The new HIV study
December 16, 2006
AS REPORTED in yesterday's issue of this paper, a new study – conducted by Surinamese Ms. Julia Terborg – has been launched which shows that Female Sex Workers (FSW's), and Men who have Sex with Men (MSM) are most at risk for HIV infection.
While commendable as a whole, particularly in that it serves as a blueprint for an actual action plan, judging from the Guyana Chronicle's and other reports on the study, there are a few things which seem unclear in the study, and which may have unforeseen implications not considered favourable.
For example, while not covered in the article on the launch of the report, it would be interesting to know what the report has to say, if anything, on male commercial sex workers.
From the article, it is unclear how many of the men interviewed were commercial sex workers themselves. That in itself is a glaring and significant ambiguity and it stems from what seems to be a simple problem of definition.
MSM was a term coined in America to accommodate the self-identity issues of men who engage in sexual activity with men but who do not consider themselves homosexual or truly bisexual.
The logic behind it was to remove the stigma associated with, and to reflect the inherent complexity of definition of the term. For example, a man who engaged in sexual intercourse with other males during a period of imprisonment, but was exclusively heterosexual while not incarcerated.
MSM therefore includes those men, identifiably homosexual and bisexual men, and men who happen to offer commercial sex services to other men. The term MSM therefore has a more complex definition than any which implies gay or bisexual male prostitutes, something which its usage in the study seems to incorrectly imply.
If it is that the men interviewed were indeed in the habit of engaging in commercial sex services, then that would of course be a significant factor in the fairly high prevalence rate of 21%.
If it is that the men interviewed were not CSW's, then it would be a wakeup call for the MSM population in Guyana.
Either way, the number of CSW's which made up the population interviewed would be a significant factor in determining what strategies would be used to reverse the infection rate among this vulnerable population.
And there is another benefit to clearing up any ambiguity in this area.
If nothing else, any publicised ambiguity about the prevalence of HIV/AIDS among the male homosexual population in Guyana – especially one which puts a scientific backing to an already established prejudice linking HIV and homosexuality – will only help to increase the discrimination and stigma faced by this population.
This can only conceivably compound the Ministry of Health's problems in fighting what Minister Dr. Leslie Ramsammy calls the biggest obstacles in fighting the spread of the disease.
In the case of FSW's, while it should be stressed that strategies need to be devised geared at empowering these women to better insist on condom use, the issue at heart here seems to be the general empowerment of these women in general.
The study shows that FSW's not only have lower education levels than "MSM" but also are far more economically dependent on their trade.
Finally, while it is commendable that this new study is going to serve as the basis for an action plan, the information it presents has been out there in various forms for a long time – including the volumes of published and unpublished HIV/AIDS studies conducted in the past ten years.
What Ms. Terborg’s report does is that it confirms, and expands upon, the obvious and already widely known.