With talk of sex in Indian society taboo, male to male sexuality is hardly recognised in HIV research and policy-making. And yet, the country's male homosexual population is estimated at a considerable 50 million. Keya Acharya assesses the implications of this situation
India's community of men who have sex with men is eagerly awaiting a Delhi High Court judgement on a December 2001 petition to decriminalise homosexual behaviour.
The petition, filed by the Lawyers' Collective on behalf of the Delhi-based nongovernmental group Naz Foundation Trust, wants the government to repeal Section 377 of the Indian Penal Code, which it says is a "major impediment" in carrying out HIV/AIDS work among men who have sex with men (MSM).
It has asked that the section cover only child sexual assault and exclude consensual sexual activities between adults.
But even while this case awaits a decision, some experts doubt that repeal in the law will improve the country's approach to HIV/AIDS prevention among MSMs.
Researchers at the universities of Plymouth, Britain, and Amsterdam, The Netherlands, say that because talk of sex itself is taboo in Indian society, male to male sexuality is hardly recognised in HIV research and policy-making.
The country's male homosexual population is estimated at a considerable 50 million by the Mumbai-based Hamsafar Trust. Criminalised under Section 377 and pressurised by mainstream family culture to marry, many seek out same-sex partners in an undercover world.
What makes HIV prevention among MSMs harder still is the lack of a single gay identity in India, says Sheena Asthana of Plymouth University. The researchers identified several categories of men who have sex with men. According to Asthana, "very few of these men would even identify themselves as 'gay'."
The groups include:
- hijras, men who may or may not be emasculated and who dress permanently as women;
- kothis, who have overtly feminine traits; and
- panthis, the kothi's partner. Theoretically identified as the overtly masculine sexual partner, he could be a father, brother or son who considers himself to be 'straight'.
The implications of HIV spreading to wives and unborn children through their panthi husbands is worrying.
"These patterns are important for both the transmission of HIV and its prevention," says Asthana.
In the West, in part because of the development and acceptance of a positive 'gay' identity, homosexual activity has become more narrowly defined. Gay men tend to have sex with other gay men and there has been a drop in the numbers of men who have sex with other men who are also involved in heterosexual relationships.
"In India, by contrast, panthis provide a bridge between heterosexual and homosexual circuits and a high level of bisexual activity tends to facilitate the rapid spread of HIV," adds Asthana.
In a cramped office that doubles as a medical clinic-cum-lunchroom in a busy commercial street in the southern city of Bangalore, a group of young MSMs meet to share their experiences.
Trained by the NGO Jagruti to disseminate sexual health information and condoms in Bangalore's cruising areas - parks, movie theatres and public toilets - they say that most clients are panthis. They also say that less than 50 per cent of practising sex workers use condoms for fear of losing their clients.
The relief of being able to open up and talk about their almost-surreal daily existence is palpable among the group.
"You keep your condom ready in your hand inside your pocket while you tell your client to go into the bushes for secrecy. Then you quickly tear the wrapper, cover your mouth as though coughing and place the condom on your tongue like an inverted foot-sock, ready for the penis," demonstrates a field-staffer, who did not want his name divulged.
According to the government agency National AIDS Control Organisation (NACO), there are 3.8 million cases of HIV in India. But the government seems to be ignoring the MSM issue.
India's national message on safe sex does not highlight same-sex behaviour. As a result the majority, including most MSMs, think that heterosexual and multiple partner behaviour are the only cause of the spread of HIV.
Condom-usage appears to be the government's main 'field tool' in its AIDS control programme. But condoms distributed by each state's AIDS department are usually unsuitable for oral and anal sex, and most cash-strapped NGOs are hard put to buy and distribute other kinds of condoms.
The government policy also promotes monogamy, saying people should be faithful to one partner.
This has made it difficult for women to negotiate safer-sex options in India's male-dominated society. If one partner asks the other to use a condom, the former stands accused of suspecting the other of infidelity, says Elavarthi Manohar of Bangalore-based sexual-minority organisation Sangama.
Dr Venkatesan Chakrapani, co-ordinator of the Chennai-based Solidarity & Action Against The HIV Infection In India, a countrywide network of NGOs, warns against targeting MSMs as a separate group. Homosexual behaviour also happens in non-MSM groups such as truckers, drug-users and prison inmates, he says. "Acknowledging this and providing common prevention messages such as safer-sex in same-sex behaviour is a possible solution."
There is some evidence that same sex behaviour occurs among the police as well. Commercial sex workers complain that policemen use rounded-up suspects for sex. Police have also used Section 377 to arrest NGO workers and refuse them bail.
If the Naz Foundation Trust petition cannot change India's social mindset, it may at least stop such misdemeanours by the police - it specifically asks that Section 377 should not be misused by the police.
(This feature is a specialist strand of Panos Features that critically assesses the latest international development research)