spokeswoman for a support group called Karlene.
“If the community finds out you are a sex worker, your opinion will no longer
mean anything. We are not regarded as human beings.”
Prostitution is legal in Senegal for women over 21, and those who register
get easier access to health care, health information, general support and
condoms.
But an estimated 80 per cent aren’t registered — in many cases because women
fear the stigma of being officially labelled a sex worker.

National and international health organizations desperately need to reach out
to these groups to ensure they don’t spread HIV to sex partners or, in the case
of mothers, to their children during pregnancy or while breastfeeding, according
to Michel Kazatchkine, executive director of the $18.7-billion U.S. Global Fund
to Fight AIDS, Tuberculosis and Malaria.
He said social stigmatization represents the second-biggest barrier facing
national and international bodies waging a multibillion-dollar battle against
AIDS.
It is next only to weak government health-care systems in recipient
countries, said Kazatchkine, whose organization funds Enda-Santé, Xam Xamle and
Karlene.
“These people, because they’re harassed, will hide,” Kazatchkine said.
“Because they hide they will not access treatment services, and they will go
underground and spread the epidemic. So stigma and discrimination are major
issues.”
Senegal has received considerable praise for its efforts to contain the
spread of AIDS. Senegal’s relatively low infection rate stands out against the
dismal records of countries like Swaziland, with an adult prevalence rate of 26
per cent, and South Africa’s 18 per cent. The country, which is considered one
of sub-Saharan Africa’s most stable post-colonial countries despite its poverty
(the country ranked 166 out of 182 countries in the 2009 United Nations Human
Development Index), launched major efforts in the mid-1980s to educate the
public, explaining the symptoms of HIV infection and urging safe sex
practices.
In 2003 the government announced that there would be free access to
anti-retroviral treatment, and the country’s parliament is considering a law
intended to protect AIDS victims from discrimination.
Yet, the government’s mostly laudable efforts have been hampered by
stigma.
Senegalese who see clinical television programs showing what happens to a
person’s physique when they have AIDS, or explaining that the virus can be
transmitted through breast milk, are suddenly given tools to help the community
identify, and then gossip about, possible victims, according to Alice Desclaux,
a French anthropologist who has done several studies on stigmatization of AIDS
victims here.
“Sometimes education does not dissolve stigma. It may encourage it,” she
said.
Enda-Santé co-ordinator Daouda Diouf wrote a critical paper for the Open
Society Institute in 2007 criticizing the government for not adequately
targeting the most at-risk groups — the “neglected” MSMs and sex workers. He
also said the government had failed to provide adequate access to
anti-retrovirals outside major cities, and he scolded the national parliament
for debating, but not passing, anti-discrimination legislation.
Diouf said Senegal has made major strides since the publication of that
paper, in part because of the millions invested in outreach and treatment
programs to MSM, sex workers and other vulnerable groups by the Global Fund,
which was launched in 2002 to help the world meet the ambitious U.S. goals on
combating AIDS, malaria and TB.

Senegal’s national parliament should be pushed to get rid of the law which,
like laws in the majority of African countries, criminalizes homosexual
behaviour, he advised.
“I know it would be difficult to get rid of it, but clearly as long as we
have these laws, the work with sexual minorities will be extremely difficult,”
Diouf said.
“All these people live in secrecy, because of the fear that they will be sent
to jail.”
The Global Fund, which claims to have saved almost five million lives over
six years by providing 2.5 million people with AIDS treatment, putting six
million on TB treatment, and distributing 104 million anti-malaria bed nets, has
so far disbursed $23 million U.S. in Senegal since 2003.
That money, by funding ARV treatments for 3,616 people, is expected to help
Senegal meet its objective of achieving universal access to treatment in the
country by 2010.
Globally, the number of new HIV infections peaked at 3.5 million in 1996, and
has since declined to 2.7 million by 2007. AIDS-related deaths, after topping
out at 2.2 million in 2005, have fallen to two million in 2007. The lower death
rate, thanks partly to soaring access to ARV treatments, means the number of
people living with HIV keeps rising each year.
Initiatives, such as the outreach effort through Xam Xamle, have helped reach
gay men who were oblivious to the government’s efforts to encourage safe
sex.
“Three years ago, we were having unprotected sex all the time,” said Lamine
said.
“Now condom use is almost 100 per cent among our members.”

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Citizen
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