AIDS: Men make a difference

AIDS: Men make a difference

JAKARTA (JP): "Eliminate prostitutes! That will solve the AIDS
problem." So screams a headline on the website of a well-known
professor of psychiatry at the University of Indonesia in his
World AIDS Day message. Wish that it was that easy (forgetting
for the moment the small matter of human rights).

Are sex workers, in particular, and women, in general, the
sole source of the problem or the solution? I think they are not.
At last this is being acknowledged in the theme for this year's
World AIDS Day: AIDS and Men.

Up to now, our prevention activities have tended to focus upon
women, either as "vamps or victims", to use the terms from a
well-known female AIDS activist, Robin Gorna. They are either the
"immoral" sex workers or the "innocent" housewives.

We ignore the fact that, if women are infected by HIV, the
virus that causes AIDS, in most cases they have been infected by
men. Either a client, for sex workers, or an unfaithful husband,
in the case of 80 percent of women with HIV in the world.

Because of the way their bodies are constructed, women are
much more vulnerable to HIV infection than men. Put the other
way, men are less likely to be infected during sex with an
infected woman than vice versa.

Much less likely. Epidemiologists (experts on the spread of
infection) tell us that reducing the infection of women by men
would be the fastest way to halt the AIDS epidemic. Surely
therefore it makes sense to focus on changing the behavior of
men.

Further supporting this approach is the fact that, in general,
men have more sex partners than women. This means that a man with
HIV is more likely to infect more people than a woman. And men
are more likely to force themselves upon women, sometimes even
young girls. Women often have limited capacity to determine when,
where and whether sex takes place.

As we talk of men's' vulnerability to HIV infection, let us
not forget an often forgotten group of men--transvestites.
Surveys in Jakarta have shown that these people are among the
most vulnerable to infection, with as many as 6 percent infected
in 1997, the last time such a survey was carried out. While many
may wish to ignore such people, what is often forgotten is that
their sexual partners are exclusively men--and it is these male
clients who are infecting them. Such clients are usually married
and are thus also putting the wives at risk of infection--and
through their wives, also their children during birth or breast-
feeding.

What can we do about this? In Indonesia, there is frequent
criticism of NATO--No Action, Talk Only! And often this is
justified. But as has been noted by Nafsiah Mboi, our tireless
AIDS activist, sometimes talk is a form of action. And nowhere
more so than in connection with the silence which so often
surrounds AIDS. Although wives often suspect husbands of risky
behavior, they are scared to discuss it, fearing physical or
mental violence, or how it will affect their relationship.
Parents are unwilling to discuss matters related to sex and drugs
with their children, because the subject is taboo, or because
they don't know how to start. Businesses put their heads in the
sand, hoping that AIDS will bypass their workforce.

To often, AIDS is seen as someone else's problem, one not
likely to touch us. All too often it is infection among our
family, our friends, or our employees, which disabuses us of that
denial--too late.

And when that happens, the burden of care for the infected
person usually falls upon women. Men need help to accept their
role as fathers, and to be willing to provide care and support,
both in the family and the community.

When it comes to AIDS, men do make a difference. But also,
with encouragement and with care to avoid the finger pointing
which women so often experience, men can make a difference.

--Chris W. Green