Africa News Report 2007

by Andrew Heavens
Khartoum (Reuters) - When Ali started blogging that he was Sudanese and gay, he did not realize he was joining a band of African and Middle Eastern gays and lesbians who, in the face of hostility and repression, have come out online. But within days the messages started coming in to black-gay-arab.blogspot.com. "Keep up the good work," wrote Dubai-based Weblogger 'Gay by nature'. "Be proud and blog the way you like," wrote Kuwait's gayboyweekly. Close behind came comments, posts and links purporting to be from almost half the countries in the Arab League, including Egypt, Algeria, Bahrain and Morocco.

Ali, who lists his home town as Khartoum but lives in Qatar, had plugged into a small, self-supporting network of people who have launched Web sites about their sexuality, while keeping their full identity secret. Caution is crucial - homosexual acts are illegal in most countries in Africa and the Middle East, with penalties ranging from long-term imprisonment to execution. "The whole idea started as a diary. I wanted to write what's on my mind and mainly about homosexuality," he told Reuters in an e-mail. "To tell you the truth, I didn't expect this much response."

In the current climate, bloggers say they are achieving a lot just by stating their nationality and sexual orientation. "If you haven't heard or seen any gays in Sudan then allow me to tell you 'You Don't live In The Real World then,'" Ali wrote in a message to other Sudanese bloggers. "I'm Sudanese and Proud Gay Also." His feelings were echoed in a mini-manifesto at the start of the blog "Rants and raves of a Kenyan gay man" that stated: "The Kenyan gay man is a myth and you may never meet one in your lifetime. However, I and many others like me do exist; just not openly. This blog was created to allow access to the psyche of me, who represents the thousands of us who are unrepresented."

News and Abuse

That limited form of coming out has earned the bloggers abuse or criticism via their blogs' comment pages or e-mails. "Faggot queen," wrote a commentator called 'blake' on Kenya's 'Rants and raves'. "I will put my loathing for you faggots aside momentarily, due to the suffering caused by the political situation," referring to the country's post-election violence. Some are more measured: "The fact that you are a gay Sudanese and proudly posting about it in itself is just not natural," a reader called 'sudani' posted on Ali's blog. Some of the bloggers use the diary-style format to share the ups and downs of gay life -- the dilemma of whether to come out to friends and relatives, the risks of meeting in known gay bars, or, according to blogger "...and then God created Men!" the joys of the Egyptian resort town Sharm el-Sheikh.

Others have turned their blogs into news outlets, focusing on reports of persecution in their region and beyond. The blog GayUganda reported on the arrests of gay men in Senegal in February. A month earlier, Blackgayarab posted video footage of alleged police harassment in Iraq. Kenya's "Rants and Raves" reported that gay people were targets in the country's election violence, while blogger Gukira focused on claims that boys had been raped during riots. Afriboy organized an auction of his erotic art to raise funds "to help my community in Kenya". There was also widespread debate on the comments made by Iran's President Mahmoud Ahmadinejad last September about homosexuals in his country.

The total number of gay bloggers in the region is still relatively small, say the few Web sites that monitor the scene. "It is the rare soul who is willing to go up against such blind and violent ignorance and advocate for gay rights and respect," said Richard Ammon of GlobalGayz.com which tracks gay news and Web sites throughout the world.

"There are a number of people from the community who are blogging both from Africa and the diaspora but it is still quite sporadic," said Nigerian blogger Sokari Ekine who keeps a directory of lesbian, gay, bisexual and transgender blogs on her own Web site Black Looks.

Ways to Meet

The overall coverage may be erratic, but pockets of gay blogging activity are starting to emerge. There are blogs bridging the Arabic-speaking world from Morocco in the west to the United Arab Emirates in the east. There is a self-sustaining circle of gay bloggers in Kenya and Uganda together with a handful of sites put up by gay Nigerians. And then there is South Africa, where the constitutional recognition of gay rights has encouraged many bloggers to come wholly into the open. "I don't preserve my anonymity at all. I am embracing our constitution which gives us the right to freedom of speech ... There is nothing wrong that I am doing," said Matuba Mahlatjie of the blog My Haven.

