Painting gay men as diseased is reckless and immoral

Brian-Paul Welsh GUEST COLUMNIST

The tone of the rhetoric coming from members of the Jamaica Coalition for a Healthy Society (JCHS) and the Love March Movement (LMM), particularly Dr Wayne West and his protégé Daniel Thomas, is doing much more harm to the health of society than I think they realise.

Dr West's insistence on typifying men who have sex with men (MSM) as vectors for infectious disease is reckless in light of the facts that he so skilfully manipulates to suit his divisive agenda. In fact, it is worrying that his assertions have not been challenged by civil society largely because he is a presumed authority given his profession as a medical doctor.

The multimedia campaign titled 'Speaking Truth is Not Homophobia', which the coalition recently launched, has revealed itself to be nothing more than a sophisticated smear campaign designed to suit an agenda of institutionalised prejudice, not 'love' or a 'healthy society' as is claimed.

The series of ads which has been running since International Day Against Homophobia (IDAHO) on May 17 paraphrases articles contained in the Lancet and 'AIDS Behaviour' under five points:

1. "Ninety-eight per cent of the difference in HIV rates between MSM and heterosexuals can be explained by anal receptive intercourse." This is a reformulation of one of the key messages contained in 'Global epidemiology of HIV infection in men who have sex with men'.

The deliberate selection and modification of this finding reveals the sinister motive behind the advertisement. The singular theme from the article was an already well-established fact: Unprotected anal receptive intercourse is a very efficient medium for the transmission of HIV. The coalition fails to acknowledge that only two bullet points below the one they chose to paraphrase, the researchers pointed out: "If unprotected anal intercourse in casual relationships instead happened within long-term main partnerships, HIV prevalence would be reduced by 29-51 per cent."

Quite obviously, the coalition and its supporters have no interest in preserving the lives of MSM by promoting healthy monogamous relationships. They are more content with demonising their identities and criminalising their private consensual activities while revelling in the suffering of gay men as 'divine ordination'.

2. "MSM - only group with increasing HIV in countries of all income levels." Again, this is a reformulation of a line in the executive summary of the Lancet Series HIV in Men who have Sex with Men. The very executive summary they reference goes on to point out just a few lines below that the series is an exploration of the known biological, anthropological, and structural factors which influence the disproportionate rates of infection among MSM compared to the general population.

Therefore, the increase in rates of infection is not a mysterious stand-alone fact but is caused by a host of complex variables which the series of articles addresses. Evidently, this omission was deliberate.

GROSSLY IRRESPONSIBLE

Paraphrasing one line from an executive summary without providing the full context is grossly irresponsible because it conveniently ignores the solutions contained within the very series they hold up as validation for their agenda. The Lancet articles recommend expanded testing and treatment, new and more effective prevention strategies, the encouragement of positive identity formation, legislative reform, poverty reduction, and other structural adjustments as key strategies for the reduction of the disproportionate rates of HIV infection affecting MSM worldwide.

These are conveniently ignored by the JCHS and LMM which insist on frightening an ignorant public and demonising sexual minorities by abusing epidemiological data.

3. "HIV disproportionately high and increasing among MSM in USA despite significant increases in rights." Once more, the JCHS propaganda machinery is glib with the facts as they paraphrase from 'AIDS Behaviour 2011'.

They pulled a single line from an article which goes on to explain some of the reasons for this disproportionate increase, including: lack of knowledge; failure to reach MSM with effective interventions (a CDC study found that up to 80 per cent of MSM in 15 cities had not been reached by HIV interventions); use of alcohol and drugs; mental-health consequences of stigma and discrimination; and, most important, complacency about risk due, in part, to the fact that this generation of MSM has never known HIV to be a death sentence.

This merely reiterates the earlier point that prevention programmes and messaging have been deeply flawed in their design and execution. In fact, the very abstract that West et al used to formulate this argument concludes by saying: "A sexual health approach has the potential to improve our understanding of MSM sexual behaviour and relationships, reduce HIV and STI incidence, and improve the health and well-being of MSM."

In other words, the very article they cite as proof of gay men's sexual dysfunction and predisposition to disease actually urges the creation of comprehensive health policies that are much broader than simply issuing condoms and that seek to understand the population so as to improve their quality of life. Quite obviously, this does not interest the JCHS.

4. "HIV 'out of control' among MSM in France." This is one of the coalition's most egregious citations from the Lancet 2010. The article in question, 'Population-based HIV-1 incidence in France, 2003-08: a modelling analysis', explored HIV incidence (new infections over a specified time period) among MSM in France for a five-year period.

The 'out-of-control' phrase they so love to quote referred to the rate of decline in HIV transmission among MSM being found to be significantly lower than the rate of decline among other populations. In other words, according to the study, between two and three per cent of MSM contracted HIV in France during the period studied as compared to one per cent of the population at large.

The study did NOT point to a new epidemic among MSM in France. Nor was it alarmist in its tone or intention. In fact, the medical and epidemiological fraternity has used these findings as an indictment on France's public health system, which has seemingly become complacent in its health policy and has neglected to design and implement the necessary targeted intervention programmes to prevent HIV among MSM.

The inference that HIV is uncontrollable among MSM in France, despite the absence of sodomy laws, is, therefore, a fallacious conclusion as it demonstrates a lack of understanding of the cultural, medical, and political realities of France.

To apply this non-sequitur logic to Jamaica and other countries that still have sodomy laws is reckless and irresponsible.

5. "HIV risk of infection in black MSM 100 times that of general population in UK and 72 times in the USA and Canada." Again, reformulating a finding of a study and presenting it as a conclusion is grossly irresponsible. The study conducted by Millet et al and found in the Lancet 2012 speaks emphatically about the urgent need to address the structural barriers which predispose black MSM in Canada and the USA to HIV infection. These include unemployment, low income, previous incarceration, less education, and cultural insulation.

In other words, the systemic disenfranchisement of people of African descent in the USA and Canada also serves to exacerbate the vulnerability of gay men within this minority group to HIV infection.

The very article cited by the JCHS and reiterated by the LMM concludes by saying: "Elimination of disparities in HIV infection in black MSM cannot be accomplished without addressing structural barriers or differences in HIV clinical care access and outcomes."

HOMOSEXUALITY DOES NOT SPREAD HIV

Unprotected sexual intercourse with an infected partner spreads HIV, not homosexuality. These self-appointed bastions of virtue are creating more of an unhealthy society by seeking to legitimise falsehoods as facts and prejudice as truth and it is time that they stop it.

The insistence of the JCHS and its allies to obfuscate scientific data, spread half-truths, and to mislead the public with skewed epidemiological information is evidence of their desperation and moral bankruptcy.

Their determination to paint gay men as diseased and disordered in a hostile society such as ours is reckless and immoral.

It is not ad hominem for me to say they are lying; it would be ad hominem for me to say they are liars. I will leave that for the public to decide.

Brian-Paul Welsh is a law student and sector representative on the Jamaica Country Coordinating Mechanism for the Global Fund to fight AIDS, Tuberculosis and Malaria. Email feedback to columns@gleanerjm.com and brianpaul.welsh@gmail.com.