Washington Blade - September 8, 2006
Vincent Macisaac*

"I'm an American. We have free speech," he continues, as though this is a fact he needs to remind himself.

We're talking about AIDS. Specifically, the epidemic among gay and bisexual men in Thailand, where infection rates in Bangkok have surged by more than 50 percent in two years, to 28.3 percent last year, according to studies by the U.S. Centers for Disease Control & Prevention.

What I want to know is whether the U.S. government's "ABC" prevention strategy - abstinence, be faithful in relationships, and condoms - is hindering efforts to contain this epidemic.

I'm not qualified to answer the question, but I can say with certainty that almost every time I ask it the conversation veers "off the record."

"In the age of the internet, everything has to be sanitized," says the American health official, referring to safe-sex information.

This is because congressional interns and fanatics are surfing for evidence that U.S. tax dollars are being spent on gay sex, infidelity, prostitution and even sex-change operations in the world's poorest countries.

He mentions an e-mail he received from a senior government official after an article in a Thai newspaper misquoted a transvestite saying her U.S. funded AIDS-prevention group gave "counseling on surgery." Within three days the question, "Are you promoting sex-change operations?" arrived in his inbox.

"It was the level of scrutiny and how rapid the response was to a comment at the bottom of an article" that caught him off guard. "There are people out there who are just looking for an excuse to attack us," he says. "We just want to continue doing the work we are doing."

STILL, AT THE center of the prevention effort lies a paradox, perhaps a lethal one. American health agencies are pioneering the response to the epidemic among gay, bisexual and transgender Asians. These are people facing an epidemic that is being ignored by their own governments and societies.

The first signs of an epidemic among gay men in Bangkok can be traced back to 1999, when data from an anonymous testing clinic found the rate of infection had risen to 11 percent. Seven years later, gay and bisexual men have yet to be included as an "at-risk group" in the country's national AIDS prevention strategy.

American NGOs, like Family Health International and Population Services International, and government agencies like USAID and the CDC, are funding the Thai NGOs that are trying to raise awareness about this epidemic. They have been instrumental in setting up Thailand's first legally registered group for gays, lesbians, bisexuals and transgender people, called Rainbow Sky.

AMERICAN AGENCIES HAVE the expertise and money to upgrade detection systems, launch tailored prevention programs and provide access to treatment.

They are also staffed with people who treat those at risk with respect. They advocate on behalf of Asia's most stigmatized groups - "queers, junkies and whores," as one NGO worker put it.

But in some cases they are imposing constraints on the groups they fund that are so outrageous they would have the Log Cabin Republicans embracing ACT-UP.

Would NGOs working in America tolerate funding conditions that require outreach workers to advise men who cruise parks and saunas to consider abstaining from sex?

Would they put up with conditions that require a group helping sex workers to propose abstinence and fidelity as "choices" for preventing infection? Would they tolerate restraints on images and language in safe-sex brochures and pamphlets that are so stringent that they make the materials banal?

Perhaps if Thailand had a politically active gay community the situation would be different. But Rainbow Sky was only formed in 2001 and most of its members are under 30.

They have to rely on us. We aren't helping enough. Even off the record.

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*Vincent MacIsaac is a Canadian journalist based in Southeast Asia with 20 years of involvement in gay and lesbian groups. He can be reached at vince_macisaac@yahoo.com.

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