Cultural mainstreaming in Thailand leaves MSM at high HIV risk

Via PlusNews.

Gay rights activists in Thailand say a unique combination of muted discrimination and cultural mainstreaming of the gay and transgender community is to blame for a dangerous lack of knowledge about HIV among gay and transgender persons, especially the youth.

"There are no discrimination laws here against gay people, so a young gay Thai may feel like, 'My life is free, I can do anything I want,' when in reality, most gay people here live a double life, both with a straight male identity and with a gay identity," said Narupon Duangwises, a cultural anthropologist who works as a consultant with Bangkok Rainbow, an NGO that supports the gay community.

Teenagers who identify as gay and transgender seamlessly blend with Bangkok's mainstream youth culture, spending their days at the city's popular, glitzy malls. At home, however, many find entertainment on the video chat service CamFrog, which they use to meet other young gay Thais, and sometimes as a platform to sell or buy sexual services.

"Young people cannot go to bars, so they go on CamFrog. They don't know about HIV, because they don't learn [about it] in school," Nikorn Arthit, president of Bangkok Rainbow, which has begun an online HIV-educational campaign through CamFrog. "They are excited to be meeting people but they don't know how to protect themselves."

CamFrog says it has more than 30 million users, mainly in Asia.

Duangwises expressed concern that not enough was being done to address the HIV needs of young gay people. "The gay organizations don't know what has happened with this health situation. The community is not well organized," he said. "We think HIV infections may be much higher than we realize. We need to instil a sense of social responsibility among gay Thais. We can't just be passing out condoms."

Thai health workers say a similar lack of knowledge is also caused by the disparity between the levels of HIV programming for male and female sex workers. According to Noi Apisuk, director of the Empower Foundation, an NGO for sex workers, Bangkok's female sex workers know all about safe sex and can always find multiple sizes of condoms at Empower’s office.

Nicha Jitjang, programme officer for the male and transgender sex worker rights' group Service Workers In Group, or SWING, estimates that most seasoned male and transgender sex workers know to use a condom when engaging in sexual activity, but the same cannot be said for newbies.

Her colleague, Nanokporn Sukprasert, a transgender former sex worker, remembers first learning about HIV two or three years after she began working at a bar.

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More Teen Virgins? Not So Fast

Via RHrealitycheck.org, by Martha Kempner

In 2006–2008, 29 percent of females and 27 percent of males ages 15 to 24 reported that they had never had sexual contact with another person. This was a small but statistically significant change from 2002 when it was 22 percent for both males and females.

Many teens are making responsible decisions when it comes to their sexual behavior; they delay sex, have fewer partners, and use contraception. And yet, we adults give them so little credit for behaving, in many ways, better than us.

AND THE SURVEY SAYS…

Traditionally, when thinking about sex and surveying individuals about their behavior, we have concentrated on penile-vaginal intercourse. This focus makes some sense from a public health perspective as it is the only behavior that can lead to both pregnancy and STDs. That said, other behaviors certainly carry a risk of STDs, and, the focus on vaginal sex by nature excludes all same-sex behavior. Still, I sense that the primary reason for this focus is something different—a societal understanding (however, inaccurate, incomplete, and exclusionary) that only penile-vaginal sex is sex.

There are lots of different theories about why the percentages of young people who had vaginal intercourse dropped during those years. Some argue that this is when teens started becoming highly aware of the risk of HIV and that a life-threatening STD was a game changer for teenagers.

Others credit sexuality education while still others undoubtedly credit abstinence-only-until-marriage programs. One mother of a teenager jokingly argued it was all because of video games, "if teens are really logging 30 hours a week of screen time, when would they possibly have time to have sex?" We may never really know but it is worth trying to understand as the numbers seem to have leveled out in recent years.


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African Girls Getting World Bank Cash Deters Sex With 'Sugar Daddies'

Via Bloomberg, by Simon Clark

Young women in sub-Saharan Africa have HIV infection rates up to three times higher than their male peers, largely because of relationships with older "sugar daddies" who give them money in exchange for sex.

The phenomenon contributes significantly to HIV's spread, said Ester Etkin of loveLife, South Africa's largest anti-AIDS group.

A World Bank study in Malawi examined cash incentives among approximately 3,800 females ages 13-22. One group received roughly $10 a month and payment for school fees if they regularly attended class, while the control received no incentives. HIV infection rates at 18-month follow-up were 60 percent lower among girls who were given cash: 1.2 percent, compared with 3 percent. The study also showed a delay in the start of sexual activity among beneficiaries and a decline in the number of partners among those who were sexually active.

Though the study's results are being assessed by a peer-reviewed journal, plans are underway to repeat the experiment elsewhere in Africa, said Mayra Buvinic, director of gender and development at the World Bank. "The potential could be huge to reduce HIV rates in teenage girls," she said.

But some experts question whether cash payouts are an appropriate strategy. "We could end up creating an environment of dependency that cannot be sustained," warned Peter Lamptey, a Family Health International physician practicing in Ghana. "Paying people to influence their sexual behavior won't solve the wider problems of abuse, esteem, neglect and inequality that cause them to get HIV," said Sophie Harman, a senior lecturer at London's City University who has studied World Bank AIDS policies.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]