So I've read...

By Mon Mon Myat

RANGOON, June 3, 2010 (IPS) - The only son in his family, Maung Maung Oo was forced to marry when he was 24 years old. By then he had been carrying on a sexual relationship with a man for four years – which he continued even after his marriage.

For the next 14 years, Oo led a double life. But in 2005, he finally decided to be true to himself: He left his wife and three children for his male partner.

"My wife was so shocked when she learned of my affair with a man," says Oo. "But I can’t change how I feel though I have the body of a man."

Oo, however, is still living a life in the shadows. Although he and his partner are now living together, their relationship remains a secret to most people. "My partner does not want people to know we are living together as a couple," Oo explains. "He wants to pretend that we are brothers."

According to Ko Aye, who conducted a pioneering study on men who have sex with men (MSM) in Burma in 2003, stigma remains against people like Oo in this South-east Asian country of 48 million people. Yet while he says there is "not a very serious or strong reaction" against MSM, many MSM themselves apparently think there is a need to keep their "true identity" secret.

This has complicated efforts to limit, if not stop, the spread of HIV among MSM in the country. According to official data, HIV prevalence among MSM in Burma was 29.3 percent as of 2008, or 42 times higher than the national adult prevalence rate.

Men who have sex with men include both those who may not identify themselves as homosexual, and those who do and include those in sex work as well. Estimates by the Department of Health and the World Health Organisation put the MSM population in Burma, as of 2007, at 280,000.

Aye says that the stigma against MSM in general stems from "religious principle or traditional beliefs." This has led to people like well known make- up artist Soe Soe to believe that having relationships with men could not possibly be called "fortunate."

"We end up in this kind of life because of karma in the past," Soe Soe told IPS. "This is not what we choose to be."

It is a viewpoint that persists despite Aye’s observation of an improvement in the public attitude toward MSM. Thanks to the "development of information technology," Aye says, "people usually accept it" nowadays.

"For example," he says, "students may know a teacher is gay, but they accept him as a teacher."

There are also several prominent members of the entertainment and fashion sectors who are gay, whether they are out in the open or not, but enjoy public acclaim and respect.

Yet, for sure, it has not helped to reassure many that the government continues to portray homosexuality as "evil" or at the very least deserving of public scorn.

Just in February, the prominent ‘Bi-Weekly Eleven Journal’ ran an article quoting supposed medical experts as saying that homosexuality could lead to mental illness and sexual crimes.

Section 377 of the Penal Code also prohibits homosexuality, with penalties ranging from 10 years to life, plus fines. (A travel advisory by the British government says that in June 2007, an "EU national" was sentenced to seven years in prison in Burma for "committing homosexual acts.")

As a result, many MSM would rather keep their sexual preferences – and obviously their sexual lives – tightly under wraps. Chances are, too, they are reticent in seeking treatment even if they suspect that they already have HIV.

Soe Soe, for instance, says that he does not even "dare to join an MSM network."

In truth, despite the official condemnation of homosexuality, there are dozens of local MSM networks in major cities such as Rangoon and Mandalay, with local community-based organisations providing these with information and counselling services.

One of these networks is called ‘Golden Queen’, which has as members 45 MSM, including several who are living with HIV.

Unlike Soe Soe, Myo Tun, a sex worker who has an entirely male clientele, apparently thought nothing of becoming one of Golden Queen’s members. He says, "Whether society accepts us or not, we have already ended up in this life."

"We need to raise awareness among our fellow (MSM) as we are at high risk for HIV infection," he adds. "We often face problems of condom tearing. That could spread HIV easily."

Maung Maung Oo now knows this all too well. Two years ago, he discovered that an illness his partner was suffering from was actually one that comes with having AIDS. Not long after, he found out that he himself had it as well.

Unlike many other MSM in Burma, however, Oo and his partner did not hesitate in seeking treatment. They have since been regularly receiving anti- retroviral treatment from an international nongovernment organisation. Every six months, they also have their blood checked to monitor the number of white blood cells that fight infection and that helps indicate the stage of the disease in their system.

Oo says that when he first found out that his lover had HIV, "it was like a flame in my heart."

"If he dies," he says, "I think I’d also die soon after from depression."

And yet Oo says that he has found his life more meaningful than it was when he was still with his wife and children. "I believe there is real love between us," he says of his relationship with his partner. "Without that, how can we keep this relationship for 23 years?"

(END)

BY ZARIN HAMID, MAY 12, 2010

In recent weeks, a potential ban on polygamy to reduce the spread of HIV/AIDS has raised the ire and concern of many Malawians. While the law will not affect those already in polygamous marriages, it carries a five-year jail sentence for those who attempt to take multiple wives after its passing. Malawi is a country stricken with a 12% prevalence rate of HIV, with almost 1 million people living with HIV/AIDS. A recent BBC article reports that the Minister of Gender and Development, Patricia Kaliati, said the proposed ban is also intended to protect women from abuse in polygamous marriages, in which wives inevitably contend for attention and resources from their joint husband.

I'm away visiting my kids, folks, hence the long silence. Meanwhile so many things have been happening that I can't keep up to comment on them. Others have written some great comments on various issues that I don't think I can match them.

