Sex workers, MSMs most at risk -- HIV/AIDS study finds By Neil Marks
Guyana Chronicle
December 15, 2006

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A NEW study in which Female Sex Workers (FSW) and Men who have Sex with Men (MSM) say they encounter a double burden of stigma and discrimination, based on their lifestyles and of their HIV-positive status, is to be used by the Ministry of Health to develop care, treatment and support programmes.

Releasing the study yesterday at Hotel Tower in Georgetown, Minister of Health Dr. Leslie Ramsammy said stigma and discrimination continue to drive the HIV/AIDS epidemic and this remains one of the major hurdles in the fight against the disease.

Ramsammy said that while the national response in fighting the disease has met with considerable success, groups such as FSW and MSM, who show an HIV prevalence rate of 27 per cent and 21 per cent respectively, are highly vulnerable and the programmes to help them need to be accelerated.

He said that in the past, programmes of care and treatment were not effective because they were conceived without real information about vulnerable groups and so the new study, funded by the Pan American Health Organisation (PAHO) and the Canadian Society for International Health (CSIH) would be used to develop targeted and tailored made programmes for these two groups.

Ms. Julia Terborg, a Surinamese, who conducted the study in interviewing 102 commercial sex workers and 67 men who have sex with men, said these groups are identified as “most at risk” populations due to the clandestine nature of their sexual relationships, the marginalisation, stigma and discrimination they often face, and their high risk sexual lifestyle.

The study found that although both groups have access to HIV/AIDS related services such as knowledge, condoms, early treatment of STI and HIV testing, there are many complaints about the quality of services, in particular public health services.

They complained of having to deal with long and inconvenient waiting hours, lack of confidentiality, limited pre-counselling and inadequate post counselling, lack of informed consent, prejudiced attitude of health workers and their lack of adequate communication skills.

HIV-positive respondents expressed specific problems related to post-counselling, confidentiality, procedures of Anti Retroviral (ARVs) provision, and other issues, the study found.

Most FSW and MSM expressed a strong need for psychosocial support. In times of problems, they mainly rely on family and to a lesser extent on peers.

The study found that structured and systematic psycho social support from community resources, such as specialised government institutions is absent.

Ramsammy indicated that work has been ongoing with FSW and MSM, but the study found that for MSM, no actual programmes have yet been implemented to focus on this particular target group.

Males having sex with males are commonly identified as “hard to reach” because most hide their behaviours.

Much more than commercial sex, male-to-male sex is highly stigmatised, and the study found that no MSM organisations exist, although there are specific networks of such men existing.

The study noted that despite the fact that both commercial sex work and sexual contacts between males are legally defined as criminal offences, the overall government policy is one of relative tolerance.

Among all stakeholders in the area of HIV/AIDS, there is widespread acknowledgement that interventions among these groups are necessary considering their vulnerability in the AIDS epidemic.

Apart from the risk of contracting the HIV virus, FSW and MSM are seriously exposed to other health risks related to drug use, sexual abuse, infection with Sexually Transmitted Infections and unwanted pregnancies.