Beyond the blogging scene, the Internet's chat rooms and community sites have also become one of the safest ways for gay Africans and Arabs to meet, away from the gaze of a hostile society. "That is what I did at first, I mean, I looked around for others until I found others," said Gug, the writer behind the blog GayUganda. "Oh yes, I do love the Internet, and I guess it is a tool that has made us gay Ugandans and Africans get out of our villages and realize that the parish priest's homophobia is not universal opinion. Surprise, surprise!"

(Editing by Andrew Dobbie and Sara Ledwith)

pinknews.co.uk
http://pinknews.co.uk/news/articles/2005-6974.html

27th February 2008

2
African lesbian conference demands equal rights

by PinkNews.co.uk staff writer
Lesbians from across Africa have held a conference in Mozambique to highlight the homophobia and prejudice they face across the continent. Most nations in Africa criminalise same-sex relationships and in some countries gay people can be put to death. The Coalition of African Lesbians conference was attended by more than 100 delegates.

Women from 14 African countries gathered in Namibia's capital Windhoek in August 2004 to develop the Coalition of African Lesbians. Lesbian organisations and a number of individual women from Sierra Leone, Ghana, Nigeria, Liberia, Rwanda, Kenya, Uganda, Tanzania, Zambia, Zimbabwe, Botswana, South Africa, Mozambique and Namibia are members of the organisation. "Our main goal is that lesbian and homosexuality can no longer be seen as a criminal offence," the group's director and conference spokeswoman Fikile Vilakazi told Reuters. "You should not be arrested and charged for how you use your own body."

The coalition lobbies for political, legal social, sexual, cultural and economic rights of African lesbians by engaging strategically with African and international structures and allies and to eradicate stigma and discrimination against lesbians. South Africa, one of the few countries on the continent where gay men and lesbians are allowed to marry and legally protected from discrimination, has been rocked by several murders of prominent lesbian activists.

Sizakele Sigasa, 34, an activist for HIV/AIDS and LGBT rights, and Salome Masooa, 24, were discovered dead at field in Soweto, Johannesburg, on July 8th. They had both been shot and, it is suspected, raped.

On 22nd July Thokozane Qwabe, 23, was found in a field in Ladysmith, KwaZulu-Natal with multiple head wounds. She was naked and it is thought she was also raped.

Africa Today
http://africatoday.eh7.co.uk/cgi-bin/public.cgi?sub=news&action=one&cat=65&id=1374

March 31, 2008

3
Lesbians rise against discrimination

byBunmi Akpata-Ohohe
The Coalition of African Lesbians from across the continent has, at an extraordinary meeting in Maputo, Mozambique, called on African governments to confront discrimination against homosexuals across the continent and to stop treating them like criminals. Conference spokeswoman Fikile Vilakazi, told the forum that action was needed on growing homophobia that, she claimed was widespread in Africa and which violates individual's human rights. Scores of traditional African societies deem same-sex relationship as detestable and campaigners accuse some African governments of state-sponsored discrimination and persecution.

According to the International Gay and Lesbian Association, homosexuality is outlawed in 38 African countries, and legal or unmentioned in the statute book in at least 13. In Mauritania, Sudan and northern Nigerian states, homosexuality may be punished by death. In Uganda, 'offenders' may receive life imprisonment, and in countries including Gambia, Kenya and Tanzania, homosexuality is punishable by up to 14 years in jail. In contrast South Africa has the most liberal attitude enshrined in its constitution banning discrimination against gays and lesbians, although discrimination is still alive and kicking in the country too.

pinknews.co.uk
http://www.pinknews.co.uk/news/articles/2005-7456.html

April 21, 2008

4
Website celebrates Africa's gay heroes

by Staff Writer, PinkNews.co.uk
A Supreme Court judge, an HIV treatment campaigner and an anti-apartheid activist all feature on a new website highlighting African heroes. All three are from South Africa. The website, africansuccess.org, was created by Kadija Traoré Bush, who is of is Malian and Beninoise heritage. She wants to add more African lesbian, gay, bisexual and transgender (LGBT) biographies to the site, and is asking people to submit entries. "Gay Africans make up a part of the landscape of the continent," she said. Any member of the gay community who has achieved something of merit deserves a place on our site. We welcome the submission of their biographies."

