Indian Gay Sex Workers Confident They Cannot Contact HIV

Shujaat plies his trade well. As dusk falls on the Pir Wadhai bus station in the Pakistani city of Rawalpindi, the slender 19-year-old gauges disembarking passengers for that 'look' - a responsive glance or wink suggesting a desire for more than just a quick bus ride home.

"Here you can find all sorts; mostly truckers, soldiers, day labourers, and of course married men," he said, leaning against the wall.

"I always find someone," the now veteran male sex worker (MSW) boasted.

After three years on the streets, Shujaat's confidence is dwarfed only by his ambivalence towards contracting HIV - a virus that he and other men who have sex with men (MSM) are increasingly at risk of.

"I'm careful and I'm clean, so what's the problem," he asked?

But for medical experts in Pakistan, a nation which until recently enjoyed a low prevalence for the virus, this line of thinking is worrying.

The South Asian nation of more than 160 million inhabitants now faces a concentrated epidemic among certain high risk groups - particularly intravenous drug users (IDUs), estimated at close to 200,000.

In the country's commercial capital of Karachi alone, a reported 30 percent of IDUs are infected with HIV

Pakistan's National AIDS Control Programme (NACP) officially confirms just over 3,000 HIV/AIDS cases across the country, while health experts assess the real numbers to be much higher.

According to UNAIDS, about 85,000 people are living with HIV in Pakistan today.

And while the issue of IDUs is often discussed in the media, the issue of MSM is usually ignored; a troubling reality in conservative Pakistan, where homosexuality is not only not discussed - it is often denied.

The male sex worker - a taboo subject

"It is very difficult to talk about sex and sexuality in Pakistan and more difficult to talk about homosexuality," said Dr Naeem-ud-Din Mian, chief executive officer for Contech International Health Consultants, a local NGO recently assigned a five-year project for the delivery of preventive services for MSM in the city of Faisalabad by the Punjab AIDS Control Programme and the World Bank.

Echoing that, Brian Miller, field coordinator for the Organisation for Social Development, a local NGO running an outreach programme near Pir Wadhai remarked: "People know about it, but it's a taboo subject as it's not in keeping with Pakistan's Islamic social setting."

As a result, open discussion about MSWs is all but impossible, despite the fact that most health experts in the country now view MSM, many of whom are married, as the singular most at-risk group after IDUs - and an important bridging population into mainstream heterosexual Pakistani society.

Government health figures reveal prevalence rates among IDUs of up to 27 percent, with around seven percent among MSM.

According to the Infection Control Society of Pakistan (ICSP), another NGO targeting the prevention of HIV/AIDS among MSWs in Karachi, around half of the MSWs in the city are married, while more than half of the unmarried MSWs buy sex from female sex workers - underscoring the group's capacity to act as a conduit to the virus's spread.

"They're the next risk group," Naseer Muhammad Nizamani, country director for Family Health International (FHI) in Islamabad - which is actively engaged in promoting safer sex practices among MSM and MSWs in the country - said about MSWs.

The US-based NGO estimates that there are some 50,000 MSWs in Pakistan, while others estimate their numbers are much higher.

ICSP says that in Karachi alone, there are between 40,000 and 50,000 male sex workers, depending on the criteria used.

The impact of poverty

Although many MSWs are gay, poverty, lack of job opportunities and broken homes appear to be the driving force behind this activity.

The majority of MSWs are below the age of 24 and began work at the age of 16, with many starting out under the guise of providing massage to men.

Today 'Malishias' - as they are commonly known - have become a common euphemism for sex in Pakistan, attracting their clients by massaging their private parts and masturbating.

"Massage boys are a traditional way of this happening. It's a big business in Pakistan," Nizamani said.

The average charge per sex act averages between just US$1 and $3. Pricing in turn largely dictates the number of clients a boy may be prepared to service on a given day.

According to an NACP survey carried out in eight separate cities, most MSWs average 2.3 customers a day or more than 31 a month. This is even higher among members of the 'Hijra' (transgender) community.

