Mumbai: A notable increase in the prevalence of HIV among men having sex with men (MSM) in the recently concluded HIV Sentinel Surveillance in the city has alarmed anti-HIV crusaders. The annual surveillance carried out by the National Aids Control Organisation (Naco) has pegged the prevalence at 12.5% in 2010-11 (April-March ) compared to 9.2% recorded in 2008-09 , an almost 36% jump from the base figure.
Though commonly MSM population is equated with gay men, activists debate that it is not so, as bisexuals-men having sex with both men and women–too come under the gambit.
HIV prevalence among MSM in the city had seen a huge fall from 23.9% to 6% between 2000-2001 and 2005-06 . But, after that, the graph has only zoomed upwards with the prevalence going up to 7.6% in 2006-07 , to 8.6% in 2007-08 and 9.2% in 2008-09 . There was no surveillance for the year 2009-10 .
Project director of Mumbai District Aids Control Society (MDACS) Dr S S Kudalkar did not want to comment on the issue.
Project director of Mumbai District Aids Control Society (MDACS) Dr S S Kudalkar did not want to comment on the rise in prevalence of HIV among men having sex with men in the city and said he was yet to receive the detailed figures of the HIV Sentinel Surveillance (HSS). NACO officials , too, remained unavailable for comment.
While, the state agencies have reached out to only 39,572 MSM, NGOs accept that the number is “grossly underreported” . “It is a complicated area where even gay organizations have limitations as far as reaching out is concerned. Here, we are talking about men, many of whom do not want to be identified as gay,” said public health expert Dr Shilpa Merchant, previously associated with Population Services International.
Activists are unanimous that there are many men who regularly indulge in sexual activity with other men but resist being labelled as gay fearing social stigma.
Gay activist and chairperson of Humsafar Trust Ashok Row Kavi said that the government had managed to reach out to only networks of identified homosexuals. “Bisexuals do not even want to come to identifiable places. This population is incredibly difficult to access ,” he said, adding that the number of MSM population could be “very, very high” .
Medically, the debate has often revolved around anal sex being riskier than vaginal sex, and therefore, spouses being vulnerable of getting infected not only with HIV but other sexually transmitted diseases. But Kavi said that it would be impractical to say that only gay men indulged in such sex. “Studies have shown that up to 45% of heterosexual married couples indulge in it, though that too is a high-risk behaviour . The idea is to educate men about safe sex,” he said.
Kavi also said that in the course of reaching out to gay men, his NGO had observed that between 50% and 55% of men were having sex with their wives as well as other men. “Of these, around 25% were married and did not seem to be under any pressure to indulge in such sexual behaviour,” he said. “Internet holds the key to reach out to MSM. We have to reach them through emails, tracking sex sites and then educate them,” said Kavi. The internet has emerged as the most commonly used medium by men to look for ‘partners’ .
Merchant said the government should think of ways to reach out to all men rather than only gay men. “There are hardly any dedicated programmes to target this high-risk population . We need neutral organizations to participate,” she said.
by Sumitra Deb Roy, TNN
Source – The Times of India
