Author’s Note: This is a completely neutral article with no value judgements attached. The term MSM was created by epidemiologists in the 90s to describe men who have sex with other men. This allowed them to study the spread of diseases among this particular subgroup without any sexual identities thrust upon them. MSMs can be gay, bi or straight and we are not bothered about sexual orientation. Please refrain from making any homophobic comments.
Due to the stigma attached to homosexuality, it has been hard to study the spread of diseases by intercourse between men. According to estimates, MSMs number could vary from 2% of the world’s male population to as high as 16%. Due to the stigma attached to homosexuality, there is no way to confirm this number. Recently the health ministry estimated that there could be four lakh MSMs in India and they are a high risk group and about 31000-41000 could be HIV positive. This makes MSMs (7%) the second highest HIV risk group after intravenous drug users (9.5%) and more at risk than female sex workers (4.5%).
Why MSMs are at a higher risk of contracting AIDS
When AIDS was discovered in the 80s, there were rumours that it was a disease that only affected MSMs and drug addicts. Though the rumours subsided, the fact remains that MSMs along with intravenous drug users are high-risk groups. This is because AIDS primarily spreads through the exchange of body fluids, which can occur during sexual intercourse, intravenous drug sharing, etc. Now the most common sexual practice among MSMs is anal sex. Anal sex is far more potent mode of transmitting HIV than vaginal or oral sex…
1. Anal Sex
- The anus presents an environment that is host to more micro-organisms than any other part of the body which leads to an increased chance of infection.
- Anal sex gives the body an increased potential for exchange of STDs because it can allow micro-organisms to enter either through the urethra or through small cuts, abrasions, etc. on the penis. Because of the added friction during penetration, the possibility of a condom breaking during anal sex is considerably higher than vaginal sex.
According to Wikipedia, these are the chances of contracting the HIV virus from an HIV positive person assuming protection is not used.
Receptive anal intercourse – 0.50%
Insertive anal intercourse – 0.065%
Receptive penile-vaginal intercourse – 0.10%
Insertive penile-vaginal intercourse – 0.05%
As we can clearly see, anal sex is 5 times more dangerous for the receptive partner than vaginal sex and 13 times more dangerous for the insertive partner.
2. Lack of use of condoms
Before AIDS became prevalent in the United States in the 80s, the condom was always seen as a contraceptive and not as a protection device against AIDS and other STDs. For this very reason, the condom has never been popular with MSMs because they never had to worry about unwanted pregnancies. Condoms remain the best bet against sexually transmitted diseases.
3. Stigma and lack of HIV/AIDS education
In most societies, AIDS education is aimed at heterosexuals. None of the AIDS-HIV educational teaching aids specifically looks to educate MSMs. These have a tendency to skirt over anal sex. Also as a nation because of our Victorian English attitude towards sex, we haven’t really had any sex education to speak of. Personally, all I remember about AIDS/sex education is a very nervous teacher with some charts who would hastily mumble some things as if trying to get it over with as soon as possible. It’s very inadequate and there is a need to educate people. HIV-AIDS has enough stigmas attached to it. The stigma attached to HIV positive MSMs isn’t just exclusive to India. When AIDS was first discovered in the 80s in the US it was believed to be a disease that affected homosexuals and drug addicts, people who ‘deserved’ it. It wasn’t until Magic Johnson, Freddie Mercury, Ryan White, Robert Reed and other high profile heterosexual people revealed that they had AIDS did the public’s perception change about the disease.Myths still persist about the disease and MSMs. This has made it very hard to reach out to that particular demographic whether it be to provide sex education or to provide services vital for HIV positive people.
Prevention and precautionary measures for MSMs
1. Always use a condom for anal sex. Even though a condom provides less protection than say vaginal sex it decreases the transmission risk. In addition, lubricants should be used to reduce friction, which will decrease the chance of the condom breaking. However one is advised to use water-based lubricants with latex condoms as oil-based ones may dissolve the latex and make them porous. An oil-based condom can be used with polyurethane condoms.
2. Avoid high-risk behaviour (casual sex or sex with strangers). It’s always a good idea to avoid sexual intercourse with people you don’t know. However, there may be circumstances when you do decide to have sex so it’s a good idea to always have condoms.
3. We need to reach out to all sections of society to promote safer sex. It’s necessary to educate people about safer sexual methods and that includes all forms of sex.
We have created a delusional bubble where we are simply not prepared to accept that people might be gay or not ‘normal’ or indulge in casual sex. The fact is we need to prepare them and educate people about AIDS, gay or straight.
No comments:
Post a Comment