23 Jul 2018
Double Tragedy: Being gay and living with HIV
Written by : Agrippa Chalimba
In a rural township, on the outskirts of the highly urbanized city of Lusaka, there is a community of people from various ethnic groupings living together. They struggle, and many fail daily to meet their basic needs; the literacy levels are low, and unemployment is high. Religion is of great importance, and so people gather in large masses every Sunday, filling all the churches in their area.With religious teachings heavy on the minds of many, the overriding consensus is that homosexuality has no place in the community. This is strengthened and supported by their strong cultural beliefs.
In a casual chat with a local resident, it was clear that the mention of homosexuality sent shivers down his spine. For many people the topic is received with anger, disgust and fear.
The emergence of HIV/AIDS, which has claimed and continues to claim many lives,is responsible for the ever-evolving approaches which have led to the inclusion of homosexual men in health programming. This has improved the chances of containing the HIV/AIDS epidemic. However, homosexuality continues, not only to be criminalized, but to be seen as socially unacceptable.This limits the access of several health and social services for homosexual persons. It also seriously limits the various HIV prevention efforts in the country.
It was with this knowledge in mind that I embarked on a visit to this rural township. It was a Thursday afternoon and there was a bustle of traders and shoppers in the local market. I was scheduled to meet a young man named John*. He was twenty-three years old and self-identified as homosexual and living with HIV.
In a phone call with John the previous day, I could sense ahint of suspicion in his voice. I had been given his number by his healthcare provider who said that he would participate in my interview. I tried to make him feel comfortable and he agreed to meet the next day.At his request, I was to meet him at a designated filling station near his home, as he strangely found it convenient.
John was a light skinned, tall young man with dreadlocks,and an open yet quiet expression. He approached me and introduced himself. He was standing next to a building adjacent to the filling station. I guessed that he wanted to assess his safety from afar. We then left to go to his house. It was a small one-roomed spacewhere he lived by himself.
“Well, I don’t know when I discovered I was gay,” he said as hebegan his story.“I never knew what I was. I was the outcast in my home, weirdly treated by my brothers and other friends. I only had female friends. My interests were that of the female friends.”
“At age 9 my mother passed away and father shortly afterwards. My brothers and I were separated and taken in by various family members,” he continued quietly.
Then he recalled memories from his childhood which he described as some of the worst he had experienced. They still had psychological effects on him. “With my new family, I lived in a home that clearly defined what constituted a man and a woman’s role and behaviour. Whenever I spoke, dressed or expressed myself in ways different from the expected, I was reprimanded, mostly verbally. Often my dead mothers’ name was mentioned, and it was said that I had reached this stage because she had been too tolerant and hadn’t disciplined me enough.”At this point, John was quite emotional and struggled to hold back tears.
He continued to explain that his school environment was no exception. He had been bullied and hated being teased and punished for always scoring low marks.“I never liked it at school, they laughed at me for behaving like a girl and since I was not good academically I was constantly punished and laughed at. I did not look forward to school at all.”
Due to the constant pressure he had both on the home and school front, John ran away from his aunt’s place and quit school and joined his older brotherwho had recently become independent.
He narrated further that it was great staying with his brother for a while, but this changed when rumours of his sexuality were being spread. “When rumours that I was gay reached my brother, he didn’t take it lightly. Several times he confronted me about it,but I denied it. Later he beat me up and told me that if he found out or heard these rumours again, his wouldn’t be pleased and would personally take me to the police.”
John said that at that point he was on the verge of committing suicide as life was no longer pleasant for him. Being constantly reprimanded by his brother and the judgmental eyes he saw and felt as he walked around the community made him feel hopeless. “I couldn’t stand it anymore, so with the help of a [homosexual] friend, I ran away from home to survive on my own.”
“We started going to night clubs and at times walked the streets in search of male clients in order to sustain ourselves. With the help from a network of female sex workers, bartenders and security guards, we managed to stay safe and learnt where to find clients,” he said.
He described this activity as a struggle.They constantly needed to be aware of their safety and hold a consciousness of the laws which criminalized homosexual ‘tendencies’ and sex work.They needed to be very careful as they, like female sex workers, were also prone to random detention, sexual violence and non-payment by clients.
John then explained how his struggles mounted when he was diagnosed with HIV, and the challenges he faced in this journey.
“I became seriously ill which lead to my admission to hospital. There the news was broken to me that I was HIV positive. This was devastating, I must say. How and when I got it I don’t know, but it changed my life. The day I discovered this I was already struggling just to survive and was hated already for that being gay. Now I was also HIV+!”
One of the challenges was John’s popularity in his community and among members of staff at the clinic.Seeing as the clinic was the only nearby ART (antiretroviral treatment)distribution centre,news of his HIV+ status broke out. “My presence at the clinic in my area was the hardest of times. I felt judged already by staff who knew me well in my community. ‘This gay man is also sick!’ I could feel them say as I passed by. I could tell this based on the way that a nurse,who lived in my neighbourhood, looked at me as she picked up my refill card. The struggle of facing discrimination and stigma from people who knew me as I stood in the queue waiting for ARV medication, or walking from the waiting room to the ART corner to the pharmacy was a nightmare. A walk of shame. Soon my HIV positive status was known by my neighbours. I didn’t know who had told them, but it happened. I was depressed and couldn’t go and collect my drugs anymore. I didn’t find it safe and stories like ‘he got what he deserved’ were rampant. My livelihood in the gay community, in as far as solidarity and support, was eroded as most thought they would get ill if they associated with me. It was not only hard dealing with rejection from people because I was gay but also from the community I felt safe in. They didn’t want me for fear that I would infect them. It was indeed a double tragedy!”
When asked how he came to acceptance of his situation, John highlighted the support he received froma group of female sex workers who he described a strong pillar and his true friends. They had been living with the HIV for a long time and managed to help him, introducing him to a facility far from his location where he currently receives his ART.
Reflections and lessons learnt
From the story of John, we see how the religious and cultural views held by a community determine what is considered to be morally and socially acceptable. These views in turn shape and affect the lives of those whose actions and behaviours that seen to be in disagreement with the masses. This can be seen in the struggle that John went through in his childhood and how it influenced the direction of his life.
The stigma and discrimination faced by John isalso felt by many like him.The journey seemed to start in his youth with his peers at school and others in the community. Eventually, his family was embarrassed by questions around his sexuality and this resulted in them alienating him. Through sex work and a network of peers, he is able to make a living. However, because of the stigma and laws which outlaw his work and his sexuality, he is forced to live and work in secret. This makes him even more vulnerable. This is a reality faced by many others like John, and others who live and work in ways that are considered to be unacceptable to the masses in Lusaka.
When John discovers his HIV status, his right to privacy and dignity is severely undermined. The attitudes of the health care providers become so extreme, that he is forced to receive his ART from another clinic much further away. His friends who have more experience are to be credited for this intervention. Many others who suffer the same stigma are likely to default on their medication because of the treatment they receive.
John’s story makes us sensitive to the psychological, socioeconomic and legal challenges faced by homosexual persons. It is especially difficult for those who express their identities openly or are known in their communities. This is why we have to continue to build awareness, develop support structures and solidarity through HIV workshops that support persons living with HIV. It is of paramount importance that we continue to protect and build the confidence of others like John.