November 21, 2010
For our World AIDS Day 2010 section, we wanted to capture the diversity of the AIDS community. So, we reached out to people across the world -- mostly those who have never written for us before -- and asked them to guest blog. These columns are written by people who are living with HIV, have been affected by HIV, or work in the field.
December 1 is a very special day in my life not least because it is my father's birthday as well as the feast day of St. Edmund Campion, the patron saint of my alma mater. Whilst I am not Catholic, I remember the annual school holidays in St. Edmund's honour and for this I am eternally grateful. The world, however, will on that day mark 22 years since the inaugural World AIDS Day event in 1988. The custom is that on World AIDS Day activists throughout the world will call on everyone to remember the millions of persons on all habitable continents and islands that have been infected with this disease. These same activists will also remind us that in some way, every member of the human race is affected by the continuous presence of this illness and that as a collective we have failed to solve the, albeit difficult, social calculus that continues to support its spread.
Much has changed since the first World AIDS Day celebrations. In 1988, South Africa was an international pariah under an economic and diplomatic embargo; the Berlin Wall still stood; the Iron Curtain had fortifications in place in Eastern and Central Europe; China was a closed state and India was a destination to be avoided. Thus the global picture of the scourge of HIV/AIDS on far-flung regions of the world, especially Sub-Saharan Africa, was not yet developed and was only slowly emerging. In fact in some localities the photograph is only just coming to the fore. However, the scenes of competitors refusing to enter the pool at the Olympic Aquatic Center in Seoul after Greg Louganis hit his head against a springboard juxtaposed against the Free Hugs movement at the recent International AIDS Conference also highlight how far we have come as a global community in understanding how the disease is transmitted.
Yet whilst much has changed at the global level, at the local, national and community level in many parts of the world it is as if time has stood still. In Jamaica for example, official government statistics indicate that the incidence of HIV/AIDS in the MSM population is acutely high at 33 percent; however, Victorian-era laws remain on the books preventing the development and distribution of lifesaving prevention messages targeted specially toward the most at-risk populations (the so-called MARPs). These laws contained in the 1856 Offences Against the Persons Act criminalizes inter alia anal penetrative sex and other forms of same-sex intimacy. These offences attract lengthy prison sentences of up to 10 years in prison at hard labour. (Ironically, within the English-Speaking Caribbean, except for the Bahamas, Jamaica represents a best-case example as the penalty for anal sex is life imprisonment in Guyana and Barbados and 25 years in Trinidad and Tobago).
The policy and programmatic implication of the Jamaican examples is a state of paralysis! In effect the state and its relevant agencies not only recognize the size and scale of the HIV/AIDS problem but also the priority areas; yet cannot commit resources to tackling same because of legislative constraints. The quantum of this paralysis can be seen in the absence of a nationally focused campaign surrounding the use of lubricants; or the coven-like atmosphere that surrounds workshops organized by NGOs (nongovernmental organizations) working with members of the community. Thus the question that emerges is: What are the solutions that can be employed over the short to medium term to deliver prevention messages to the marginalized MSM community in Jamaica and the wider English-Speaking Caribbean region?
In the first instance MSM-specific prevention messages that are localized and contextualized must be developed irrespective of the huge social and political risks. Notably Barry Adam, in his research Accounting for Unsafe Sex: Interviews With Men Who Have Sex With Men, writes that these HIV prevention programs (should) benefit from engaging with the rich understandings of sexual risk and safety that many men have already developed. Such an approach would need to address directly the issues at the forefront of the minds of gay and bisexual men, such as avoiding ejaculation during anal and oral sex, the distinction between the insertive and receptive roles in anal sex, and whether condoms are needed in couple relationships.
Secondly, HIV/AIDS campaigners must leverage the immense distributive power of information and communication technologies (ICTs). One of the great innovations of the 21st century is the power to create self-regulated virtual communities. The often quoted statistic is that if Facebook was a country it would be the fourth most populous in the world. Further, marketers the world over have lately recognized the power of the forward and share button. Couple the aforementioned with the fact that Jamaica has a mobile tele-density rate in excess of 100 percent (signifying that each and every Jamaican irrespective of sexual orientation has a cell phone), the opportunity exists to develop programs that are personal whilst operating in a space that is outside of the reach of domestic laws. As such HIV/AIDS programming must step into the age of mobile applications and Web 2.0.
In an era of tight fiscal constraints in both the developed and developing world, increased use of ICTs can have the effect of shifting budgets away from spending on media slots to content and actual messaging. The fact is primetime television and radio slots are expensive compared to the free distribution that occurs from hosting content on sites such as YouTube and investing sweat and time into developing and building virtual communities.
Thus as we honour and seek to remember our brothers, sisters, colleagues and strangers that have died and continue to live with this disease, we must congratulate ourselves on the huge strides we have made as a global community. However, we must also reflect on the various challenges of the present! These challenges include laws, custom, programme funding and a generally uncertain economic climate.
In Jamaica, in spite of the laws, we can meet the programmatic challenges of "GETTING THE MESSAGE OUT' through the use of ICT-based strategies. Indeed here in Jamaica, the Pink Report (of which I am a part) is actively working in the field to create and exploit the opportunities that the Internet and ICTs provide. In the final analysis, however, programming can only get the message to the individual; it is up to the individual to act on this message!
Due to the political and legal climate surrounding homosexuality in Jamaica as described in this article, Shane McCarthy declined to include a photo of himself with the piece for his safety.