More than 90 percent of gay men in the Asia Pacific region do not have access to HIV prevention and care services, according to a new report from the United Nations. Released to coincide with the International Day Against Homophobia (IDAHO), the report says levels of the HIV infection are soaring to “alarming levels” in some parts of the region.

The study, conducted by the United Nations Development Programme (UNDP), highlights the social context of the problem. Dr Maneep Dalhiwal, director of UNDP’s Human Rights, Gender & Sexual Diversity programme, told RNW the health and legal issues are interlinked:

“Punitive laws, policies and practices are having a detrimental effect on health and on exercising the right to healthcare for these populations. And really, if we want to make any kind of change, then not only do we have to provide services - comprehensive prevention, treatment and care services – we also need to do the hard work of improving the legal environment. So, laws, law enforcement and, at the same time addressing social attitudes, stigmas, homophobia, which often underpin the punitive legal environment and also underpin poor quality services or prevent access to services.”

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Decriminalisation first step
Homosexuality is illegal in 19 of the 48 countries that make up the Asia Pacific region. Even where it’s not, legislation and law enforcement frequently lag behind HIV policies, and this limits the reach and effectiveness of healthcare and prevention programmes.

Many countries do have HIV policies that prioritise men who have sex with men and transgendered people, but the UNDP says there needs to be greater coordination between the health and justice sectors within governments. Decriminalisation is an important step – but only the beginning, according to Dr Dalhiwal:

“For example, I’m speaking to you today from Hong Kong. Hong Kong decriminalised homosexuality in 1991. There's still stigma and there's still discrimination, there are still issues with law enforcement practices. So there's still work that needs to be done even where the legal environment on paper is positive”.
 

Hearts and minds
A number of countries have introduced laws and policies aimed at addressing the legal problems and others, including India, Indonesia and China have specific strategies for targeting the men and transgendered people most at risk. The UNDP also supports and encourages programmes designed to win over hearts and minds and change the attitudes that can make the problem worse.

In India, for example, the agency helped set up a welfare board for the transgender community in Tamil Nadu state which has been such a success that the national government is considering expanding it into other states. This kind of initiative is undertaken together with local people:

“We’ve done some really interesting work where the transgender community has been sensitising the police, so that law enforcement practices are better and not unnecessarily punitive. There’s some exciting work and we support a lot of work around human rights and gender in the region as well as other regions of the world. Supporting governments as well as communities to address those problems.”