Simon Nkoli, the South African gay rights and anti-apartheid activist, Zachie Achmat, the HIV treatment campaigner and Edwin Cameron, the openly gay and HIV-positive South African Supreme Court judge are the first three entries. The new website is being supported by gay human rights campaigner, Peter Tatchell of OutRage! "The first three LGBT entries are all South Africans," he said. "There are many other heroic LGBT campaigners in Uganda, Zimbabwe, Nigeria, Cameroon, Ghana, Mozambique, Kenya and elsewhere. I hope that people who know these courageous, inspiring individuals will add their biographies to the AfricanSuccess website in the coming weeks and months. This is, in part, a user-generated website, a bit like Wikipedia. It depends on public contributions to expand its data base."

The website organisers are keen to debunk the often negative public image of Africa. "Africansuccess.org wants to get people to look at Africa in a different and positive way," said Kadija Traoré Bush. "We want to inspire the young, give hope and ambition to Africans everywhere, and to change the way the world sees Africa. Our aim is to create a website that will inspire a continent. If we can show the world where Africans are successful, we can change the way in which we are perceived. It is an interactive community website, which encourages the people who visit the website to add the names and biographies of people that they know and consider worthy of being included. The site is free access and it is free to add names, biographies and other historical information. We hope that people from all countries and all walks of life are going to put up the biographies of people they feel proud of, so we can offer role models for today's children and tomorrow's leaders."

All Africa
From: The Global Forum on HIV and AIDS
http://msmandhiv.org/

29 May 2008

5
Homophobia Continues to Hamper HIV Efforts Globally

Mexico City/Geneva – The International AIDS Society (IAS) today expressed its deep concern about continuing inflammatory and homophobic statements by political leaders in Uganda , Poland , and most recently by the President of The Gambia, and urged national and international leaders to reject homophobia and to take affirmative steps to reduce its impact on HIV. One of the many lessons learned in the IAS' more than 20 years of leadership in HIV/AIDS, is that well-designed and appropriately targeted programs, implemented with the support of public health and political leadership, can effectively reduce HIV transmission in communities most at risk for HIV, including gay men and other men who have sex with men (MSM).

A report issued at the end of 2007, led by researchers at the Johns Hopkins Bloomberg School of Public Health in the US , provides solid evidence that HIV among MSM continues to be widespread, and in many cases, is exacerbated by stigma, criminalization and the lack of appropriate services. The study indicates that, even in countries with low HIV prevalence in the general population, the epidemic among MSM is raging. According to UNAIDS, fewer than one in 20 MSM around the world has access to HIV prevention, treatment, and care – and even fewer in low-income settings. Compared to the HIV testing rates of 63-85 percent seen among MSM in Australia, Europe, and North America, rates among MSM in much of Africa, Asia, and Eastern Europe are often under 20 percent.

As it has been demonstrated in many different countries, reducing the social exclusion of gay and MSM communities through the promotion and protection of their human rights (including sexual rights and the right to health) is not only consistent with, but a prerequisite to, good public health. Once discriminatory policies are abolished and stigma and discrimination are confronted, country-based programs can be put in place to encourage gay men and MSM to stay free of HIV-infection, thus supporting national goals of reducing HIV burden. However, efforts to replicate these successful strategies in more countries are hampered by recent homophobic statements made by political leaders from Uganda , Poland and The Gambia. Comments from these leaders, and other politicians who call for the arrest, detention, and even killing of homosexuals, are reprehensible.

In 2008, despite the accumulation of more than a quarter of a century of knowledge of successful HIV interventions, homophobia and the criminalization of homosexuality continue to be significant obstacles to the scale up HIV prevention, treatment, care and support. Though countries such as Cape Verde and South Africa have repealed their sodomy laws, and government officials in Kenya, Malawi, and Mauritius have begun discussions about the harmfulness of such laws, a resurgence of intolerance and homophobia, coupled with lack of action to repeal laws that violate the human rights of same sex practicing men and women, is posing a grave threat to the AIDS response in many countries. Despite its much heralded success in promoting a public health response to HIV, Uganda continues to cling to a colonial-era sodomy law that punishes homosexual conduct with life imprisonment. And, Uganda is by no means the exception. Worldwide, more than 85 countries criminalize consensual homosexual conduct. Such laws give governments a pretext to invade people's private lives and deny them essential human rights: to live in peace and in health.

