Taking a principled stand on HIV

It’s not about freedom of speech, nor academic freedom. It’s about fighting HIV/Aids through a comprehensive approach which includes granting human rights to all groups in society. This was the view of several stakeholders in the campaign against HIV/Aids in the Caribbean as they weighed in on the controversial firing of Trinidad-born academic Prof Brendan Bain by UWI, Mona.

What triggered the controversy? 

A release from UWI on May 20 said Bain, a retired member of staff at UWI, was fired as director of the Caribbean HIV/Aids Regional Training Centre (Chart), a position he had held since Chart’s inception in 2001. Chart is a regional organisation managed by UWI, aimed at preventing HIV/Aids in the region and providing care, treatment and support to people with HIV/Aids.
The issue arose in 2012 in a case in Belize in which Caleb Orozco, a gay man in Belize, challenged an 1861 law that criminalised men having sex with men (MSM). Bain provided a statement to the court that, according to UWI, supported arguments for retention of the law.

UWI’s action caused outrage among some in Jamaica, who described UWI as a “spineless” organisation that had bowed to pressure from powerful gay lobby groups. But in statements released last week, regional health agencies came out in UWI’s defence, saying UWI’s action was based on maintaining proper leadership and a sound public health strategy to end the HIV/Aids epidemic in the region.
 
Dr Edward Greene, 
UN Secretary General’s 
Special Envoy for HIV 
in the Caribbean

Bain’s submission to the court was “aimed at upholding a law that, in the opinion of public health experts and members of civil society, reinforced stigma and discrimination against MSM,” Dr Edward Greene said. He said laws and policies that criminalised certain populations prevented them from seeking information, treatment, and support services, making it difficult to mount an effective response to HIV/Aids in the region. “These laws are discriminatory and counterproductive. They must be repealed or at least modified.” “The protests against the university’s decision unfortunately mischaracterise it as a threat to freedom of speech and to academic freedom. “On the contrary, it is simply a lack of credibility to lead Chart, given the organisation’s goals surrounding the elimination of stigma and discrimination toward MSM and other communities that are vulnerable to HIV.”

He said recommendations will be presented to Caricom heads of government in July on ways to strengthen the region’s response to HIV/Aids, which include: “To accelerate the process for repeal of laws criminalising sexual acts in private between consenting males and females and replacing them with provisions criminalising sexual acts between persons in public or with the use of force.”

  
Dr Ernest Massiah, UNAIDS
Lost in the passionate public debate surrounding Bain’s firing was the reality of HIV/Aids in the region, Dr Ernest Massiah, UNAIDS Caribbean Regional Support Team director, said.
“At the end of 2012, UNAIDS estimated that there were 260,000 people living with HIV in the region. In many countries, approximately one in three new cases is among MSM. How do we deal with this as we work to end the epidemic in the Caribbean?” Pointing out that HIV was a virus and not a crime, Massiah said laws that criminalised sexual behaviours and orientations made it difficult to end the HIV/Aids epidemic in the region. “Persons who know their sexual behaviour or orientations are illegal are less likely either to go to health services or to speak openly about their sexual behaviour while there, thus limiting their treatment options and prevention efforts.

“Our laws should help create an environment in which there is no impediment to delivering targeted prevention and treatment services to a population particularly affected by HIV.” 
Therefore, removing laws that criminalised sexual behaviours and orientations was recognised by global and regional agencies as a key step to defeat Aids, he said. Laws that criminalised sexual behaviours and orientations, he added, reinforced stigma and discrimination. A recent internet survey by UNAIDS found that in two Caribbean countries, about ten per cent of doctors and nurses would rather not provide services to MSM. Pan Caribbean Partnership against HIV and AIDS (PANCAP) “Prof Brendan Bain's testimony in the Orozco v AG Belize (2012) case is not consistent with the stated goals of Pancap to reduce stigma and eliminate discrimination and is in dissonance with Pancap’s ongoing work to remove discriminatory laws and affirm human rights.

“In adopting an active position of opposing the decriminalisation of anal sex between two consenting male adults in private, Prof Bain has undermined the public health and human-rights goals of Pancap.”  The release noted that the Global Commission on HIV and the Law found that countries that criminalised same-sex sexual activity have higher HIV prevalence rates among MSM than countries that do not. Pancap said a “multi-sectoral” effort to remove legal, social, and cultural barriers that prevented universal access to health care was needed to move toward an Aids-free Caribbean. 

Prof Rose-Marie Belle Antoine, former UWI lecturer in the Faculty of Law
The firing of Bain has nothing to do with academic freedom and those who claim otherwise are “misinformed, with perhaps a few who are simply being opportunistic,” says former UWI lecturer Prof Rose-Marie Belle Antoine. “At the core, it is about a programme leader publicly undermining the very programme and principles he was mandated to support.” Responding to those who said Bain’s statement represented his personal views, Belle-Antoine said: “The very reason authorities like Prof Bain are called upon to speak is because of their professional capacity, which is inextricably linked with the institution, the UWI. Thus, Prof Bain cannot separate his personal views from these comments that have come to represent the institution that is the UWI, which is why they are viewed as harmful and irresponsible.” Belle-Antoine said it was a fact that “the elimination of discrimination on the ground of sexual orientation is a key ingredient of the UWI’s HIV programming, which Prof Bain had the honour to lead for many years.”

Colin Robinson, executive director, Coalition Advocating for Inclusion of Sexual Orientation (Caiso)
Leadership principles and an effective public health strategy are at the core of this issue, according to Colin Robinson of the Coalition Advocating for Inclusion of Sexual Orientation (Caiso).
In an interview with the T&T Guardian, Robinson said, “The outcome here is really about integrity in leadership and consistency of principles, and about the fact that criminalisation of any group ought not be a part of an evidence-based HIV response.” Human rights, he said, had to be at the centre of all public health programmes, including the HIV response. “You can’t make people well and whole if you say that they aren’t fully human.”
 
HIV/Aids in the Caribbean—the facts
 
Total number of adults and children living with HIV: between 220,000 and 280,000.
Prevalence of HIV (the ratio of infected people to uninfected people in a population) among adults: between 0.9 and 1.1 per cent—the second highest in the world. (With a prevalence of 4.7 per cent, sub-Saharan Africa is at number one.)
· In 2012, there were between 9,400 and 14,000 new cases of HIV.
· Approximately one in three new cases is among men who have sex with men (MSM).
· The prevalence of HIV among MSM is 25.4 per cent—the highest in the world.
· Men who have sex with men are at increased risk for HIV. This is because unprotected anal sex has much higher transmissibility than vaginal sex.

 (Statistics from 2013 UNAIDS Global Report; UNAIDS Guidelines on surveillance among populations most at risk for HIV (2011); and The Lancet (2012))