One Hijra, who had no other source of income, said she could easily service up to 20 men in a single day.

"There is no limit to the number of customers and no limit to the service," she told IRIN/PlusNews openly.

Insufficient services and low condom use

Despite such candour, however, there are limits to levels of awareness among MSWs, most of whom have no real understanding as to how the virus is contracted or simply fail to use condoms to protect themselves.

"People have heard of AIDS. But when you go deeper into what proportion actually know how the disease is contracted, that's something else," FHI's Nizamani said.

Although the NACP survey revealed that 70 percent of MSWs knew something about HIV and that a large majority of those who had heard about HIV also knew that it could be transmitted through sexual intercourse, less than half knew that injections could transmit HIV.

In Karachi, ICSP found that just 18 percent of MSWs in that city knew about HIV, its preventions and modes of transmission, while the NACP survey found that only about 60 percent reported condom use as an HIV prevention method - a fact largely dictated by money.

"I don't use a condom," 25-year-old Javed, who works in Rawalpindi, told IRIN/PlusNews. "They [the customers] complain that they don't feel the same amount of pleasure."

"If the customer wants to have sex without a condom and is willing to pay for it, how can I refuse," another MSW, who declined to give his name, asked?

Less than 25 percent of MSWs reportedly used a condom for anal sex with their last client, and even fewer used any form of lubrication aside from saliva.

According to Dr Kartar Lal of ICSP, 74 percent of MSM use saliva and oil in place of water-based lubricants, which facilitates the virus's spread.

"In-depth interviews of target groups revealed a significant proportion of these individuals are aware of the risks associated with unprotected sex, but are unable to negotiate safe sex practices with their partners," said Dr Rafiq Khanani, ICSP's president.

Male sex workers cite reasons of low self esteem, lack of empowerment and a genuine fear of losing the client to other sex workers willing to provide the service without a condom.

"It's very hard to speak openly about condom usage," Miller reiterated. "It's simply not done in a country like Pakistan."

He said the government had done little to publicly support the use of condoms or their distribution, given the strong religious opposition in the country.

According to UNAIDS, less than 10 percent of people most at risk of contracting HIV, such as MSM and drug users, receive preventative services.

Sphere: Related Content

Why George Michael Kept His Homosexual Lifestyle Secret?

Andrew Johnson

The pop singer George Michael has revealed how years of hiding his homosexuality from the public took a deep psychological toll - but he did it so his mother wouldn't have to worry about Aids.

Speaking on Radio 4's Desert Island Discs, the songwriter, who has sold more than 100 million records and is the most played artist on British radio, gave an unusually candid interview, during which he discussed drug-taking, his sexuality, the price of fame and the death of his first lover.

Michael, the son of Cypriot immigrants, who has always had a difficult relationship with the press and has been guarded about his personal life, admitted to presenter Kirsty Young that he is "ridiculously ready to say these things now".

He said hiding his sexuality made him feel "fraudulent", and his eventual outing, when he was arrested for soliciting sex in a public toilet in Los Angeles in 1998, was a subconsciously deliberate act.

"What people have to acknowledge ... is that there's a level of honesty that's natural to me [and] that I'm uncomfortable with anything else," Michael said.

"So firstly, understand how much I love my family and that Aids was the predominant feature of being gay in the 1980s and early 90s as far as any parent was concerned ... My mother was still alive and every single day would have been a nightmare for her thinking what I might have been subjected to.

"I'd been out to a lot of people since 19. I wish to God it had happened then. I don't think I would have the same career - my ego might not have been satisfied in some areas - but I think I would have been a happier man."

He added that he came out to some people, including one of his two sisters, when he was 19, but friends advised him not to tell his parents.

"Then Aids changed everything. I was too immature to know I was sacrificing as much as I was," he says.

He also spoke about his community service following his recent conviction for driving while under the influence of sleeping pills, which has seen him work with mentally ill and homeless people.

