Homophobia Causes AIDS, Organising Can End It: A structural intervention to prevent HIV among men who have sex with men (MSM)

Published: March 20, 2013

In Trinidad, Homophobia Causes AIDS, Organising Can End it is operated by The Coalition Advocating for Inclusion of Sexual Orientation (CAISO). CAISO is a coalition committed to equality, citizenship and social inclusion of all consensual sexualities and gender expression. It fosters community building, political action, and public education to improve public policy and generate social change on sexual citizenship and gender justice issues.

Context
The Lancet’s July 2012 Special Issue on MSM evidenced how all over the world biological, network, social and structural factors combine, unlike in any other vulnerable group, to cause a concentrated HIV epidemic in MSM.1 According to a 2008 study by the Harvard School of Public Health, the Caribbean tops the list of regions whose policies and laws present obstacles to HIV prevention for MSM.2 Punitive laws, coupled with a culture of silencing and impunity for discrimination and failure to align funding with the magnitude of HIV prevalence have resulted in Caribbean MSM having one of the highest HIV prevalence rates in the world.

In Trinidad and Tobago, MSM HIV prevalence is estimated at above 20 percent, at least ten times that of the general male population.3 While the National Strategic Plan 2013-2018 mentions MSM as a “most at risk” group, to date there has been very little spending on targeting this population. Between 2002 and 2009 less than 6 percent of the annual HIV budget was spent on “most at risk” populations.4
All same-sex intimacy is criminalised in Trinidad and Tobago, “sexual orientation” is excluded from anti-discrimination protections and same-sex relationships are not recognised for state benefits or domestic violence protections. Since 1999, the lesbian, gay, bisexual, and transgender (LGBT) community, and then CAISO has been lobbying the government to amend the national anti-discrimination law – the Equal Opportunity Act (EOA) – to extend protection against discrimination to LGBT people. When the law was passed in 2000, it specifically excluded “sexual orientation or preference” as grounds for protection. Organisations working with LGBT people in Trinidad regularly receive reports of violence and discrimination towards members, but victims rarely report these abuses to the police because of fear of discrimination or previous experience of ridicule.

Sensationalising media causes chronic stigma for LGBT people in Trinidad and Tobago, and the most poor and visible bear the brunt of this. As is the case in Jamaica, young people are often forced out of their homes and jobs because of their sexual orientation or gender expression and into marginal housing or homelessness and unemployment. Bullying at school and lack of counseling support also mean many drop-out of school or underachieve, limiting their job prospects and leaving sex work as one of their few options for survival.

While civil society organisations have been responding to HIV within MSM populations for over eighteen years in Trinidad, building capacity and staff within these organisations to deliver services and effectively lobby and mobilise has been difficult. As one of the Caribbean’s strongest economies, Trinidad qualifies for little international development funding and there is little local philanthropic support for LGBT issues.

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