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Society
Manoj, 30, of Chandni Chowk in Old Delhi, has been struggling with ambivalent feelings about his sexuality since adolescence. He recalls roaming the streets in search of sexual adventures with 'like-minded' boys. Manoj knew nothing about the dangers of unprotected sex and wouldn't recognize a condom if he saw one. Then, during one of his cruising ventures at a local park, he heard about a dreaded mysterious illness that seemed to strike men having sex with men (MSM). Curious to know more, he accompanied the informative young man to a 'drop-in centre' for MSM in east Delhi. Here, Manoj met several men like himself who had the same fears and queries regarding their sexual orientation. - 'So-called normal people also engage in sex. How come they are respected and we are not?' 'Why am I like this?' 'Why can't I be accepted for who I am?' - These are the questions that the young volunteers at the centre patiently answer over and over. There is a sense of purpose in the room as men clamber forward to pick up new facts. The walls are plastered with posters that have HIV/AIDS awareness messages, while neat stacks of condom boxes are piled high on the shelves in one corner of the room. A banner stretching across the room identifies the group as the Development, Advocacy and Research Trust (DART). Registered as a non-profit community-based organization in 1998, DART has been working with MSM in Delhi and neighboring areas on HIV/AIDS prevention issues and STI (sexually transmitted infections) treatment and counseling. Over the past eight years, it has supported approximately 25,000 MSM through two drop-in centres that offer information on HIV/AIDS/STIs as well as referrals to other services. One centre is in Uttam Nagar in West Delhi, and the other one in Shastri Park, East Delhi. "It really opened my eyes," says Manoj. "For years, I could not communicate my fears and doubts about my sexuality even with my family. Today, as an outreach worker here, I talk to so many people about HIV prevention and care and various issues concerning MSM." For men like Vikas, 21, of Rohtak (Haryana), the growing up years were fraught with shame, denial and confused feelings about his sexuality. Condemned and ridiculed by his family and acquaintances for his effeminate ways, he found peace for the first time when he joined DART two years ago. "I've always felt like a girl and was attracted to men from the beginning. When a boyfriend brought me here, I learnt for the first time about HIV and the need to practice safe sex," he recalls. Today, as a peer educator with the organization, he tries to help other young men deal with the socio-cultural pressures that haunt MSM and to instil in them a sense of self-worth. The centre in Shastri Park has a 17-strong staff - six outreach workers and 11 peer educators. On Sundays, MSM gather here to dance, debate and hold other cultural activities. They also organize support group meetings for HIV+ men and for MSM and eunuchs. Thrice a week, staff members go to cruising areas (places where MSM and eunuchs gather to solicit sex) all over Delhi, such as places in Dhaula Kuan, Mehrauli, Kalyanpur, Najafgarh, Janakpuri and Badarpur. The teams, each consisting of one outreach worker and six peer educators, attempt to reach out to MSM and counsel them about protective sex measures and HIV/AIDS information. "It's not always easy," says Vikas wryly. "At first, most men try to shrug us off, grumbling that we're interfering with their work. Some throw away the leaflets and condoms we press on them." There is change, though, however gradual. An increasing number of MSM in Delhi and neighboring areas are looking for access to safe, supportive spaces, and are contacting DART for services and support. Increased awareness levels have also brought with them new challenges. "Information alone does not lead to a motivation for behavior change," says Charan Singh, Project Coordinator, DART. "It is very difficult for an MSM to go to an STD clinic even when escorted by a volunteer. What MSM desperately need is an onsite clinic that is conveniently located, so that they feel safe and confident enough to access and use its services." Singh explains this need: "Their lack of self-esteem, coupled with a lack of socially accepted friends' circle and a safe space, creates a tremendous pressure of dual existence. Added to this are the regular tensions of joblessness and marital discord." He also faults the superficial interpretation of MSM behavior in government programs. "Our experience of working with MSM has shown us that people do not have one concrete identity throughout their life, so it's very misleading to categorize and define MSM by their sexual preference, behavior or outward appearance, dress and mannerisms," he says. This view finds echo in a new report, entitled 'MSM and HIV/AIDS Risk in Asia: What is Fuelling the Epidemic Among MSM and How Can it be Stopped'. The report, released at the International AIDS Conference held in Canada in August 2006, concludes that a 'gay' identity is not dominant among Asian MSM. This makes it difficult to reach MSM communities through the type of public health campaigns that have succeeded in lowering rates of HIV infection among gay men in Europe and North America. The report - undertaken jointly by the Bangkok-based Therapeutics Research, Education, AIDS Training (TREATASIA) and New York-based amFAR (The Foundation for AIDS Research) - surveys 23 countries, including India, and finds that current HIV prevention efforts do far too little to address the root causes of the epidemic among MSM, a diverse group that includes gays, bisexuals, trans-gendered people and others who, often for cultural reasons, do not identify as gay. Gender roles and sexual behaviors among Asian MSM have been poorly understood, as a result of which it has been difficult to design effective interventions that will reach the appropriate populations. In a
promising move for India's gay and MSM community, the Ministry of Home
Affairs has set up a Task Force that has met twice to review Article 377
of the Indian Penal Code, which criminalizes homosexuality. "Article 377
places a huge constraint on the government's HIV/AIDS prevention
programme because it makes it difficult for health workers to access MSM,"
National AIDS Control Organization (NACO) Project Director Sujatha Rao
stated at a recent conference here on male sexual health and HIV in
Asia. Tough laws like this and the Narcotics Control Act, which makes
drug use punishable, are a major hurdle to introducing HIV preventive
interventions - such as needle exchange programs among injecting drug
users and condom promotion among MSM and sex workers. October 22, 2006 By arrangement with Women's Feature Service
The Week of October 22, 2006
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