Michael spoke of his early career, claiming that a bang on the head when he was eight led to an obsession with music.

He added he "resents" the success of his career which "never seems to suffer".

"I never had any feeling that my talent was going to let me down. [My career] never seems to suffer. I suffer around it - bereavement, public humiliations - but my career just seems to right itself like a duck in the bath."

Michael said that when he had his first hit with Andrew Ridgeley as Wham! at the age of 18, it was wonderful for a time, but the experience of fame quickly soured.

"For a while it was just magical," he said.

"With your best mate, playing out your fantasies. It was just a dream. I was supremely confident I was writing pop classics but I was also supremely aware that if I left the imagery a little bit more to Andrew, kids loved it.

"Then we were massively successful and I went from being Andrew's shadow as a sexually confident being to being the centre of attention. At that level I lost all my confidence. I suddenly felt like a fake, so the whole thing turned me into somebody who felt the camera was my enemy."

Among his current musical selections are Amy Winehouse, Nirvana and Rufus Wainwright.

Of Wainwright's Going to a Town, he says: "It really lays into the Bush administration, talking about America soaking the body of Jesus Christ in blood. Fantastic lyrics."

Sphere: Related Content

Lesbian and Bisexual Women In Islam

Kecia Ali

Same-sex sexual activity is a taboo subject for many Muslims. Some go so far as to deny that gay men, lesbians, and bisexuals exist in Muslim societies today or even that sexual activity between men or between women has existed in Islamic history. Rather, they claim that such issues are “western” or “modern.” Those who do acknowledge the topic generally agree that the Qur’an explicitly forbids all same-sex sexual activity and that Islamic law prescribes dire punishments for it. Thus, in dealing with same-sex sexual behavior among Muslims, there are two key issues: First, what is practiced? Answering this question involves determining what the historical role of lesbian women and female same-sex sexual behavior, for example, has been. Second, and more importantly for contemporary Muslims grappling with the issues raised by same-sex attractions, what is permissible? Just because some Muslims in the past have behaved in a certain way does not mean it is religiously legitimate to do so. This essay will briefly address the first question of past practice, then turn to a discussion of permissibility.

Despite current conventional wisdom to the contrary, same-sex sexual expression has been a more or less recognized aspect of Muslim societies for many centuries, as can be seen through literature, history, and law. Medieval Arabic literature, including both belles-lettres works (in the genre of adab) and copious amounts of erotica, discusses same-sex sexual activity frequently and explicitly. Most often, it is sexual activity between men that is discussed, but these literary works also include discussion of sexual acts between women. Generally, lesbian sexual behavior is referred to as sihaq, “rubbing” or “pounding”. (The term is also sometimes used for female masturbation.) Sihaq, or musahaqa, translates approximately as “tribadism.” Recently, some have begun to study these literary sources to understand female same-sex sexual activity in the medieval Muslim world. A few articles provide a starting point for understanding tribadism in Muslim contexts historically. There is also an extensive literature on male homoeroticism in Islamic literature and Muslim societies. (Link under construction.)

Islamic jurisprudence (fiqh) also recognizes the existence of same-sex sexual contact. While jurists devote more attention to preventing, regulating, and punishing illicit intercourse between a man and a woman than to same-sex sexual activity, the jurists do address male/male sex. While sexual acts between two men are “forbidden,” according to the jurists, the legal texts do not simply state punishments to be applied. They regularly explore the question of what other legal consequences attach to these forbidden acts. As with cases of zina (basically, intercourse between a man and woman who are not married to each other), the jurists attempt to regulate the social consequences of the illicit actions. For example, does an act of (anal) intercourse between two men create a barrier to one of the men marrying the other’s daughter, as it would if one of the partners was a woman? (Some hold that it does.) Texts even address the issue of whether an ablution (ghusl) is required after male-male intercourse, just as after male-female intercourse, before the men can pray! (It is.) Clearly, in addition to a dogmatic condemnation of same-sex activity, the jurists also had a pragmatic approach to dealing with its occurrence.

