Stigma and homophobia against gay men is hampering efforts to manage a growing epidemic of HIV in Islamic countries, warn epidemiologists this week.

“The stigma is a barrier to HIV prevention services,” says Laith Abu-Raddad of the Weill Cornell Medical College-Qatar in Doha. He heads up a team that is assembling, for the first time, data from the Islamic world on the growing prevalence of HIV in practising gay men.

They report that the arrival of HIV in the gay community has been relatively recent compared with other regions of the world, but warn that it is on the rise. In Pakistan, for example, the prevalence of HIV in transgender male sex workers rose from 0.8 per cent in 2005 to 6.4 per cent just three years later.

Historically, HIV epidemics have often begun in minority, high-risk groups such as men who have sex with men or intravenous drug users, then spread to the general population. A problem in much of the Islamic world is that men having sex with men is illegal. That, coupled with homophobia, hampers efforts to contain the virus by making gay men too scared to seek treatment, a pattern that has been seen in eastern European countries, India and sub-Saharan Africa.


Leave it to the NGOs

Abu-Raddad says that governments are managing “to deal with [HIV] discreetly” by inviting non-governmental organisations to provide testing, counselling and treatment for gay men.

The spread of HIV is at a relatively early stage in Islamic countries, so there is an opportunity to stop it growing. But this will only happen if governments accept that it is spreading among gay men, and that action is required.

“We need much better HIV prevention, surveillance, testing, counselling and treatment, but NGOs can only do it with resources from governments,” says Abu-Raddad.

Journal reference: PloS Medicine, DOI: 10.1371/journal.pmed.1000444