Criminalisation

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• Criminalisation Human Rights MSM
• Warren Lindberg
• Ministry of Health
• New Zealand

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Limitation of rights of the individual out of
respect for the rights of others

• In the exercise of his rights and freedoms,
  everyone shall be subject only to such
  limitations as are determined solely for the
  purpose of securing due recognition and respect
  for the rights and freedoms of others and of
  meeting the just requirements of morality, public
  order and the general welfare in a democratic
  society (Article 29 UDHR)

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morality, public order and the general welfare in
a democratic society

• laws penalising infection of others
• laws penalising socially disapproved behaviours
• sex between men
• discrimination against MSM

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Men who have sex with men

• Sexual behaviour
• anal sex
• Sexual orientation
• sexual attraction
• Sexual identity
• Gay
• Faafafine/Fakaleiti
• Takatapui

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Levels of male to male sex

• Self identification as homosexual (China 2)
• Self identification as bisexual (China 7)
• Ever had male-male sex (Hong Kong 4.6 India
  truck-drivers 15 Bangladesh rickshaw pullers
  22 Pakistan truckdrivers 49)
• Ever had unprotected male-male sex
• (rural India 3 married men 10 single men)
• Ever had sex with both men and women
• (Philippines 12)

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Can we be sure?

• Dakar, Senegal - of 88 of MSM also reported
  vaginal sex, and 20 reported anal sex with a
  woman
• China - half of MSM reported sex with a woman and
  one third were married
• Eastern Europe one third of men in gay venues
  reported having both male and female partners

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Percentage of Adult HIV Prevalence Attributable
to MSM in Some African Cities

• In low HIV prevalence countries, MSM epidemics
  can contribute substantially to adult HIV
  prevalence
• For example, Dakar, Senegal
• Estimate that 3 of men engage in male-to-male
  sex
• HIV prevalence in MSM is 21.5
• Adult HIV prevalence is 0.9
• Percentage of Adult HIV Prevalence Attributable
  to MSM
• (0.03/2)21.5/0.9 35.8

(Brown, personal communication, 2006)
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MSM in society

• socially disapproved behaviour
• stigma
• secret, anonymous sex
• silence about risks
• consequences of disclosure
• punishment
• discrimination
• Isolation
• characteristics of a hidden minority
• shame
• passing
• inability to contribute to society
• misunderstanding in rest of society

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Consequences of criminalisation

• hard to reach with information about
  risky/healthy behaviour
• hard to obtain accurate information about
  risky/healthy behaviour
• increase in risky behaviour
• increase in epidemic

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Consequences of social inclusion

• easy to reach with information about
  risky/healthy behaviour
• easy to obtain accurate information about
  risky/healthy behaviour
• decrease in risky behaviour
• decrease in epidemic