More ways to change...Same sex relationships and stigma

During the first plenary of the conference, Anandi Yuvaraj, from the Programme for Appropriate Technology in Health (PATH) in India, described the discrimination she personally faced from relatives - and also how she and her close family were able to shift their attitudes by showing open acceptance of her HIV status.

Stigma and discrimination was also the highlight of one of the following sessions, which focused on consulting community when addressing the needs of men who have sex with men (MSM) in China. Mr Xu Jie outlined some of the ways in which the government in China is now partnering with the MSM community. This is in stark contrast to a few years ago when the government did not even mention MSM. According to Edmund Settle, from UNDP in China, the government now sees the MSM community as a partner in AIDS programmes. This has led to increased funding for MSM groups at both the national and local levels.

In a presentation from Japan in the same session, Jane Koerner described the situation for young MSM in central Japan, where homosexuality is largely invisible in society - as a result, MSM groups in the country have not been mobilized and funds are in short supply.

As part of the discussion, the question arose of whether reducing stigma is the government or civil society's responsibility. Jan W De Lind, from UNESCO in Bangkok argued that society follows policy.

"If there is a legal policy in place then the society is expected to abide by it," de Lind commented. "Policy-makers should follow evidence; there is good data available now about the rising HIV rates in the MSM communities. Collaborating with MSM communities is a good way forward."

Participants had an active discussion, stressing that public health researchers should play a stronger role in pushing the government towards framing policies to reduce stigma and discrimination.

Ms Revati Chawla, the Sri Lankan co-chair, remarked that leadership at the community and government levels plays an important role in reducing stigma and discrimination. The other co-chair, Mr Aditya Bandyopadhyay from India, highlighted that same sex discriminating laws exist in India, Pakistan, Sri Lanka, Bangladesh, Malaysia and Nepal.

"Legal reforms should be the first step," he commented.

Some of the participants agreed that if international pressure on governments in these countries to reform the laws would be helpful. Collective measures across countries could play an important role in ensuring that governments repeal laws that discriminate and block interventions for HIV prevention work among same-sex communities.

Representatives from the MSM group Bandhu, from Bangladesh, argued that HIV is a good background to start mobilizing work with the MSM communities and partnering with governments. Even in India, which is in the process of drafting the anti-discrimination law, it is being suggested that the idea of a 'safe-area' of working with MSM groups as part of HIV prevention work is being accepted has been identified as part of the way forward.

Ishdeep Kohli-CNS