HIV & AIDS in Sri Lanka Journey to Equal Grounds LGBTIQ community faces many challenges

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By 2018-01-14

By Kaushi Sendanayaka

Sri Lanka's record of a low prevalence of people living with either Human Immunodeficiency Virus (HIV) or full-blown Acquired Immune Deficiency Syndrome (AIDS) is being maintained but experts warn that negative attitudes towards people falling within the LGBTIQ (Lesbian, Gay, Bisexual, Transgender, Intersex and Questioning) spectrum remain and that it hinders programmes to help patients.

According to the 2016 UNAIDS HIV and AIDS estimates, Sri Lanka's prevalence of HIV is at 0.1% with
4,000 adults over 15 years of age living with HIV. This compares well with our giant neighbour India which has a prevalence of 0.3%.

The global HIV epidemic has always been closely linked with negative attitudes towards LGBTIQ people, especially men who have sex with men, a group that is particularly affected by HIV and AIDS. The search for the real reasons behind these misconceived notions is much needed in order to demystify the issue.

Prevalence

A recent survey done by the National STD/AIDS Control Programme (NSACP) reveals that nearly half of all males reported with HIV have a history of male to male sexual contacts. Most of these men are married and added the risk of spousal transmission and mother to child transmission of HIV. Moreover, the UNAIDS factsheets of 2016 reports a total of 7, 551 men who have sex with men and the HIV prevalence among these groups 1.5%. According to the 2014 IBBS Survey only 47% reported regular use of condoms as protection.

Speaking to Ceylon Today, Dr. Sisira Liyanage, Director of NSACP, said that men who have sex with men are one of the main categories among HIV risk groups. Other high risk groups are female sex workers, intravenous drug users, beach boys and prisoners. Moreover, the NSACP Annual Report for 2016 states that a total of 249 HIV cases were newly reported during 2016 in Sri Lanka and all three districts in the Western Province and Galle District reported higher numbers than other areas in the island.

NSACP engages in the prevention, control and provision of services for sexually transmitted infections (STI) including HIV. They conduct various tests and screenings in order to detect HIV among the community. Moreover, the Antiretroviral Therapy (ART), available only at NSACP prevents the growth of the HIV virus by preventing its replication.

As Dr. Liyanage pointed out most LGBTIQ groups are accessible since they gather and meet in public places such as hotspots, clubs, guesthouses etc, but there remains a group of people who meet discreetly for instance via websites, who haven't been reached yet by outreach workers handling AIDS prevention programmes.

Disputing assertions

The best practice he said was for people to use condoms and stick to one partner. He also said that the lack of sex education in schools is not to be blamed for people being unaware as everyone is now part of the digital world and knowledge is an open source available to all, but encouraged schools to discuss the topic openly. He also said that the subject should be discussed with
parents. He also proposed a sex education paper to be provided to students in their local curriculum.

Rosanna Flamer-Caldera, a leading LGBTIQ activist disputes Dr. Liyanage's assertions calling them grossly inaccurate. Flamer-Caldera who is Executive Director of Equal Ground, the only non-profit organization advocating LGBTIQ rights in Sri Lanka, told Ceylon Today that only 15% of those diagnosed with HIV/AIDS are identified as belonging to the LGBTIQ community.

She said 85% of those living with the disease are heterosexuals. Flamer-Caldera said that it is erroneous to point a finger only at gay men for spreading diseases and questioned as to why women are less doubted. She also said that the term 'MSM' (Men having Sex with Men) was derogatory and discriminatory to homosexual men. Moreover, based on a study done by Equal Ground in four districts; Colombo, Kandy, Nuwara Eliya and Matara, it was found that 19.6% of the population in these areas belong to the LGBTIQ community which in turn means that 6 - 10% of Sri Lanka's population are members of this community.

When asked about reasons behind these miscalculations Flamer-Caldera said the social stigma attached to these people, discrimination they suffer and criminalization of LGBTIQ people have driven them underground and therefore they do not come forward for any surveys or studies that are conducted.

Conservative thinking

Flamer-Caldera proposes decriminalization of LGBTIQ people and the adoption of non-discriminatory policies where certain services be made available to this community. She also proposed the establishment of a bureau, one similar to the Ministry of Women and Child Affairs, for LGBTIQ people to forward any complaints or harassments faced in their day to day lives.

Yet, despite these statistics, the social stigma and discrimination towards people living with HIV has always been on the rise and it is even more traumatic to be a person from the LGBTIQ community. This arises most probably due to lack of awareness and education regarding issues pertaining to HIV, sex, gender identity and sexual orientation being confined to a 20th century conservative thinking frame. According to Denning LJ (as he was then) in the United Kingdom case of Roe v Minister of Health [1954], "We must not look at the 1947 incident with 1954 spectacles." Similarly, the issue at hand should be looked at without any pre conceived notions and institutional biases.

Status Quo

While LGBTIQ rights have made progress over the last decade in some countries by legalizing same-sex marriages and identifying discrimination against gender and sexual orientation, most countries still continue to criminalize same-sex marriages. LGBTIQ is recognized as a taboo in our society and most people question its legality and thus consider it to be unnatural, marginalizing this community. Therefore, the LGBTIQ community is constantly struggling for their civil rights in Parliament, courts and on the streets.

In Sri Lanka, Article 12 of the 1978 Sri Lanka Constitution , the provision of equality, recognizes non-discrimination based on the grounds of race, religion, language, caste, sex, political opinion, place of birth or any one of such grounds as a Fundamental Right. This measure protects persons from stigmatization and discrimination on the basis of sexual orientation and gender identities.

Homosexuality is illegal in Sri Lanka, with up to 10 years of prison for 'carnal knowledge' against the order of nature. Article 365A of the Penal Code prohibits anyone, irrespective of gender, from engaging in 'gross indecency,' which is not explicitly defined.

The Penal Code of Sri Lanka, which was enacted in 1883, made sex between men an offence. Both Sri Lanka and India were colonies of Britain, so it is clear that the Sri Lankan Code is also based on British criminal laws as they were then. The existence of lesbianism was not even acknowledged by the 1883 Penal Code.

Universal Periodic Review

Needless to say, Britain has moved on, and Australia and Canada, both former colonies have legalised same-sex unions.

The Sri Lankan government received seven specific recommendations on 15 November 2017 where the UN reviewed Sri Lanka's record on human rights as part of the country's third Universal Periodic Review (UPR) under the Human Rights Council and advised amending sections 365 and 365A of the Penal Code, which targets LGBTIQ people in consensual, adult relationships.

Despite this, LGBTIQ people living in Sri Lanka still continue to face discrimination and harassment. Many are abused physically and mentally within their own family, bullied at school and arbitrarily arrested by the Police.

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