The XVII International AIDS Conference, to be held in Mexico City from 3-8 August 2008 (http://www.aids2008.org/start.aspx), will highlight successful work with MSM in several Latin American countries. The experience from Latin America, as well as from other parts of the world, can provide invaluable guidance to leaders from other middle- and low-income countries in Africa, Asia and Eastern Europe . The very high proportion of MSM in Latin America who, over the past 25 years, became infected with HIV, developed AIDS and later died can only be described as catastrophic. But, in the past decade, in a growing number of countries throughout the region, there have been positive responses that continue to serve as shining examples to the rest of the world. If national and world leaders are serious about curbing the epidemic, programmes that bridge across sexual orientation, that protect public health, and transform stereotypes and prejudices must be a first line priority.

"Homophobia – whether propagated by government leaders, enforced by outdated laws, or perpetuated through stigma and discrimination – continues to fuel this epidemic, and should therefore be the number one enemy of those who are serious about ending this global tragedy," said Dr. Pedro Cahn, IAS President, AIDS 2008 Co-Chair and President of Fundación Huésped in Buenos Aires, Argentina. With an international membership of more than 10,000, the International AIDS Society is the world's leading independent association of HIV professionals.

Reuters
http://www.alertnet.org/thenews/newsdesk/IRIN/f719e5778f80ebdc4fcd79068e1bb67a.htm

19 June 2008

6
Angola: Invisible and vulnerable Gays

Luanda, Angola - It was a wedding that pulled out all the stops, including a party at the Marine Club on the island of Luanda and a five-star nuptial night at the Hotel Presidente Meridien. The ceremony didn't go unnoticed by Angola's newspapers. "Shameless," screamed the cover of one of the country's weekly news magazines. "Abominable," read the headline of another. Angolan couple, Bruna and Chano paid a high price for making their homosexual relationship public. The two young men met when they were both living in the Luanda neighbourhood of Bês. After seeing each other for three and a half years, they decided to hold a ceremony to make their relationship feel official, although doing so legally was not an option.

On May 6, 2005, 21-year-old Aleksander Gregório (Chano), and 23-year-old Bruno*, better known as Bruna, signed a letter of commitment in the presence of a retired notary. All aspects of the ceremony were discussed in minute detail in newspapers and café conversation: the fact that Bruna wore a wedding dress, the party's guest list and, above all, the couple's sexuality. Newspapers used terms such as "shameless" to describe the young men's relationship. Despite the attacks, Chano and Bruna held out and remain together, five years after beginning their relationship.

The love that dares not say its name
Data from an epidemiological study carried out in 2007 by the National Institute for the Fight Against AIDS (INLS) showed that five percent of all HIV infections in Angola were among men who had sex with men (MSM). These numbers, however, do not make the subject any less taboo. According to Américo Kwanonoka, an anthropologist, "Angolan society is not yet prepared to accept homosexuals." The local culture, which is influenced by Christianity, calls for the perpetuation and expansion of the family. Homosexuality is therefore viewed as an affront to the laws of nature, said Kwanonoka. Jane Dias, 35, who was born João Dias, has personally felt the effects of such intolerance.

"I've had rocks thrown at me in the street. I used to think I was the only transvestite in Viana [a neighborhood of Luanda]," she told IRIN/PlusNews. Edna, 21, who was born Edson*, dropped out of school in 8th grade because she suffered so much persecution from her classmates. Not surprisingly, few individuals in Angola are prepared to risk being open about their homosexuality. "Many of those who cuss and throw stones at us on the street are the same ones who come knocking at our door at night," revealed Dias. Social psychologist Carlinhos Zassala explained that many Angolan gays use marriage as a way of avoiding stigma, but once married, continue to have occasional sex with other men. In many cases, the casual sex does not involve the use of condoms. In Angola, a commonly-held assumption that only men with feminine mannerisms are homosexual means that many who have sex with other men do not self-identify as gay, pointed out Roberto Campos, an official with UNAIDS. "If the person fails to recognise himself as such, the message of safe sex doesn't reach him. The fact is that unprotected anal sex presents a high virus transmission risk."

The men interviewed by IRIN/PlusNews confirmed that they had repeatedly exposed themselves to risk.

Edna said she did not like to use condoms because she was allergic to the lubricating oil. She admitted to having sexual relations without a condom with her boyfriend, who is married and the father of two children. According to Edna, her boyfriend has tested negative for HIV. She herself tested after becoming convinced she was infected. "Four months ago, I was feeling weak and nauseated, so I decided to take the test. The result came back negative, but they asked me to take it again in three months," she said.

