Select Committee on International Development Written Evidence


Memorandum submitted by Shivananda Khan, Executive Director, Naz Foundation International

  In all the prevention activities that are being developed regarding the spread of HIV/AIDS and STIs in South Asia, very little effort is being made in regard to male to male sexual behaviours. While DFID has supported Naz Foundation International in a range of activities that reflect concerns in this area, MSM issues and needs have not been an integral part of strategy development.

  Recently a series of situational assessments have been conducted in India by NFI, in the cities of Hyderabad, Bangalore, Pondicherry (all in India) and in Sylhet, Bangladesh. These assessments (as well as those previously conducted in Lucknow, Delhi, Madras and Calcutta) indicate a significant proportion of male to male sexual behaviours, high rates of anal sex, gendered patterns of sex encounters, low condom use, significant rates of STIs, low levels of treatment, high rates of partner exchange, no access to appropriate condoms of water-based lubricant, high degree of stigmatisation and social exclusion . . . DFID have received several reports regarding these issues over the past few years from NFI, but as yet, there seems little in terms of the broader dissemination amongst DFID programmes and initiatives.

  It is very clear that MSM activities are not an inclusive activity of a small number of middle class "gay"—identified men, but spread across the social spectrum, including amongst those from low income and marginalised groups of men. Further, because of the social dynamics of South Asia, most MSM will be married or become married, and because of the social construction of MSM behaviours, many MSM will also have sex with female sex workers . . . please refer to the numbers reports that NFI has forwarded to DFID, as well as our quarterly newsletter Pukaar.

  It is essential that any strategy developed to prevent the spread of STI/HIV/AIDS in South Asia must include issues relating to (a) anal sex as a behaviour that has a significant presence in the sexual repertoire of many South Asian males, as well as those amongst MSM with a significant risk, such as male sex workers, and feminised males (called kothis indigenously) who are regularly anally penetrated through multiple partners. The risk of this network of males acting as a "core group" which enables the spread of HIV both within and without is significant enough to demand attention.

  While very little high quality research has been done on this issue, NFI has developed an extensive knowledge, as well as a range of situational assessments that verify this conclusion.

  I would suggest that DFID would conduct a literature review both internally and externally on this issue . . . since it has received extensive documentation from Naz foundation International, and that the evidence garnered should be included in any strategic development for South Asia in terms of preventing the spread of HIV/AIDS and STIs.

Shivananda Khan,

Executive Director, Naz Foundation International

September 2000

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