Op-ed: As Long as Homophobia Lives, AIDS Won't Die

Zambian AIDS activist Mannasseh Phiri was once as homophobic as most health officials in the southern African nation. But after Phiri met an out, HIV-positive man, he had an epiphany about gays and the disease -- he now warns that if others like him don't have a similar change of heart, AIDS will continue to ravage the continent, and the world.

History has a very unfortunate way of repeating itself.

Thirty years ago, the gay community in the West faced an unprecedented crisis -- a new, unknown virus that was taking the lives of gay men from San Francisco to Stockholm. It was a medical crisis exacerbated by silence from politicians and society at large, leaving the gay community completely alone -- for years -- in its fight to educate people and save lives. Only when the broader public realized that this virus -- now known as HIV -- crossed all sexual orientation, gender, race, and national border lines did governments, corporations, and the media finally throw their weight into fighting the epidemic.

In my country, Zambia, the reverse scenario has taken place. The HIV/AIDS crisis is largely a public issue, and the government, media, and international and local organizations are committing huge resources to protect babies, couples, and individuals from HIV infection, and to treat those infected. Today, more than 400,000 Zambians are receiving free HIV/AIDS treatment and care, and millions more are being reached with HIV testing and prevention messages, tools, and services. Except the gay community.

Due to endemic homophobia and fear in Zambian society, both self-identified gay men and MSM (men who sleep with men) are completely absent from the HIV discussion, leaving them uneducated about HIV risk, unreached by prevention and treatment services, and alone in their fight against HIV/AIDS. It is an unacceptable scenario -- one that threatens our ability to turn the tide of HIV/AIDS in Zambia and across most of Africa. To break the status quo, we must take a hard look in the mirror to reset our priorities. Six years ago, I had to do the same thing at a personal level.

Until 2005, I was as homophobic as the next well-educated, well-traveled Zambian man. My professional and personal life was thriving. I had established myself as a family physician and a well-known broadcaster and newspaper columnist. In many ways, through my activism and media profile, I had become a well-known and recognized face of Zambia's movement to end HIV/AIDS. But all my work -- and my words -- left out one of Zambia's most vulnerable populations.

While I did not tolerate or approve of homosexual people and homosexual activities, I did not mind their existence in Zambian society as long as they kept their distance from me, my family, and my career. What I did not realize was that my prejudiced line of thinking (as an "educated HIV activist," no less) was exactly why the gay/MSM community was being left out of the HIV/AIDS discussion. Left alone. Left, in many cases, to become infected, get sick, and die.

Everything changed the day I met Hayden Horner during a training I helped conduct for senior journalists from the southern Africa region in late 2005. Hayden raised his hand in the middle of a session I was leading on antiretroviral drugs. He stated that he had contracted HIV from having sex with multiple male partners, and was now using antiretrovirals. Later that day, I sat down with Hayden and listened to his story. I listened as he recounted the struggle he had faced trying to find information about HIV/AIDS to preserve not only his life, but the lives of his friends as well.

Hayden told me about his weekly "Hayden's Diary" published on Plusnews; an online UN news service. In it he wrote with courageousness and feeling about his life as a young gay South African journalist living with HIV. As he spoke, he became more than simply another person living with HIV to me (and I had seen many.) He personified my failure as a physician -- and as an activist -- to protect the health and future of all Zambians.

MSM are among the most-at-risk populations in Zambia for HIV and AIDS, chiefly because they are "hidden," unable to access or ask about health services freely due to prejudice and blatant homophobia in traditional African society. As a result, MSM have a high risk of dying of HIV/AIDS-related illness -- a scandalous statistic in an era when many HIV-positive people are living productive and optimistic lives with free modern treatment.

After meeting Hayden, I knew I could no longer stand on the sidelines. I featured his story in my weekly newspaper column and have continued to advocate for the end of homophobia and for HIV/AIDS services to be made accessible to MSM.

This year at the Clinton Global Initiative Annual Meeting in New York City, I made a commitment -- not only a professional commitment, but also a personal one. I committed to bring the issue of MSM health risks to the forefront of political and social discussion in Zambia, and hopefully across Africa. I committed and already started to stimulate public debate and dialogue around MSM and HIV using my radio programs, newspaper articles, and every public speaking opportunity I get to speak on HIV (and I get many!)

I know that many in Zambia will claim that I am a Western "puppet," using my commitment to obtain financial and personal gain from MSM advocacy. Nothing could be further from the truth, but I do not mind. I am receiving no financial or other assistance from any quarter. My activism is my own and comes at some personal risk to me, but that risk is nothing compared to the risk faced by the mostly hidden gay community in Zambia.

I do it because I care about Zambia -- and Zambians -- all of them. I care deeply and passionately about erasing HIV and AIDS from our future. And I know that we cannot fully tackle the epidemic unless we reach all segments of our population -- without exception -- with health information and services they need and deserve.

December 1 is World AIDS Day, and this year's theme (and for the next four years) is "Getting to Zero: Zero New Infections. Zero Discrimination, and Zero AIDS Related Deaths." How can we in Zambia even hope to achieve zero new infections when gay men and MSM are discriminated against and frightened into hiding from HIV services?

One of my life mentors is Professor Michael J. Kelly, a Catholic priest, educationist, and HIV activist. In his 2008 book, Education: For an Africa Without AIDS, he responded to the question "Are we looking in the right place?" by stating: "We are like a person on a dark night, hunting frantically under a lamplight for a lost key -- not because that is where the key was lost, but because that is where we are able to see."

For the last 30 years, we have been looking for answers and solutions to HIV/AIDS where we can see, leaving some of our most vulnerable citizens in the dark. It is time to shed light on this problem. It is time to stop unnecessary suffering and deaths among gay men/MSM just because we cannot bring HIV services to them. It is time to start doing something today.

ZIDZE PANO N'ZA TONSE (Chewa language): "Everything that comes here is the concern of all of us."

Mannasseh Phiri is the executive director of Society for Family Health, the Zambia affiliate for Population Services International.