Marginalisation, discrimination hamper progress in reducing HIV/AIDS among homosexuals, sex workers
December 15, 2006
Female sex workers (FSW) and men who have sex with men (MSM) are more vulnerable to HIV infection because of the clandestine nature of their sexuality and the stigma attached to the high-risk lifestyles.
This is according to Suriname Pan American Health Organisation (PAHO) Consultant, Julia Terborg.
Terborg was presenting the results of a study on “Perceptions and Behaviour regarding HIV/AIDS Prevention and Care among Female Sex Workers (FSW) and men who have sex with men (MSM) in Guyana .”
She made the presentation yesterday in the Rupununi Room of the Hotel Tower .
Terborg said preventing the pandemic among the two groups will take much effort since the practice of homosexuality and prostitution is considered “immoral behaviour”.
She noted that prostitution and homosexuality are also taboo among East Indians, making them the hardest target group to reach.
Widespread marginalisation and discrimination continue to hamper progress in the area of reducing the number of infections each year.
However, her findings show that there has been a significant reduction in the HIV infection rate of female commercial sex workers over the years.
Terborg found that in 1997, there was a 46 percent infection rate among FSW compared to 27 percent in 2006.
There has also been improvement in the regular use of condoms from 36 percent in 1997 to 94 percent in 2006.
Terborg classified the FSW and the MSM as ‘most at risk populations' (MARP) because of their vulnerability to marginalisation.
She said although achievements were made in the area of increased knowledge and access to treatment, Guyana has not been able to adequately protect most vulnerable groups against HIV infections.
Terborg stated that more emphasis must be placed on interventions and reduction of stigma in order to achieve greater impact in Guyana 's national response.
Regarding ethnicity, 77.6 percent of men who have sex with men and 57.8 percent of FSW are Afro-Guyanese.
The percentage of East Indian MSM is 10.4 percent while East Indian population of FSW stands at 30.4.
However, Terborg said this is not a true representation of the population since these sexual lifestyles are taboo among East Indians.
Terborg found that the average age of FSW range from 15-59 years while MSM were between 16-50 years.
There was a higher percentage of Christians FSW standing at 70.6 percent than Hindus which made up 19.6 percent and Muslims with 5.9 percent.
The Field Officer revealed that both FSW and MSM were of varying educational levels with 56.7 percent of the males highly educated and a mere 45.1 women.
Economic analysis disclosed that 55.9 percent of FSW and 40.3 percent of MSM had no regular income.
The MSM also ranked high on the income charts with 74.7 percent having other sources of cash and 82.4 percent of FSW depending on commercial sex.
There was also a variation in their relationship patterns with 61.4 of FSW and 39.8 percent of MSM having no regular partner.
Most of the FSW were single comprising 60 percent, and 40 percent of MSM accounting for fewer marriages of less than 10 percent for both groups.
According to Terborg, most of the FSW and MSM had no children with 70 percent of the women and 29 percent of men being childless.
The FSW were diversified into downtown, uptown, club-based, drug addicted, HIV positive and street workers.
Commenting on their sexual reproductive health, Terborg said 39 percent of FSW used contraceptives, 43 percent had at least one abortion, 67 percent never did a pap smear test and 16 percent had contracted an STI in the last year.
She found a high percentage of substance abuse among the FSW as well as regular alcohol and marijuana use.
Contrary to FSW, the MSM community is much more diverse with men classified as ‘givers, ‘takers' ‘receivers' and ‘cross-dressers'.
This group is also identified by their involvement in commercial and non-commercial sex (sex worker or client).
Terborg said the sexual lifestyles of most MSM are characterised by a relatively high number of changing partners and short-time sexual relationships.
“Many MSM still experience great difficulty in maintaining protected sex even with HIV positive partners,” Terborg said.
She further stated that unprotected sex is more likely to occur in sexual contact with a regular partner.
Much more than FSW, MSM complained of negative effects of stigma and discrimination and in general perceive Guyana as a predominantly homophobic society.
“In this hostile social environment, many MSM tend to hide their sexual orientation and live with the constant threat of having their hidden lifestyle revealed with the likely consequence of losing their families, jobs and becoming social outcast,” Terborg said.
A total of 102 FSW and 67 MSM were interviewed and the research population was varied in terms of sexual behaviour, health status, age, gender, working conditions and socio-economic status.
According to the Field Officer, the findings presented in the research will be used for the development of a targeted and tailored STI/HIV/AIDS prevention and care programme for FSW and MSM.
She remarked that while AIDS-related illnesses have been the principle cause of death among people 25 to 44 years, the HIV prevalence rate in Georgetown is estimated at 154 persons for every 10,000.