Works of Islamic jurisprudence, however, devote almost no attention to female-female sexual activity. Several factors contribute to this silence. Perhaps the most important is simply that the legal effects of sexual activity attach to (vaginal or anal) penetration by a penis. When this penetration does not occur, there is no question of ablution, or the creation of barriers to marrying kin, or other consequences of sexual acts. In the few cases where lesbian sexual activity is mentioned, the legal discussion revolves around what punishment, if any, is to be imposed by the authorities; the jurists themselves disagree on this issue.

Jurisprudence has addressed same-sex sexual activity as illicit sex outside of a legally sanctioned relationship. Traditional jurists vehemently condemned all such illicit intercourse, including that between a man and a woman. Ibn Hajar Haytami’s famous “List of Enormities” (i.e., major sins), which treats several offenses together, can illustrate this point, as it groups together:

[I]llicit intercourse (zina); sodomy (liwat: anal intercourse between men); bestiality (ityan al-baha’im); anal intercourse with a woman other than one’s wife; female tribadism (musaahaqat al-nisa’), which is a woman doing with a woman something resembling what a man would do with her; and a husband having sex with his wife’s corpse.

In this list, Ibn Hajar does not make a distinction between acts that are forbidden because they are intrinsically sinful (bestiality and necrophilia can be assumed to fall into this category) and those where the issue is the lack of a proper legal relationship between the parties. This is the case with illicit intercourse between a man and a woman (zina). If the parties were married, there would be no sin; thus, the problem is not the sexual act but rather the partner with whom it is performed.

Islamic jurisprudence has never addressed the question of same-sex sexual behavior (male-male or female-female) except as illicit contact outside of a legally sanctioned bond. This raises an important question: Is homoerotic sexual activity always forbidden? Or might the impermissibility be the result of the lack of a legal relationship between the same-sex pair? In other words, is the problem the same as with an unmarried male-female couple that commits zina? If there were such a thing as a lawful relationship between two women or two men, then would the verdict about sexual activity between them differ? Whether such a licit same-sex relationship can exist is a different legal issue – one that I would not presume to be qualified to decide – but it is one that Muslim jurisprudence has not addressed.

There is also the larger question of whether Islamic jurisprudence is the necessary framework for resolving these issues. While some insist that the legal framework developed by Muslim jurists from approximately 900-1400 CE must govern all Muslim behavior, the reality in the contemporary world is that the vast majority of social and economic transactions engaged in by Muslims do not strictly follow these legal precepts. Only on some matters of personal status (marriage, divorce, inheritance) do some majority-Muslim nations retain religiously-based laws, and these differ widely from one country to another. In many cases, these modern family laws also diverge from the classical Islamic jurisprudence on which they are purportedly based. In nations where Muslims are a minority of the population, Islamic law has no coercive power, though it does have moral weight. However, when it is followed, it is again only selectively.

In any case, for most Muslims seeking guidance, the primary authority is not jurisprudence but rather the Qur’an and prophetic traditions (hadith) which are themselves the main sources of Islamic law. However, those who turn to scripture or hadith collections looking for material on lesbian sexual activity and relationships will find little to help them grapple with these issues. While the Qur’an explicitly addresses male-male sexual activity (albeit interpreted in various ways), there is no consensus as to whether the Qur’an even mentions female same-sex activity. There are numerous hadith addressing men’s sexual behavior with other men, but, again, little mention of lesbian behavior in hadith collections.

There are groups of self-identified lesbian, gay, bisexual, and transgendered Muslims working to address these issues, and to reconcile their spirituality and religious identity with their sexual orientation. [Link under construction to groups, organizations, and resources for those concerned with lesbian, bisexual, and transgendered Muslim women.] Again, the vast majority of groups and resources address themselves primarily to men, but there is at least one listserve, Iman, for Muslim women who identify as lesbian, bisexual, or transgendered.

Sphere: Related Content