Instead of instilling confidence, the United Nations global conference on AIDS was an unwelcome reminder that, in the third decade of the pandemic, much of the world still lives in deep denial about a disease that has killed 22 million people and continues to ravage sub-Saharan Africa. When a score of Roman Catholic and Islamic countries objected to the benign designation of gays and prostitutes as populations vulnerable to HIV in the summit's draft declaration, the language was modified. At one point, the U.N.'s General Assembly debated rancorously whether the International Gay and Lesbian Human Rights Commission should even be allowed to participate in an informal roundtable discussion on human rights and AIDS. In the end, the advocacy group was allowed to participate, but this pair of disputes serves as a stark reminder of the role homophobia continues to play in the spread of AIDS.
Six million people in South and Southeast Asia are infected with the virus, yet a Pakistani representative recently told the New York Blade, a gay newspaper, that gay transmission of AIDS is a nonissue in her homeland: "These kinds of things are not prevalent in Muslim countries," she said. " ... Pakistan is against this kind of relationship." That would be an understatement: Pakistan, according to a recent Amnesty International report, uses flogging to punish homosexuals. Education about AIDS and gays may stop at the Pakistani border, but the illness is not so discreet.
The United Nations' determination to address the global crisis is a good thing, and U.N. Secretary-General Kofi Annan is to be applauded for his efforts to sweep away the intertwined and seemingly intractable strains of denial and bigotry that sometimes seem to rival the virulence of the pandemic itself. "We cannot deal with AIDS by making moral judgments ... and still less by stigmatizing those who are infected," he chided delegates from 188 member nations. But Annan's candor only emphasizes the need for such a reprimand, for his statement reflects the reality that the U.N. has for too long placated countries that put their own citizens at risk in the name of morality.
Comments made recently by Wendy Fitzwilliam, the Goodwill Ambassador for UNAIDS, illustrate this attitude. Last year, in discussing the infection rates in her home country of Trinidad and Tobago--where 1% of the population has HIV, with boys age 15-19 infected at five times the rate of girls the same age--Fitzwilliam chastised Caribbean culture for "encourag[ing] our men to practice loose sexual behavior and disrespecting our women." When the mode of transmission is heterosexual sex, the infection rates of women, not men, skyrocket. Unless Fitzwilliam, a former Miss Universe, has pioneered a new scientific theory for the transmission of HIV, someone needs to explain to her that all these boys are not being infected by so few girls. "Telling the truth about sex is so scary for many of us," she concedes. No kidding.
The perception lingers that AIDS is--at least primarily--a gay disease in developed countries. Yet in undeveloped countries, AIDS is discussed almost exclusively in terms of the threat to heterosexuals, as if the fundamental rules of biology that govern human sexual behavior are turned away at the borders of poor nations.
I bought into the same mentality when I was asked by the United Nations Chronicle to write a piece to coincide with the summit entitled, "What the World and Its U.N. Can Do About the HIV/AIDS Crisis." I was ever so diplomatically discouraged from focusing on the gay perspective (I think my editor used the phrase, "select group"). I didn't think much of it: What did the U.N. need to do for gays, who have, since the epidemic's beginnings, established the best organized, most effective patient advocacy groups in medical history? To me, gay meant white and American, or at least Westernized. In my article, I instead discussed the devastation in Africa and the need for the widespread distribution of inexpensive generic drugs to combat AIDS.
I understand that the U.N. doesn't want to offend anyone. In fact, I had to soften my criticism of the Bush administration for not taking a stronger leadership role in the worldwide struggle to contain the illness. Now I see that mentioning gays in the context of AIDS would have been even more inflammatory to some of the delegates. Squeamishness about homosexuality and lack of AIDS education was exactly what caused the disease to spread in this country, and it is probably no coincidence that we began to control AIDS only when the Clinton administration removed the taboos against speaking out about AIDS and gay rights. Eric Sawyer, director of the HIV/AIDS Human Rights Project in New York, has stated that "moral views can get in the way of common sense." So can diplomacy.