KHOPOTSO: South Africa’€™s new strategic plan detailing its response to the HIV/AIDS epidemic over the next five years is expected to be released early in the new year. Young people between the ages of 15 and 24 are a top priority in the government’€™s efforts to curb new infections, as most occur in this age category. However, some warn that this could remain but just a pipe-dream if all sexual practices that young people engage in are not included in the response.

JONATHAN BERGER: When we ask people: ‘€œWhen was the last time you had sex’€, in a survey, we should actually ask them: ‘€œWhat kind of sex did you have ‘€“ was it anal, was it vaginal, was it oral’€¦ thigh sex? What was the sex of the person you had sex with ‘€“ was it a man, was it a woman? Do you have sex exclusively with men, exclusively with women’€¦’€? Until we understand those questions, our programmes are not really going to be able to succeed.

KHOPOTSO: Jonathan Berger, a researcher with the AIDS Law Project. His view is that research questions need to be more probing, particularly with regard to the youth.  Currently, national research and prevention and awareness programmes are based on the assumption that all South Africans engage in heterosexual sex only.

JONATHAN BERGER: For me, one of the most dangerous aspects of ABC is that it’€™s a single one size fits all message for everyone. Questions have been asked of government to say ‘€œwhere are your programmes for gay men or just your materials for gay men or other men who have sex with men’€’€¦ such as the Khomanani materials that are published’€¦ And the response has been ‘€œwe don’€™t want to stigmatise gay men. We treat them as men, and therefore, our programmes and our materials for men are appropriate for them’€, which is nonsense. With all due respect, it’€™s nonsense because gay men are having sex with men and not with women. They may be engaging in anal sex. They may themselves, in many cases, be penetrated. And those concerns do not apply to men who are exclusively heterosexual.

KHOPOTSO: Supreme Court of Appeal Judge, Mr Justice Edwin Cameron, acknowledges that South Africa has a largely heterosexually-driven HIV epidemic. However, he argues that it’€™s dangerous to ignore the contribution made by men who have sex with men, whether clandestinely or not, to the rising epidemic.  

JUDGE EDWIN CAMERON: By not highlighting this in our prevention and awareness messages we’€™re doing a terrific disservice ‘€“ not only to the gay community – because I think we’€™ve got very high levels of HIV amongst men practising sex with men in South Africa – both those who identify themselves as gay, but even more significantly, those men who have sex with other men but don’€™t identify themselves as gay, those men who are also having relationships with women, but aren’€™t talking about their gay relationships as well’€¦ Gay men are particularly vulnerable for very distinct physiological reasons to HIV transmission. We should be speaking about those reasons. We should be highlighting them. We should be informing people. It should be part of our national campaign.      

KHOPOTSO: Berger believes that there is a need for a campaign aimed at men who have sex with other men that would focus more on the reduction of risk. This could help young men who are still not sure about their sexual orientation and experiment with both sexes.  

JONATHAN BERGER: There is a greater likelihood of HIV transmission during anal sex than during vaginal sex’€¦ Many gay men will know how to have anal sex safely’€¦  using condoms and lubricants. I’€™m not that convinced that heterosexuals recognise the need for lubricant, particularly when having anal sex’€¦ If we don’€™t give out that kind of graphic information about ‘€œthis is what you do to make that kind of sex safer’€, in effect talking about harm-reduction rather than complete elimination of risk, then people may well be placing themselves at risk without knowing that they’€™re doing so.                                                

KHOPOTSO: Government is opening itself up to future criticism by ignoring the needs of the gay male community on HIV prevention and awareness, adds Judge Cameron. However, he is also concerned about the apathy that seems to exist within the community itself on HIV issues.

JUDGE EDWIN CAMERON: There’€™s lamentably little activism within the gay community itself. If you go to a gay bar or a commercial venue in Johannesburg there is very, very little awareness, very little prominence. You’€™ll find condoms there. You’€™ll find some HIV prevention messages. But there is very, very little HIV prevention and awareness. And for that the gay male community, I think, has principally, itself to blame. But we cannot absolve the national organisations and the national government efforts that are also sidelining gay men.

KHOPOTSO: Up till now, there have not been any conclusive studies on the prevalence of HIV infection among South Africa’€™s gay community. The first research of this kind is currently being carried out by the Human Sciences Research Council.