Invisible population
Because they are an invisible population, gays are ignored in government AIDS policies, such as the 2007-2010 National Strategic Plan for the Control of Sexually Transmitted Infections, HIV and AIDS. A 2007 study carried out by the International Gay and Lesbian Human Rights Commission called "Off the Map: How HIV/AIDS Programming is Failing Same-Sex Practicing People in Africa," found that gays throughout the continent were excluded from HIV/AIDS programmes. The "silence regarding HIV infection among homosexuals" meant that messages about safe sex were exclusively tailored to heterosexuals, leaving the gay population neither informed nor protected.

The lack of information also creates problems at health facilities. Esmeralda, 29, who was born Pedro*, said that when she went to the Military Hospital in Luanda to take an HIV test, the nurse told her she didn't need to test, because it was certain she was already infected. All of the men interviewed by IRIN/PlusNews expressed their wish to access HIV and AIDS services at a facility tailored to their specific needs. "I would like for us to have special attention. Many organisations have already made promises, but to this day none of them have been put into practice," Edna said.

Political change
In 2006, the non-governmental organisation Acção Humana (Human Action) tried to develop a prevention programme for gay men.
The idea was to encourage the use of condoms, combat discrimination and advocate for human rights. "We wanted a project implemented by gays themselves as educating peers who would get in contact with other gay people at night clubs, bars and beaches," explained Acção Humana Coordinator, Pombal Maria. The organisation managed to recruit 14 men who were given preliminary training, but the initiative lost steam due to a lack of resources. In 2007, when the NGO presented a proposal for a similar programme to donors, they rejected it on the basis that there were not enough homosexuals in Angola to justify the project.

One positive development for Angola's homosexual population has been the launch of a study this month that will be conducted by the INLS, in partnership with the United States Centres for Disease Control. The aim is to identify the habits and behaviours of this group, including their risks and vulnerability with regards to HIV.

"This demonstrates an important political change. Before, gays were not a priority issue. Now they have stopped being invisible and have been included in discussions on public health and the HIV epidemic," said UNAIDS' Campos.

pinknews.co.uk
http://www.pinknews.co.uk/news/articles/2005-8362.html

July 15, 2008

7
Foreign Office issues advice to Pride travellers

by Staff Writer, PinkNews.co.uk
The Foreign and Commonwealth Office has issued advice for LGBT people travelling to gay Pride events. Holland, Denmark, and South Africa are holding major gay Pride marches later this summer, and Stockholm is hosting EuroPride. The FCO is urging potential travellers to look at their website for safety advice.

"You can cut down on avoidable problems if you prepare well and research your destination before you leave the UK," spokesman Steve Jewitt Fleet said. "This year, hundreds of Brits will be travelling to global gay Pride events. Attitudes towards gay, lesbian, bisexual and transgender travellers can differ widely around the world and from those in the UK. If you’re planning to join the party at one of the upcoming Pride events, check out the FCO’s dedicated advice for LBGT travellers, which can be found on our website. You should also visit the FCO’s country-specific travel advice pages before you leave, so that you can familiarise yourself with local laws and customs of your destination.!

Among the gay-specific advice from the FCO:

a) Be aware of the possibility of crime - criminals have been known to exploit the generally open and relaxed nature of gay 'neighbourhoods' and beaches.

b) Check out your accommodation – many hotels now actively welcome same-sex couples, but check before you go and make reservations in advance to avoid difficulties when you arrive.

c) The legal age of consent varies from country to country. You should check individual ages of consent with the embassy of your destination country before you leave the UK.

d) Be aware that in some areas within the country you are visiting, open expressions of sexuality might be frowned upon.

e) Think about sexual health before you go – many sexual health products are not as readily available or of the same quality abroad as they are in the UK.

The Minister for Europe, Jim Murphy, has condemned the violence at Gay Pride events on his blog. "I was very upset to hear the reports of violence at the Pride parades in Prague, Riga and Sofia in the last few weeks, and also very disappointed that pressure from various sources meant the Pride parade in Moldova scheduled for May did not take place," he wrote. This was in marked contrast to the peaceful Pride held for the first time ever in Delhi on Sunday 29 June."

