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Homosexuality and HIV in India

The illegality of gay sex hinders the fight against AIDS, reports Balaji Ravichandran

In August 2008 the health minister of India, Anbumani Ramadoss, shocked the political establishment by calling for the decriminalisation of gay sex. Under section 377 of the Indian penal code, which dates from the 1860s, penetrative sex other than heterosexual vaginal intercourse is punishable with a maximum sentence of life imprisonment.

In India at least 2.5 million men self identify as exclusively homosexual. The legal pressure for homosexuality to remain clandestine compromises India’s ability to fight HIV and AIDS, which is a huge problem: an estimated 2.4 million people have AIDS.

Section 377 has seldom been used to secure convictions. However, according to Human Rights Watch, the law is regularly used to blackmail, harass, and threaten gay men and women, and cases of rape by the police have been reported.

People with HIV also face widespread discrimination. According to UNAIDS, at least 25% of people who present to government hospitals who are HIV positive have been refused medical treatment because of their HIV status. A psychiatrist at the All India Institute of Medical Sciences in New Delhi said, “Many of my colleagues even in psychiatry still believe that homosexuality is a mental disorder. I see at least four to five gay men or women every week. Many of them are HIV positive, and most do not declare their sexual orientation or practices to their doctors. Those that do are often told by their physicians to switch to a different doctor or to go to a psychiatrist for ‘counselling and conversion.’

“Taking away the threat of arrest from gay men and women will greatly help in diagnosing and treating patients in a non-judgemental way and much more easily than at present.”

Until recently homosexual sex was seldom discussed in public, even within the context of HIV/AIDS. In December 2002 the Naz Foundation, a non-governmental organisation that works to reduce the spread of HIV/AIDS in India, started proceedings in the Delhi High Court to challenge the illegality of homosexuality. The hearings began in September.

“Any ruling that supports decriminalising homosexuality, we hope, will make more gay men come and get tested without fear of getting arrested, particularly in rural areas. The popular myth is that gay sex is not prevalent in rural India, but in fact it is common,” said a spokesperson for the National AIDS Control Organisation, which was set up to prevent the spread of HIV and to care for people already infected.

The National AIDS Control Organisation has joined forces with the Health Ministry to support the Naz Foundation. The position of the Health Ministry, however, is at complete odds with that of the rest of the federal government.

P P Malhotra of the Home Ministry went as far as to say that homosexuality is a “disease” that needs to be contained. He said that decriminalising homosexuality would lead to “moral degradation of the society.” This view was echoed by the ruling coalition and the opposition parties as well. Not a single political party has so far endorsed gay rights in India; to do so would be political suicide. And although the national press tends to support gay rights, local media are opposed to any relaxation of the law.

“Reaching out [to men who have sex with men] is very difficult because of section 377. But, with huge publicity such as this, at least in the near future, things are going to be more difficult for us,” said one spokesman for the National AIDS Control Organisation. Homosexuality is held in contempt by most Indians, and the publicity will not help more people to be open about their sexuality, he explained.

A gay rights activist based in Chennai, the city that reported the first case of HIV in India, explained the repercussions of being open about homosexuality: “I became a social outcast within a day. Even the local greengrocer wouldn’t have my custom. None of my friends or relatives would speak to me again. I was left without any money. And I didn’t have a job. I considered killing myself.” His late partner, who faced similar social ostracism, including the loss of a well paid job, committed suicide a few weeks after he decided to be open about his sexuality. At least 45 gay couples have committed double suicide in India between 2001 and 2006.

The Delhi court criticised the government for calling homosexuality a disease; the World Health Organization states that it is not. It also condemned the government for saying that decriminalisation would cause further spread of HIV because the primary mode of transmission in India is heterosexual intercourse, and evidence from medical journals suggests the contrary.

The Health Ministry shapes public health policy, however, and given the position of Dr Ramadoss, regardless of the outcome of this case, it might start to call for public health policies that more openly target health needs specific to sexual minorities.

Competing interests: None declared.

See www.avert.org/aidsindia.htm and www.unaids.org.

See also “Straight outta India” (Student BMJ 2005;13:259, http://student.bmj.com/issues/05/06/life/259.php).

Balaji Ravichandran student University of Cambridge
balaji.ravichandran@gmail.com
Student BMJ 2008;16:425468-ISSN 0966-6494 | December

   

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