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NMP’s views at odds with AIDS relief research paper

By Jinesh Lalwani and Choo Zheng Xi

Safe sex awareness pamphlets censored as pornography. Information booths closed down for distributing “illegal” content. Awareness outreach funding stifled by choking off of charity fundraisers by homosexual groups.

The government has given its repeated assurances that s377A of the Penal Code criminalizing ‘gross indecency’ between two men will not be enforced. However, evidence from healthcare workers on the ground seems to highlight a far more insidious effect of 377A.

A paper by Aids relief expert Associate Professor Roy Chan, President of Action for Aids Singapore, highlights how 377A hobbles HIV prevention efforts by the local sexual healthcare community.

The paper, titled “Sections 377 and 377A of the Penal Code – Impact on AIDS Prevention and Control” (see below) makes a case for how 377A’s continued retention harms efforts to bring down STD rates among men who have sex with men (MSM). The criminalization and attendant discrimination of gay men hampers the effort to reduce the growing rate of transmissions between MSM.

In particular, it points to three former British colonies - Hong Kong, Australia and New Zealand, which have dismantled their anti-gay sex laws. They have since run comparatively more effective and successful AIDS control programs than Singapore.

In the recent Parliamentary debate, NMP Thio Li Ann advanced a public health reason for retaining 377a, saying:

“The New York Times reported that even informed homosexuals return to unsafe practices like bare-backing and bug-chasing after a health crisis wanes.

A British Study showed that the legalization of homosexual sodomy correlated with an upsurge of STDs among gays. Common sense tells us that with more acceptance, any form of consensual sexual behaviour increases. Sodomy laws have some deterrent effect.”

Ms. Thio’s assertions that retaining the law will prevent a public health crisis are directly contradicted by A/P Chan’s study.

In fact, the study points out that an epidemic is being perpetuated by the very law she seeks to retain.

377A hinders HIV prevention and awareness efforts

Contrary to NMP Thio’s position, the paper highlights how 377A effectively precludes healthcare workers and voluntary organizations from identifying and targeting MSM as a distinct group for the purposes of targeted treatment.

That there is a HIV epidemic amongst the homosexual community is not denied.

The paper highlights that in Singapore, although the majority of HIV infections are contracted through heterosexual sex, there is an expanding epidemic in MSM who, in 2005, formed 30% of newly diagnosed infections. By the end of that year, the cumulative number of HIV/ AIDS afflicted persons was 2852.

However, the study singles out 377A and its negative implications on hindering HIV outreach to the constituency that needs the outreach most.

One of the knock on effects of 377A is that much material on safe sex between homosexuals has been banned because of its homosexual content.

The study reveals:

“Action for AIDS has on several occasions been asked to stop distributing materials containing information on homosexuality even though these materials were meant specifically for MSM venues and events. The reasons repeatedly given by the authorities were that because homosexual sex is illegal, it cannot be mentioned; therefore providing information on safe sex relevant to MSM is also illegal.”

The study also cites examples of how AFA was asked to close down a safe sex awareness booth at MSM parties, the reason being that the material contained homosexual content.

A concert by a Christian gay support group was banned in 2005 by the authorities: the proceeds from the concert were to go to funding outreach efforts by AFA.

In contrast to the ignorance and stigma that 377A engenders in Singapore, the study highlights extensive research on foreign jurisdictions that have decriminalized homosexual intercourse.

Case study: Hong Kong

Hong Kong decriminalized sodomy in 1991. Yet, Hong Kong’s 6.9 million population had 2825 persons suffering from HIV/ AIDS in the same year. Hong Kong has over 50% more people than Singapore (4.5 million), but has 27 less reported infections than in Singapore.

Although Hong Kong has noted a rise of HIV infections in MSM, they have been proactive about the situation. The Hong Kong Advisory Council on AIDS in 2006 recommended that HIV prevention programmes “should be sensitive and specific for the culture of different sub-populations”. It also hailed “a non-discriminating and enabling environment”, underpinned by strong “policy, funding and technical” support from the government as a key ingredient to fighting the war on HIV/ AIDS.

Gay community groups and AIDS organizations are openly supported by the health department, and are actively involved in AIDS prevention activities in both Hong Kong and mainland China.

Case study: New Zealand/Australia

In New Zealand, which decriminalized homosexual sex in 1986, the pravelence of HIV infection among adults aged 15 to 49, according to the World Health Organisation, is 0.2%. Singapore has a prevelance rate of 0.3%.

Australia began decriminalization with South Australia (1972), and completed it in Tasmania (1997). Prior to repeal in Queensland, the National Health and Medical Reseach Council found that Queesnland had more than twice the rate of HIV infections and related deaths than South Australia, even, a comparatively higher rate as a percentage of its population.

The Australian Federation of AIDS Organizations in 1989 argued that outlawing homosexual acts would place impositions on health programmes targeting at-risk groups, because “the government cannot be seen as supporting or encouring illegal activity”, and that individuals cannot be engaged because they fear there may be negative repercussions.

The Queensland AIDS Council went further, saying that the attitude towards homosexuality severely blunted the response to the AIDS crisis there:

“If there had been State government support for education and behavioral change programmes, it would not be unreasonable to claim that 25 percent of the cases of Aids woudn’t have occurred." The law was finally struck down in 1990.

How does this square with the Singapore scenario? NMP Thio is rightly concerned that an escalation of disease is something that warrants concern. Yet, going by the experience of other countries, 377A would be a blunt tool to deal with the problem. It is clear that a law that requires people to acknowledge they have sex which is illegal before receiving treatment does not help the cause of HIV prevention.

The deterent effect of the law is not one of disease prevention, but in preventing a man from saying “I had sex with another man”, hence incriminating himself. This is despite the fact that this candour is the surest way of ensuring proper, targeted education for at-risk individuals. .

A/P Chan’s paper quotes New Zealand researcher Dr Phil Parkinson, commenting on his country’s own laws:

How on earth could an effective campaign against an epidemic be carried out if the very measures to prevent infection, such as the promotion of safety in sexual practices were vitiated by the confirmed criminal sanctions against those very practices?"

Associate Professor Roy Chan's research paper: “Sections 377 and 377A of the Penal Code – Impact on AIDS Prevention and Control” can be found here.

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Jinesh is a first year undergraduate at the NUS Faculty of Law. He has experience writing for several mainstream magazines and online publications.

Editor’s note: A/P Chan’s paper was written before the recent Penal Code amendments, hence the reference to s377 of the Penal Code, which has since been repealed.

A/P Chan is also the director of the National Skin Center.