Despite the 150 strong police presence at Pride in Sofia, Bulgaria, more than 60 skinheads and rightwing nationalists were arrested and a homophobic mob threw stones and petrol bombs. "The FCO is committed to promoting equality and ending the discrimination of lesbian, gay, bisexual and transgender people around the world and we've developed a programme of skills and information for embassies and diplomats to help achieve this," wrote Mr Murphy.

In May the FCO issued an ‘LGBT Toolkit’ to its 261 embassies, high commissions and other diplomatic posts. The kit contains information for other countries on the official British policy on gay rights and instructions on how to "provide added value to equality and non discrimination work." The violence and discrimination shown towards LGBT people abroad is one of the reasons why the government is under pressure over gay asylum. There are several recent examples of the Home Office refusing asylum to gay people whose home countries criminalise or repress homosexuality.

From: Xtra.ca
http://www.xtra. ca/public/ viewstory. aspx?AFF_ TYPE=1&STORY_ ID=5190&PUB_ TEMPLATE_ ID=3

July 31, 2008

8
Book review: How solutions lie in The Wisdom of Whores
‘The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS.’
by Elizabeth Pisani. Viking Canada. $23.

by Greg Beneteau
Elizabeth Pisani is taking the AIDS industry to task in print. After nearly a decade of tracking HIV-infection patterns among high-risk groups in Asia, Elizabeth Pisani has concluded that there's a worldwide shortage of frank discussion about HIV risk factors. People, she says, don't talk openly about "sex and drugs and all the other daft things you do when you're thinking with your dick, or female equivalent." The Wisdom of Whores describes in almost comic detail how the US government doles out billions of dollars to fund abstinence before marriage programs that don't work and to "eradicate prostitution" in countries where there are few alternatives. This approach is tainted by religious ideology — the kind of bible-thumping that paints AIDS as an angry and vengeful God's punishment of gays. According to Pisani political correctness, human rights and money — especially money — also conspire to distract attention from the realities of the world AIDS crisis.

"It's recognized that there's an institutional investment in making HIV absolutely everybody's problem, in making it a development issue and a gender inequality issue and in mounting an expansive multisectoral response and all of that bollocks," Pisani explains. "But while we're doing that we're refocusing prevention away from what works." A former Asian correspondent for Reuters, Pisani stumbled into the world of epidemiology after returning to school in the UK in the mid 1990s. With a PhD in infectious disease epidemiology she joined the newly formed United Nations umbrella group UNAIDS in 1996 and helped to sound the alarm about the rapidly growing numbers of HIV cases. She relates with frustration how world leaders are afraid to confront evidence that intergenerational and extramarital sex — sex that lies outside the bounds of polite conversation — fuel HIV transmission in parts of Africa. They prefer, she says, to portray AIDS as an issue of poverty and under-development.

But Uganda and Senegal, despite their socioeconomic challenges, were able to stave off the worst of the HIV epidemic by focusing prevention efforts on sex workers and people having "sex in nets," or with multiple partners. Elsewhere the timidity had disastrous consequences: By the time Pisani penned the first biennial report on AIDS in 1998 one in four adults in some African countries were believed to be infected. "I just reached a pitch of frustration that we could be making so much more difference than we were," she says. The late Republican senator Jesse Helms told the New York Times in 1995 that he wanted to decrease funding for US domestic AIDS programs because the disease was spread by the "deliberate, disgusting, revolting conduct" of gays. It was then that the "AIDS industry" — Pisani's term for the many national governments, NGOs, faith groups, pharmaceutical companies and do-gooder rock stars — finally got on board. Helms changed his tune in 2000 when celebrities like Bono and Franklin Graham, son of evangelist Billy Graham, convinced him that HIV brings immeasurable suffering "to infants and children and their families." Helms was one of the driving forces behind the 2003 President's Emergency Plan for AIDS Relief (PEPFAR), a five-year, $15-billion US program to fight the epidemic. (Recently renewed and increased substantially in July 2008.)