But one little personal event happened which I thought I would commemorate. In one way it's very sad and indeed I feel very bereft but on the other hand it's also possible to see what changed in our society because of one person.

Early this morning my friend LYL passed away. She wasn't anyone famous or wealthy or someone we would have thought was extraordinary. But to me she was special.

I met LYL around 1995. At that time I had just started working in HIV and was beginning to learn about all the issues involved with it. One of the main issues (and sadly still is) was stigma and discrimination. It was severe enough that there were doctors in private hospitals who refused to treat people with HIV and sent them off to government hospitals to be seen by the few over-burdened doctors there. At the time there was not a lot that even those doctors could do because there were hardly any treatments for anyone with HIV.

The plight of Malaysians living with HIV at the time was quite severe. Most lived in fear of society's judgment on them. They were afraid of applying for jobs or of losing what jobs they already had. Most felt there was no better fate for them than death. But elsewhere in the developed world, people with HIV were fighting stigma and prejudice and were beginning to find hope in the treatments that were becoming available there.

So my colleagues and I decided that we needed to make our case to the country's political leadership. So as President of the Malaysian AIDS Council I wrote a formal letter to the Prime Minister asking for an appointment.

And waited. And waited. Nine months later, we got a call. Nelson Mandela had cancelled his visit to Malaysia and a slot had opened up for us! It was to be a week later. (Perhaps Mandela, an HIV campaigner himself, somehow knew the appointment was really important to us.) So my colleagues including Dr Christopher Lee who is now the head Infectious Diseases doctor in the Ministry of Health, Professor Dr Sharifah Hapsah Shahabuddin (now Vice-Chancellor of UKM) and several others had meetings to prepare for our presentation.

We also made one important decision and that was to include a person with HIV in our group. That person was LYL.

LYL was a teacher whose fiance had died of an AIDS-related illness . It was only then that she found out about her own infection. Instead of retreating into depression, she decided that she would do what she could to educate others about HIV and to advocate for better treatment of people living with the virus. She often spoke at seminars and workshops, often using a different name.

When we went to meet the PM at his office at Parliament House, we had programmed our presentation so that LYL would speak last. I spoke about the general state of the epidemic and Dr. Lee spoke about the need for better medical treatment for people with HIV. After we were through, LYL got up nervously and started. "My name is LYL, I'm a teacher and I'm HIV-positive". I remember Dad's eyebrows shot up in surprise at the sight of a perfectly normal-looking young woman standing in front of him disclosing her status.

LYL spoke about what it was like to live with a virus that she always had to keep secret. She talked about her service teaching students in a government school and how she feared someone would find out her status and fire her. And how what she really needed was the treatments that were coming online in the West but were yet unavailable in Malaysia at the time. Those treatments meant everything between life and death for people with HIV.

I know that that little presentation did a lot. At our fundraising dinner a few weeks later, the PM mentioned how sad he was to hear of doctors turning away patients with HIV. I remember Dr Lee had tears in his eyes when he heard that.

Three years later at the opening of the 5th International Congress on AIDS in Asia and the Pacific (ICAAP) in KL, the PM announced that Malaysia would look at compulsory licensing of antiretroviral drugs in order to make them more accessible to Malaysians living with HIV by making them cheaper. Indeed soon after that, the price of the drugs went from over RM2000 a month to about 10% of the price, thus allowing more people access to them.

(And I know LYL had an effect on Dad because he often asked after her.)

Eventually the Ministry of Health managed to provide free treatment to Malaysians living with HIV in government hospitals. Unfortunately the take-up isn't 100% mostly, I think, because few people know that they can get this treatment for almost free. And many are still deterred by the stigma and discrimination around HIV and that is also why they don't go to get tested and onto these life-saving drugs.

But LYL was one of the beneficiaries of these drugs. Although in the last few years she has not been too healthy, she did survive far longer that she would have without them. And while she lived she was always an inspiration of strength to all of us who worked in HIV. She was always a quiet person, not one to shout out her frustrations with the state of prevention and treatment of HIV in our country. But she was an example of a model Malaysian just by being a person of such dignity, care and compassion for others.

Every once in a while I would get an sms from LYL wishing me Selamat Hari Raya or whatever the occasion was and asking me how I was. Not once did she ever sound depressed, bitter or complained about anything. She liked instead to ask after my parents and children.

Two days ago her brother sms'd me to say that LYL was in a coma and in hospital. Being thousands of miles away I couldn't do much except pray that she would recover somehow. But friends who visited her said there was not much hope. She came out of her coma briefly and was conscious enough to know that she was surrounded by family and friends. Then in the early hours she slipped away, finally at peace.

The whole HIV community mourns the passing of LYL, the first Malaysian to stand in front of a Prime Minister and make him understand what it means to live with HIV. That act of courage alone changed the lives of so many people. Not least by making the lives of HIV+ people real to those without the virus.

Men who have sex with men ( MSM ) are at least 44 times more likely to be diagnosed with HIV than other men, and 40 times more likely than women, according to an analysis released by the Centers for Disease Control and Prevention ( CDC ) at the 2010 National STD Prevention Conference.