Gay men in Burundi have been ignored in local HIV/AIDS campaigns, resulting in widespread ignorance about the virus among this largely invisible group.
When Georges Kanuma, the head of a gay rights movement in Burundi, first attended an HIV conference in 2004, he was surprised to discover that water-based lubricants, and not petroleum jelly – which breaks down the latex that condoms are made from – should be used during anal sex to prevent HIV and other sexually transmitted infections (STIs).
“I had never heard of such a thing, and I know if I hadn’t heard of it, then definitely most men who have sex with men (MSM) in Burundi didn’t know about it either,” the chairman of the Association pour le Respect et les Droits des Homosexuels (ARDHO), told IRIN/PlusNews. “We had a perception that HIV was a risk for men who sleep with women, not gay men.”
Kanuma visited several health centres and NGOs working in the HIV field, but none had a stock of water-based lubricants. A few pharmacies stocked them, but the prices were prohibitively high.
“It opened my eyes to the fact that we must do something, so ARDHO started knocking on doors to see who would help us source the lubricant, and which NGOs would provide prevention messages for HIV-positive people,” he said. “Many organisations didn’t believe me when I told them there were gay people in Burundi.”
Unlike many other countries in the region, the Burundian penal code does not criminalise sex between men, but the constitution outlaws gay marriage.
Gay Burundians occasionally experience homophobia, but Kanuma said most Burundians were unaware that MSM even existed in their society. ARDHO has existed since 2003 but has so far failed to obtain legal status as an NGO.
The Alliance Burundaise des Associations de lutte contre le SIDA, a national coalition of HIV NGOs, finally agreed to support ARDHO and helped them write funding proposals for HIV prevention activities.
“In 2007, one NGO, the Association Nationale de soutien aux Seropositifs et Sideens [ANSS], agreed to help us. They got some lubricants and condoms from donors in France, so now they deliver them to us and we give them to people in our community,” Kanuma said.
“I know so many married men in this town who sleep with gay men on the side…”
Local perceptions of homosexuality mean the distribution of lubricants and condoms has to be cloak-and-dagger, with many secretly homosexual men making calls and asking for the items to be despatched in plain envelopes to offices or residences, by people not associated with ARDHO.
“We never ask people for their ethnicity or religion before we give them medication or other HIV support, so why should we ask people about their sexuality?” ANSS founder Jeanne Gapiya, a prominent national HIV activist, told IRIN/PlusNews.
“The problem is that this is a hidden community, and the society is in denial about their existence.”
In their latest national strategic plan, the National AIDS Control Council, CNLS, has included MSM in the list of people vulnerable to HIV.
“We realise that they are a marginalised group; we have started to invite them for meetings through their NGO, but the difficulty is we don’t know who most of them are or how to reach them,” Jean Rirangira, the interim executive secretary of CNLS, told IRIN/PlusNews.
Kanuma commented: “It’s not just a problem for gay men; it’s a problem for the whole society. I know so many married ['straight'] men in this town [the Burundian capital, Bujumbura] who sleep with gay men on the side. People would be surprised,” he said.
“Silence is also what is killing us,” he added. “I had a friend who had an STI for about one year – he was self-medicating until he eventually went to ANSS and got a proper diagnosis, and then he got better much quicker.”
Kanuma has been writing newspaper articles and making guest appearances on private radio stations to raise awareness about MSM and HIV. “During every radio show I allow people to call in with questions and give out ARDHO’s email address,” he said. “We have more than 150 emails and so many calls, which shows that more information is still needed.”
ARDHO is creating brochures detailing all the means of transmitting HIV, including male-male sex, for distribution in mainstream health centres; ANSS plans to send a doctor outside of Burundi for special training in the health issues of MSM to provide them with better healthcare.
HIV prevalence in Burundi has been declining since the late 1990s, but many surveillance sites have recently indicated an upward trend; in May, officials announced that HIV infection had risen from 3.5 percent in 2002 to 4.2 percent in 2008.
Although progress is slow, ARDHO and its partners are unwilling to push the government too hard, preferring to negotiate from a public health platform before demanding for equality under the law. “We need to tread carefully so we don’t make the situation worse for gays in Burundi,” Kanuma said.