Re: Twenty pc of Mumbai's gay men are HIV+. Humsafar

[Guest guest]

Hello to the Forum and congratulations to Humsafar Trust:

It is so good to see some qualitative and quantitative research in the areas

of sexual health and safety.

It is also commendable that one of the largest and longest serving rights

organisations, the Humsafar Trust, is being accorded some recognition for

the work in ensuring that all sexually active indians are represented where

health and safety is concerned.

What appalled me was the quote by Dr Farid Karmali in the report and I

include it here in isolation from the rest of the blurb -

However, Farid Karmali, a doctor who's been involved in treating HIV

patients, disagrees with the survey.

" I don't agree with it. If this was true, we would have seen a huge

number of gay men getting sick and dying. I haven't come across any

gay men with AIDS, " he said.

I am appalled because the good doctor is still using AIDS principles that

date back to the early 1990's and someone should give him a new AIDS

treatment manual and update his public speaker training skills which sound

very much like homophobic reaction to the possibility that gay sexually

active men might be more competent at managing their sexual health . (Which

of course they are with very little help from organised medicine in India)

I am glad he is not my doctor because if I was HIV+ I would hate to be seen

by a doctor who still thinks that people who become HIV+ will get AIDS and

will die prematurely. I am also sure that if a gay man just happened to have

to use Dr Karmali's clinic he is hardly likely to let on about his

orientation so maybe Dr Karmali just hasn't recognised the ones he might

have seen.

All the HIV+ve gay men who live in Mumbai, that I know personally, live well

with the virus and enjoy life like the rest of us and so they should.

In fact everyone who is unfortunate enough to contract the virus and who

gets to know their status before their immune system becomes too damaged

should never become a statistic in the manner in which Dr Karmali thinks is

the natural progression.

I am becoming very stressed when I hear Doctors of medicine making such

misleading and potentially stigmatising statements. It is a bit like the

eminent Indian doctor who served in the Centre for Disease Control in

Altlanta USA saying in an oration in Chandigarh earlier this year, that

fungal disease can shorten the life of a HIV+ve person from the 2 year life

expectancy to only one year.

That is just so much nonsense from a treatment perspective in the years

since 1996.

I do have an interest in the seeming emphasis on the study that appears to

be suggesting that oral sex might contribute to HIV infection if it happens

without a condom. I would want to tease that out a bit from the study

organisers because from a global epidemiological viewpoint the connection is

just not there in statistical numbers. I certainly teach that the risk or

contracting HIV from unprotected oral sex between persons with otherwise

healthy oral status is between very low and no risk. That is of course not

to say that oral sex, unprotected, can't lead to infection from other

bacterial or viral conditions, but early detection and treatment will not

produce the potentially life threatening consequences of HIV infection.

Again may I congratulate the Humsafar Trust and the survey participants for

their frankness and honesty in assisting the understanding of sexual

behaviours and experiences that probably well reflect on the behaviours of

all the 100 million same or both sex atttracted Indians in the population at

large. Visibility is just so important to first, tolerance, and then

eventually, acceptance. India is well on the way, despite the protests of

decreasing numbers of influential detractors who are being dragged kicking

and screaming into the twenty first century and may I label one such problem

as the editorial staff of the Statesman Newspaper group in Calcutta who

continually approve for print the most outrageously vilifying comments about

same sex attracted members of their readership.

Geoffrey

E-mail: <gheaviside@...>

[Guest guest]

Dear Friends,

We would like to make certain clarifications in the report by Shibu in

the article of the findings of the Humsafar Trust in the MSM sector.

The research project titled 'A study on HIV risk related behavior of MSM: Review

of four years of program interventions by Humsafar Trust' did not study the

prevalence of HIV in Mumbai as reported in Mid-Day yesterday.

The study itself is the the impact of our work in the gay and MSM communities in

Mumbai. The indicators were

1) Amount of anal sex.

2) Consistent condom use in receptive/insertive anal sex.

3) Number of casual irregular partners in the last one month

4) Self-Reported health-seeking behavior.

This coupled with an assessment of knowledge of HIV/AIDS, awareness levels of

the population and socio-economic/cultural demographics of the MSM sector formed

part of the study.

The Humsafar Trust's VCCTC is also a sentinel survellence site for National AIDS

Control Organisation ( NACO ) in West India since July 1999. This entails

clinically testing a sample of a randomised three months intake of MSM into the

clinic according to the NACO protocol. The prevalence as determined by NACO

findings since the last four years has now stabilised around 20 per cent, which

is what was quoted by Shibu in Mid-Day.

We definitely respect Dr.Farid Karmali and his work but are a little concerned

about his quote in Mid-Day " I don't agree with it. If this was true, we would

have seen a huge number of gay men getting sick and dying. I haven't come across

any gay men with AIDS, " We would like to contact him and present him NACO

findings on prevalence amongst MSM in Mumbai.

Also there is serious concern about remarks made by a homosexual named Mr.

Vikram: " I am glad they are doing this (survey) in Mumbai. But the figures might

be deceptive because they are testing a high-risk group within the community. "

It is an accepted fact world wide that MSM are a high risk population. We fail

to understand what is meant by " high risk group within the community " Such

irresponsible statements can mislead the community into believing that Mr.

Vikram and his class of friends are safe !

Ashok Row Kavi

Vivek Anand

E-mail:[humsafar@...]

[Guest guest]

Re: Geofrey's comments on twenty pc of Mumbai's gay men are HIV+. Humsafar

Thank you very much for your comments. It is a bit puzzling to read Dr.Farid

Karmali's statements because we count him as a very closewell-wisher and friend.

Of course, Karmali's practice is down-town in the richer part of Mumbai where

prices start at R.s 10 million and above for a pokey little flat.

Also, Dr.Karmali is a thoracic specialist who does see HIV/AIDS patients and I'm

sure he must be seeing HIV clients at the GT Hospital where he is an honorary (I

think).

The problem is that doctors like Dr.Karmali see AIDS patients and not MSM

patients. The stigma of being both is too much in India where same-sex attracted

persons find it easier to be classified as HIV positive than being MSM -- with

the consequence that they hide their sexuality under a ton of stigma and

discrimination.

This is what happened when there was a note on an e list recently where they

mourned the death of one of their office beaers and passed on their condolences

to his wife and child, knowing full well that it automatically stigmatised the

wife as being possibly infected too, besides being married to a MSM.

When this was pointed out, what we got was a series of abusive mails. In the

'SAATHII' directory, one group claims " All our outreach workers are HIV

positive " , which is shocking on part of the directory's editors.

Obviously, a lot of learning still needs to be done here and it's not just

community workers but doctors who need to get out of their shells. To avoid all

that acrimony and needless argumentative agony, we've decided to just go ahead

and work quietly. There is no antidote to good old tough community work.

To all those who have sent in requests for our report (we've received over a 100

such requests), I seek a little patience as the soft copies are being compiled

for sending onwards.

Ashok Row Kavi/ Mumbai

E-mail: <arowkavi@...>