September 30, 2009
The Caribbean has the highest rate of new HIV infections after sub-Saharan Africa, and AIDS is now its leading cause of death among adults. Part of the region's susceptibility to HIV/AIDS is pervasive homophobia, which drives the epidemic underground, helping to spread infections and make education and outreach more difficult, experts say.
Jamaica, where gay men have a 32 percent HIV infection rate, is a case study in how widespread homophobia amplifies the impact of HIV/AIDS. The "abominable act of buggery," as anal sex is termed in Jamaican law, is punishable by up to 10 years hard labor. Popular dance music celebrates the murder of gay men, inciting and reflecting widespread acts of violence against gays. A religious context of homosexuality as a mortal sin compounds the contempt that checks any concern for gays.
"The reality in Jamaica is that men who have sex with men, for fear of being prosecuted and being found guilty under the sodomy law, pretend that they're not gay," said Miriam Maluwa, UNAIDS representative for Jamaica. "[Gay men] marry fairly rapidly, they have children fairly rapidly to regularize themselves, and that is really a ticking time bomb. So we are really talking about this targeted group, having quite high levels of infections, which is interacting sexually with the general population."
Though the growing consensus among experts suggests targeted prevention programs for gay men, rather than general public health messages, the social and political climate makes that virtually impossible.
"If it were AIDS that were killing us, I would use a condom," said a 20-year-old man in Kingston whose boyfriend was stabbed to death on the street for being gay. Another close friend was locked inside his parents' house by a crowd and burned alive. "But it's people, not AIDS, that is killing us. AIDS has nothing to do with it."