PEPFAR did raise the bar for funding HIV programs in developing countries but, Pisani points out, the same people who are silent about HIV as it rampages among gay men, drug users and sex workers in the West are also squeamish about helping gay men, drug users and sex workers in the rest of the world. Faith-based groups are singled out for special treatment under PEPFAR, despite the opposition of many churches to contraception and homosexuality. Only 20 percent of PEPFAR funds goes to prevention efforts and fully a third of that money promotes abstinence — an approach that doesn't work — as the sole means of prevention. High-risk groups have been entirely overlooked. By law, donor recipients aren't allowed to take PEPFAR funds if they intend to help sex workers do anything but get out of the business. Brazil, which wants to regulate sex work, walked away from $40 million rather than yield to this demand. And to this day not a cent has gone toward harm-reduction programs for drug users, Pisani notes. There are also those who see PEPFAR as an investment rather than an act of mercy. In the first years of the project huge amounts of cash went toward buying brand name antiretroviral drugs and "Made in America" condoms rather than relying on cheaper, local versions. In Asia, where Pisani started tracking HIV-prevalence rates in 2001, close to 100 million people were being ignored or underserviced. It was her job to figure out in which circles HIV was being spread, mainly through good old-fashioned field surveillance: sample some people and ask them about their behaviours. Pisani found that asking transgendered sex workers about condom negotiation and learning the street value of heroin in Jakarta turned out to be a lot like writing a good news story.

"I never thought I would be an arms-length number cruncher," Pisani says. "I was first and foremost a journalist and that means talking to people." Those people include Fuad, a young Indonesian long-haul truck driver who supplements his meagre income by selling sex to men, as does his girlfriend back home. Pisani spoke with Frankie, a former heroin user from Bali who used to share a single needle among dozens of his fellow inmates in prison. Pisani learned that in Indonesian jails heroin is cheaper than clean needles. We meet Nancy, who is at ease talking about her work as the headmistress of an Indonesian network of MTF transsexual sex workers known as waria. She complains that her young charges have no respect for their elders, brazenly showing off their designer vaginas — bought at sex-change clinics in neighbouring Thailand — to potential clients. Nancy also works for Jakarta's Department of Social Affairs teaching waria the practical skills they need for career options outside of sex work. But even in the face of high HIV- prevalence rates and a conservative Muslim theology that vilifies sex work and condom use, most waria remain sex workers either because the pay is too good or it's the only job they've ever known. They choose.

"It's less about the money than about the orgasms," Nancy explains to Pisani. "Let's face it, we're all human, we've all got to get laid." The book is full of such frank, often funny revelations from ordinary people. Combined with reams of statistical data collected from the red-light districts of Jakarta to the gay discos of Shanghai, Pisani comes to a simple but inescapable conclusion: sometimes people, for survival, fun or a combination of the two, take risks and they need help to do so more safely, not preaching and isolation. But Pisani is not just another angry scientist railing against conservative values. She also tears a strip off liberal activists who have their own grab bag of failed policies, what she calls "the sacred cows of the AIDS industry." Many of the ideas central to prevention today, such as emphasizing peer education, using grassroots non-governmental organizations for outreach and pressing for a strict "voluntary testing only" rule, were borrowed from the playbooks of AIDS activists in gay communities in the '80s. They were amazingly successful under the repressive conditions they faced but, according to Pisani, many of the underlying assumptions change when you go halfway around the world. Peer education?

Pisani says sex workers and drug users are more often rivals than friends, that small-scale outreach falls apart when your client base is too large or spread over too large an area, and that in some cases mandatory testing can break the wall of shame and stigma when followed up with care and support services. Pisani also unabashedly tears apart any notion that it's preferable to spend money on universal prevention campaigns rather than target high-risk behaviours. She blames this mentality on the politicization of the issue — the back-and-forth between ideologies that has hindered epidemiologists' efforts to treat HIV like any other infectious disease. "That's what it is, first and foremost," she says. "But now we're in this weird situation where saying 'HIV is a gay disease' is stigmatizing to the gay community. So we say something else. Then awareness and condom use during anal sex drops and suddenly, HIV is a gay disease again.... If, in bending over backward to avoid stigmatizing people, you lose the ability to reach them it won't work." It all sounds rather unkind. Then again public health has always been a rather fascistic discipline, Pisani concedes.

When behaviours prove frustratingly hard to change, sometimes you just need to fall back on the basics: condoms, clean needles and frank discussions about the risk factors for HIV transmission. "Everyone takes risks," she says. "It's part of the human condition, thank God; how boring would life be if it weren't? But people choose the risks they're willing to take based upon a fairly complex cost/benefit model. It's not perfect but the more information we give them the more sophisticated their analysis will be." Have her experiences made Pisani any more risk-averse? She laughs. "Oh God, no. I'm just as much of a slut as I ever was."