Mon, Jul 30, 2012 - Page 8 News List

Change approach to HIV prevention

By Jiang Ho-ching 江河清

Recently, Taiwan's Centers for Disease Control (CDC) has repeatedly emphasized that male homosexuals and "males who have sex with males" (MSM) are considered high-risk groups for HIV/AIDS infection.

The CDC has therefore encouraged these groups to undergo regular screening tests, stressed the importance of safe sex and even proposed that “sex police” (性警察) be stationed at gay saunas to advise men to use condoms when having sex.

In addition, the CDC has cited research by public health academics under its sponsorship, using various surveys and statistics that show a premeditated intent to tarnish gays and HIV-infected patients.

The CDC may seem to have been very active, but it cannot cast off the conservative disease-prevention logic that focuses on using condoms, screening and abstaining from sex. It even continues to stoke prejudice by implying that gays and HIV-infected patients are all ignorant, irresponsible or sexually immoral.

Medical anthropologist Richard Parker, who is famous for his study of HIV transmission, identifies three aspects to AIDS prevention: behavioral risk, cultural meanings and structural violence.

The first aspect, behavioral risk, emphasizes personal health management, such as reducing the risk of infection through screening tests and safe sex.

However, due to differences between different groups, prevention also needs to consider cultural meanings to be able to reach various groups and develop an effective prevention strategy.

Parker says that structural violence could cause the disease to spread. All forms of exploitation and unfairness, such as sexual oppression, poverty and racial discrimination, allow the HIV virus to continue to spread among different marginalized groups.

Simply asking someone to practice safe sex and to take a screening test will only deal with the symptoms of the problem without dealing with the root causes. If the social environment that causes people on the margins to be infected and to spread the virus further is not changed, the virus will only continue to spread.

For many years, the CDC has stressed that gay men and drug addicts are two high-risk populations for HIV infection, but apart from calling on gays to use condoms and take screening tests, and drug addicts to avoid sharing needles, it seems as if the CDC thinks that it does not have to do anything else. It refuses to understand the political and social context for drug addiction or high-risk sexual behavior and blames HIV transmission on homosexuals looking for sex on the Internet, engaging in random sex at gay saunas or having sex while using drugs.

In short, it blames everything on the ignorance, irresponsibility and immorality of gay men.

While encouraging screening tests, safe sex and sex education is very important, this is merely a part of the whole picture.

As numerous studies of HIV-infected patients keep showing again and again, marginal group members who suffer stigmatization and discrimination may try to obtain a rare sense of belonging and trust through drug use or unprotected sex. To put it differently, it is their situation on the margin that gives the virus a chance to spread.

The CDC should really work hard to eliminate stigmatization and discrimination against homosexuals and HIV/AIDS from its prevention policies. If it does not, its prevention work is doomed to fail.

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