NEW DELHI: For the Union health minister Ghulam Nabi Azad, men having sex with men (MSMs) is not only “unnatural” but also a “disease.”
According to Azad, “this disease has come to India from foreign shores”, and Indian society needs to be prepared to face it. Unfortunately, he said, the number of “such people” is increasing by the day.
In statements made while addressing zilla parishad chairpersons and mayors on HIV/AIDS on Monday, Azad said, “The disease of MSM is unnatural and not good for Indian society. It’s a challenge to identify such people. In case of female sex workers, we can identify the community and reach out to them since they live in clusters. But in case of MSMs, it isn’t always possible.”
These comments have not only caused uproar among civil society, but also in the National Aids Control Organization (NACO), which incidentally reports to Azad.
“How can this be a disease? It is just a form of sexual orientation. It’s definitely not unnatural,” a NACO official told TOI.
NACO has been working towards identifying MSMs and giving them a rightful place in society. A large number of targeted interventions (TI) have been put in place by NACO to specifically cater to the needs of the MSM community.
According to NACO’s latest surveillance data, India is home to an estimated 4.12 lakh MSMs of whom 2.74 lakhs have been identified.
Around 4.2% of all sexually-active males in India are believed to have sex with other men, with Chennai, Andhra Pradesh, Gujarat, Tamil Nadu and Orissa reporting the highest number of such cases. Of the total number of 1,511 TIs, 168 exclusively cater to MSMs. Each TI, catering to 1,000 MSMs, cost Rs 15 lakh.
The 2010 UNAIDS report on the global AIDS epidemic found that among the high-risk group that got HIV infection in India last year — 9.2% were intravenous drug users, MSMs (7.3%) and female sex workers (4.9%).
“MSMs are those who are involved in very high risk sexual behaviour. They usually have multiple partners. Some are also involved in commercial sex activities,” the report said.
Till now, a single TI would cater to MSMs and transgenders. Now, NACO has decided to have separate interventions for transgenders and MSMs.
Experts say that after Article 377 or homosexuality in India was decriminalized by the Delhi high court, virtually legalizing consensual sexual relation among adults of same gender, more MSMs started visiting TI sites.
“India has for long ignored the MSM community. India, like other Asian countries, had been addressing HIV/AIDS in high-risk groups such as female sex workers and injecting drug users, with the MSM population being left out because many men are married and do not identify themselves as gay or bisexual. That caused an alarming rise in HIV infections in the MSM community,” explained an expert.
Dr Charles Golks, head of UNAIDS in India, told TOI that MSMs are a key population, who are at higher risk of acquiring HIV and the Indian government’s initiatives is helping reduce the threat.
“India was the first country in Asia to recognize the vulnerability of the MSM population and put in place interventions required. NACO was also instrumental in putting down Section 377 that criminalized homosexuality as it was proving to be an impediment to effective public health intervention. In the next five years, under India’s National Aids Control Programme IV, stronger interventions with higher community involvement will be put in place to reach out to the MSM community.”
Data from 78 countries revealed that condom use among MSMs was more than 50% in 54 countries, including India.
Treat Asia’s report, “MSM and HIV/Aids: Risk in Asia”, which compiled studies conducted in 19 countries, said access to information and condoms is limited, with prevention programmes available to only 2% of MSMs in 16 Asia-Pacific countries. What’s worse, sex between men is illegal in 11 of the countries surveyed.