Youth advocate Anthony Adero shares a post-World
AIDS Day reflection for The MSMGF Blog.
It has only been a day since attending an HIV
panel discussion on World AIDS Day, and news just came in that the CDC
approximates 70% of HIV positive youth were infected via male-to-male sex in
the US. Now, I am reflecting on my own reality being HIV positive and a young
MSM (YMSM). I am talking about the bittersweet reality of coming out from a
humble yet complex background. In my African context, young MSM are overlooked
in the whole HIV response. They are disproportionately affected by HIV. Young
men having sex with other men living with HIV face stigma and
discrimination. There is always a deafening silence and invisibility of
this group of young people when it comes to service provision. There is also an
evidence-based scientific data gap for young MSM dynamics. This makes
evidence-based programing a challenge.
Homosexuality, as an element of normal human variation among adults, finds
little acceptance among health professionals in Africa. Non-discriminatory
policy treatment and public health for all, regardless of the type of client
that shows up for services, must become a norm. Talking about sexuality and
same-sexual activities practiced among young people is still controversial and
not discussed in local HIV responses, especially in national designs for
programs tackling young people’s sexual health, despite evidence that
unprotected anal sex is the highest risk to STI and HIV infections.
Homosexuality and same-sex sexual behaviors is still stigmatized, and it is
even considered a felony that could lead to incarceration in many places. It is
taboo in almost all African countries that often give a generalized humdrum of
homosexuality being “un-African,” and that being gay is not masculine. They
promote the myth that most gay identified people are cursed and diseased,
leaving YMSM to deal with low self- esteem and identity crises. Most African
countries view issues like homosexuality as examples of cultural abnormality
and a twisting of religion that is sinful. Most of society, academia and
community leadership show contempt and an unwillingness to support YMSM despite
startling data that show YMSM are in dire need of drastic action to prevent HIV
infections which are a public health concern.
“Same-sex experiences are often tolerated as part of a process of
experimentation toward the development of normal heterosexual behavior” A
psychiatry specialist once said to me.
The perception of such double stigma (i.e. stigma associated with *any* sexual
activity, compounded by stigma associated with non-heterosexual sexual
activity) can motivate feelings of guilt and low self-esteem among YMSM, some
of whom are in the process of developing a gay identity. Guilt can lead to
closeted sexual experimentation and heightened sexual risk. In other cases,
families learn about their gay children and react with violence, disowning
their children or implementing drastic measures like forced and arranged
marriages to the opposite sex. Pressure from society forces YMSM to “change” or
to get forced psychiatric care. The verbal and physical abuse by peers and
family members can lead to high levels of chronic stress among YMSM. As a
result, some young MSM are forced out of their homes or run away and become
involved in drug use, alcohol binging or sex work. Engagement in survival sex
(exchanging sex for food, shelter, alcohol, drugs, safety, etc.) has been found
to be fairly common among homeless or street youth.
My experience with the repressive environment of homophobia always reminds me
that safe environments for YMSM should be pragmatic, inclusive and conducive.
These safe spaces must be able to understand the personal issues linked to
sexuality. Programmatic areas targeted at YMSM must be capable of addressing
both psycho-social needs and sexual well-being of YMSM and their risk taking
decisions. Often, when we talk about young people and HIV, we fail to address
both psycho-social needs and sexual well-being of these individuals. We tend to
forget that change begins with me as a young person. I need space to
organically grow with the response, to learn about new game changers in fields
of science focused on HIV prevention. I need safe spaces to articulate my queer
identity.
When we design innovative program models for HIV services, much must be
included in a holistic and careful way. We need to consider how harmful
cultural practices, economical issues, laws and legal environments constitute
barriers to provision of and access to HIV and other health services. We must
consider the psycho-social and self-esteem issues among these groups of young
people.
Anthony Adero is a Kenyan born young LGBT and HIV activist, lobbying for access
to Sexual Reproductive Health information, STI and HIV services, and human
rights for young MSM. Anthony is also a member of the Youth Reference Group at
The Global Forum on MSM and HIV.
Anthony advocates for current and critical issues affecting young LGBT people
and wants to further pin point current strategies for effective change;
supporting anti-stigma as well as HIV education campaigns that work to ensure
we increase and enforce protective laws and strategies that oppose and repeal
laws that criminalize HIV non-disclosure, exposure or transmission,
homosexuality, and gender variance.
