The British Parliament announced last week that it would posthumously pardon individuals convicted of homosexual offences that are now deemed legal. Known throughout history as sodomy, buggery, or the abominable crime, Britain punished individuals who engaged in sexual acts not key in reproduction – or involving an animal – by imprisonment or death. Homosexual acts in England and Wales were decriminalized between consenting adults over 21 in 1967, as well as in Scotland and Northern Ireland in 1980 and 1982, respectively .
Homosexuality, as well as a wide spectrum of other sexual and gender expressions, have been a part of countless cultures for thousands of years. Several African languages have pre-colonial terms to describe homosexual activities and relationships. Even prehistoric rock paintings in Zimbabwe depict two men engaging in anal sex. In China, same-sex relationships were tolerated and prevalent among scholars and those of a higher class to denote power and wealth . Known as “two-spirit” or “berdache,” native people of the Americas were intersex, androgynous, and homosexual individuals who were accepted as part of society. In some instances, these individuals were married, served as caretakers to family members, and held rank as spiritual leaders and teachers . In some cultures, homosexual relationships were viewed as a mechanism to pass power between generations.
This inclusive worldview, expressed in various ways around the globe, changed dramatically when Europeans set foot on distant shores. Along with Christianity and communicable diseases, British imperialism left homophobia in its wake (only 22 countries have not at one time in their history been under the sovereignty of the British Empire ). Compared to other European colonizers, former British colonies are significantly more likely to have current laws against homosexual activities . A report found that 70% of countries that were once in British possession still criminalize homosexual acts, even when controlling for such factors as religiosity, modernity, and wealth.
Homophobia has led many countries to severely persecute its citizens who engage in same-sex sexual activity. In the Gambia, acts of homosexuality and HIV infection can be grounds for life imprisonment . Nigeria’s anti-gay laws make promotion of homosexuality a punishable offense with a sentence of 10 years’ imprisonment. This law is also used to punish public health workers and people who fail to inform on acquaintances and neighbors.
In Jamaica, mounting violence against homosexuals and LGBT organizations have led to the gruesome murders of activists. In the United States, anti-sodomy laws have been used to routinely deny civil liberties such as the right to marry, raise children, and job security. Today, in 9 U.S. states, discussion of homosexuality in schools is explicitly banned in sex education unless described as a route for sexually transmitted infections.
In addition to perpetuating human rights violations and encouraging discrimination and violence, deeply entrenched homophobia impedes HIV prevention efforts, further marginalizing one of the groups at highest risk for infection: MSM, or men who have sex with men.
The term “MSM” has been used in public health literature to describe this sexual minority in the hopes of reducing stigma related to HIV infection and men who engage in homosexual behaviors.
Men who have sex with men (MSM) is a term introduced in 1992 to attempt to capture a range of male–male sexual behaviours and avoid characterisation of the men engaging in these behaviours by sexual orientation (homosexual, bisexual, heterosexual, or gay) or gender identity (male, female, transgender, queer).1 MSM includes gay-identified men, heterosexually identified men who have sex with men, bisexual men, male sex workers who can have any orientation, men engaging in these behaviours in all male settings, such as prisons, and the rich and wide array of traditional identities and terms for these men across cultures and subcultures .
In the United States, MSM, along with men who identify as gay or bisexual, account for 55% of those living with HIV, though they only represent 2% of the total population. Among the age group 13-24, men who have sex with men, make up nearly the total (92%) of new HIV infections.
A six-part series published in the Lancet finds that prevalence of HIV in MSM is growing around the globe, though data concerning this population is lacking across the board. A joint report by WHO, UNAIDS, UNFPA, and UNDP found that MSM sexual health needs in Eastern Europe and Central Asia are summarily ignored:
The current response to HIV among MSM communities and transgender people in the region is largely failing to provide a basis for Universal Access (UA) among this key population. The issue is either essentially ignored due to lack of sufficient data and analysis, or marginalized with little resource allocation within national HIV programmes. The list of barriers to prevention, care, treatment and support programmes includes, but is not limited to, human rights violations, stigma and discrimination, lack of effective national policies and sufficient government support, inadequate funding, lack of sustainability and continuity of project activities, as well as the lack of biological and behavioral research in the region to better “know your epidemic”.
An article published in the Psychology and AIDS Exchange Newsletter reports that discrimination, stress, and homophobia experienced by homosexuals is a driving force in behaviors that contribute to HIV transmission. Homophobia has otherwise been implicated with risk-seeking behaviors such as substance abuse, sexual promiscuity, self-harm, and suicide. Often rejected by family and community, MSM have trouble establishing monogamous relationships, which could decrease transmission .
In countries where homosexual relationships are punishable by imprisonment or even death, MSM are even harder to reach.
Punitive legal and social environments hinder the ability of gay men and other men who have sex with men to organize and participate meaningfully in the design and implementation of programmes to provide HIV-related services. This poses a concern for the HIV response—studies have demonstrated that the involvement of gay men and other men who have sex with men and transgender people in peer outreach and other community-level behavioural interventions can reduce HIV risk behaviours by up to 25%.
As the UK prepares to expunge the records of individuals, many of whom are deceased, is it perhaps a better use of time to address this issue impacting the living?