By Patrick B. Craine

OXFORD, July 21, 2009, ( – A new literature review, published by The Lancet, emphasizes the great proportion of HIV/AIDS cases among men who have sex with men (MSM) in sub-Saharan Africa, a fact often ignored in the fight against AIDS in Africa. The study concludes, however, that the solution to the problem lies in greater openness to homosexual practices from the African nations and better access to interventions, a solution that experts from the National Association for Research and Therapy of Homosexuality (NARTH) have called “simplistic.”

The review, principally authored by Dr. Adrian D. Smith of the University of Oxford, calls for greater acceptance of MSM in sub-Saharan Africa, where the cultures are still mostly unwilling to accept homosexuality and the homosexualist agenda.

“Continued denial of MSM from effective HIV/AIDS prevention and care,” they say, “is harmful to national HIV/AIDS responses.”  According to the review, male-to-male sex is illegal in 31 sub-Saharan countries, with the death penalty a possible punishment in four of them.

There is a need, say the researchers, for increased recognition of the HIV problem among MSM, which has been overlooked in sub-Saharan Africa. “Globally, [MSM] continue to bear a high burden of HIV infection,” they write. 

The initial research conducted in the early 1980s focused on heterosexual transmission, observe the researchers, suggesting that these findings have skewed the approach ever since.  The result was that “the possibility that MSM might feature within this model [of HIV infection in Africa] soon disappeared from discussion.”

Previous reports have also indicated that the idea that AIDS is primarily being transmitted through heterosexual relations in Africa may not have a firm basis in fact.

In 2003 a study authored by Dr. Stuart Brody found that anal sex, both homosexual and heterosexual, is the second greatest cause of HIV transmission in Africa.  Poor medical practices, such as the use of dirty needles, were found to be the greatest cause, with vaginal transmission being a distant third cause.

Steve Mosher of the Population Research Institute's (PRI) has also discussed the African heterosexual transmission myth, describing how information about poor medical settings has been ignored, and how various interest groups, “for diverse ideological, political, and financial reasons, promoted the notion of heterosexual transmission in their publications, proposals, and press releases.”  According to one of the studies he discussed, the result was the “ignoring and misinterpreting of epidemiologic evidence.”

According to the authors of the most recent study, however, the finding that HIV transmission rates are indeed heavily related to MSM indicates that African countries should be more open to homosexual practices. “The neglect of research, surveillance and HIV prevention, and treatment and care programmes for MSM cannot be separated from the influence of general, largely hostile attitudes toward homosexuality in Africa,” they write.

“Political, cultural, and religious hostility towards MSM presents the main barrier to implementing effective HIV research, policy, and health programmes for African MSM.”

But Drs. A. Dean Byrd and David Wood of the NARTH Scientific Advisory Committee say they disagree with the review's conclusion.

“The overrepresentation of men who have sex with men among the population of HIV/AIDS individuals is cause for concern,” they told LSN by e-mail.  “However, the remedy suggested by the authors of the article, i.e., more openness to homosexual practices may not reduce the incidence of the disease.

“The Malebranche's research which was included in the June 2003 issue of the American Journal of Public Health,” they continued, “seems to contradict the notion that becoming more open or disclosing one's homosexuality was associated with improved mental health, responsible behavior and lower rates of HIV infection.

“To the contrary, African American men in this study who disclosed their homosexuality had higher rates of HIV prevalence than those who do not choose to do so (24 percent versus 14 percent.)  They also engaged in more unprotected anal sex (41 percent versus 32 percent) than those who did not disclose.”

Drs. Byrd and Wood said that the issue is far more complicated than the review's authors make it seem.  “The simplistic solution suggested by the authors to this rather complicated issue seems to lack merit.  Rather HIV/AIDs should be treated like any other sexually-transmitted disease and efforts directed at surveillance, risk factor identification, the implementation of interventions and evaluation.”

The pair emphasized the inherent risks associated with homosexual behaviour, a fact that the study brushes over.  “The current scientific evidence,” they wrote, “does suggest that homosexual practices do place its participants at risk for some health-related problems,” a finding that they say appears to hold true even in extremely homosexual-friendly countries like the Netherlands.

See related coverage:

Anal Sex Largest Cause of HIV in Africa

Are Africans Promiscuous Unto Death?

WHO Official Admits No Pandemic of AIDS amongst Heterosexuals

Abstinence Program Making Huge Impact in Africa: 61 Percent Reduction in Teen Pregnancy


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