Access To HIV Prevention – the Lack of It for MSM in Cameroon

Buea, Cameroon - In countries all over the world, high HIV prevalence rates have been reported among men who have sex with men (MSM). Research explains that the common practice of receptive anal sex ,which is very risky in terms of HIV transmission, is what makes MSM so vulnerable. In about a third of these countries, most of them in Africa, MSM are criminals. In these countries, it is virtually impossible for governments to work with MSM as an HIV high risk group. Cameroon is one of these countries.

Officially, the Ministry of Public Health in Cameroon does not recognize MSM as a vulnerable group with regards to HIV transmission. “Men having sex with men remains an illegal practice in Cameroon”, says Dr. Pascal Atanga, coordinator for the government controlled Regional Technical Group against HIV/AIDS (RTG) in Southwest Region of Cameroon. “It is really not a part of our national policy.” While the ministry works with other groups like sex workers and truck drivers, MSM are not part of the National Strategic Plan for HIV. Consequently, there is hardly any data on MSM and HIV in Cameroon and definitely no government funding for activities that target them.

By Cameroon law, homosexuality is a crime punishable by imprisonment and or fines. Public opinion is overwhelmingly in favour of government criminalizing homosexuality and people explain their aversion to MSM with cultural, religious and moral arguments. “Why should men have sex with men?” asks a certain young man as he listens to someone put forward an argument that MSM need access to HIV prevention. “Why should people even bother about struggling to defend some people who are going against the law of nature?”

For a certain activist called Yves Yomb, this is the attitude that he fights to change. Despite the overwhelmingly negative response to MSM in Cameroon, a few people like Yomb have begun to speak out. “As a health care provider, it is not my job to judge what people are doing…I have to provide them with access to prevention, care and treatment regardless of what their sexual behaviours are.” Yomb works for Alternatives Cameroun, an association that provides HIV prevention, care and treatment for MSM. The association is based in Douala and has representation in Buea and Yaounde. These cells of Alternative function in absolute secrecy. Alternatives is about the only institution in Cameroon that identifies and works with men who have sex with men, MSM, as a high risk group with regards to HIV prevention.

According to Yomb, many people are not aware of the risks involved in leaving out MSM in the national strategic plan against HIV. He says some of these “so called gays also have wives, sometimes because they want to but mostly because they live in an African society that dictates that some point in his life, a man should take a wife. Because a majority of men who have sex with men are bisexuals…if nothing is done to target MSM, it is very possible that current efforts to keep prevalence rates down will be neutralized.”

Yomb says even if government is uncomfortable with naming MSM as a high risk group, they should at least educate the general population on risks associated with unprotected receptive anal sex, which is the most risky sexual behavior in terms of HIV transmission.

There have been several calls for African governments to relax policy that outlaws MSM, the most recent of which came during the World AIDS Conference in Vienna, Austria, in July. The Director of the United Nations Joint Program on HIV/AIDS, former US President Bill Clinton, the Deputy President of South Africa and many others said, for a universally effective action plan against HIV/AIDS, African leaders needed to relax discriminatory laws against all high risk groups, including men who have sex with men.

Will policy makers in Cameroon heed to these calls and start to treat MSM as a group vulnerable to HIV/AIDS? “We should,” says Dr. Atanga. “We can start having the educational messages target these people indirectly … by letting them understand the risks of HIV transmission [with] anal sex which is most common among them.”