Fighting AIDS in Asia

Below are excerpts from an article written by Clive Wing for The Act, the magazine of Action for AIDS, Singapore, on the recent Chiang Mai AIDS conference.

Many of us would agree that the fight against AIDS in Asia will be lost or won through education programs whose effectiveness will often depend upon the interrelationships between culture and religion. Hence the session on this topic should have been an opportunity for us to understand the synergy between the two; where the boundaries are between public policy and religious teaching and orthodoxy; what has worked or not worked in Asia; what we need to take into account when designing education and prevention programs and so on. Instead the three speakers displayed their ignorance of these important issues by hardly mentioning culture and religion at all. No results from the field were described and no practical or empirical evidence presented. Ms. Mariena Mahathir from the Malaysian AIDS Council summed up our feelings when she said from the floor that the session was insulting to us all. Our time would have been much better spent if the organizers had selected a Mullah, Priest, Bhikku and Acharya.

What was very noticeable however was that in five days of session-going, I did not hear one speaker talk about abstinence or monogamy. The starting point was always condoms and it got me wondering if we have all been bought by the condom companies? Or are we just bowing to reality? That it's inevitable young people will have sex, so preach condom use instead?

As with the absence of celibacy and monogamy messages, I did not notice any studies on keeping free from HIV the partners of HIV positive people. This is of supreme importance in countries with high seropositivity rates such as India, Thailand, Myanmar and Cambodia. Many will find this a strange statement. After all, why would an infected husband continue to have sex with his wife and risk cross infection? The answer is we don't know, but they do. All countries in the region will report that physically and sexually abused wives continue to live with their husbands because they have nowhere to go and are economically dependent on their spouse. This deserves far more attention than it has received.

One of the most interesting sessions was a round table discussion on Alternative Sexualities. The panel consisted of gay men, a Bakla (an effeminate Filipino man), a lesbian, a transgendered female and others. Asia has a wide variety of "other" sexual expression that is deeply rooted in the culture. It is only with the western paradigm of gay, straight and bisexual being forced on ancient cultures, that what was considered innocent behavior, is now seen as deviant.

For example, several countries reported the raising of a boy child as a female in the absence of daughters. In adulthood the child is called "Aunty" and can take a male sex partner. In India, eunuchs (castrated men living as women) have for centuries performed rituals at Hindu celebrations; and the huge number of men in the region who are happily married, have sex with men and do not identify as gay or bisexual, present yet another sexual variation. The point of the discussion was to address such diverse sexuality in the context of HIV and AIDS. It did not really accomplish that because gay issues from gay participants hijacked consideration of the other sexualities.

What this session confirmed is that the Western gay model into which is lumped all men who have sex with men, is not appropriate to much of Asia. I'm convinced that gay men are fewer in number than men who have sex with men and bisexual men in many Asian countries from India to the Philippines, and that if we are to reach them we need to develop different HIV/AIDS messages, delivery routes and services.

This was not a bad conference. What the organizers didn't get to grips with is that in Asia, our problems are overwhelmingly societal: religious objection to condom use, absence of sex education in the home and at school, public distaste of open debate on sexuality and AIDS, political understatement of the AIDS epidemic, as well as the culture of casual sex in many Asian societies, and the position of women at the bottom of the family hierarchy. They all deserve greater consideration especially Asian women and the anguish they face from abusive or philandering husbands. I've often said that the AIDS crisis in Asia is a women's crisis. Nothing I heard in Chiang Mai changed this point of view.