About 2% of Bhutanese men in Thimphu have had homosexual sex and this is a cause of concern for health officials who say unprotected homosexual encounters heighten the chances for the spread of HIV.
The rapid assessment on Sexual Behavior Network in Thimphu discovered that 2% men reported their first sexual partner as someone of the same gender. Add to that, 1.7% of the surveyed men in urban areas were categorized as people who indulge in same-sex activity by the general population survey 2006.
The most recently updated stats reflects 21 new detected HIV cases as of June this year. This takes the number of people living with the bug to 225 which excludes the 52 who are dead.
Globally, an estimated 5 to 10% of HIV infections are the result of homosexual practices. With the growth in this global trend, back home, the health ministry will conduct a study on man-to-man sex (MSM) which will target the vulnerable groups on risky sexual behavior.
One of the vulnerable groups is some Transgender-groups (TG) who are also vulnerable to Aids especially when both partners are men. TG refers to self-identification of sex that does not match one’s sex.
In light of these and on the basis of findings HIV/AIDS intervention programs will be instituted.
The National STI and HIV/AIDS Control Program (NSHCP) of the health ministry will conduct a study in about a month’s time for the man-to-man sex (MSM) and the vulnerable groups.
This study is the first of its kind in Bhutan.
The NSHCP will conduct the study in few districts and the findings will be generalized with the rough estimation of MSM and Transgender-groups (TG) with the other districts.
After the completion of the study, the NSHCP will target intervention packages for the HIV and STIs with the focus on the above identified groups.
It will comprise programs on the promotion of condom and lubricant use, promotion of Voluntary Counseling and Testing (VCT), develop comprehensive MSM and TG awareness program, and a prevention program on HIV and STIs.
An official from the Ministry of Health (MoH) said currently there are no MSM cruising sites and sexual risk behaviors was yet-to-be understood.
He said, “As of now no program interventions for MSM and TG were in existence and the above findings (survey and assessment) have been based on these anecdotal findings and the global scenario.”
The health official said the NSHCP study on MSM and TG will study the size estimation and map exercise in close collaboration with the UNDP, and International Institute of Population Studies in Mumbai, India.
He said this study is purely for targeted intervention programs, which is aimed to strengthen HIV and STIs prevention programs in the country and it will not be used for policy directives.
“It’s a targeted program for intervention purpose for the most vulnerable sections of the sexual minority. We are in the dark right now,” said an official.
Apart from the MSM, the health official said, there could also be woman-to-woman sex, but, in terms of prevention of HIV, the MSM was the most vulnerable of the lot.
The study will involve stakeholders, starting from the grassroots. In order to reach the targeted population this study will reach the unreachable population.
Till date, several measures have been adopted by the NSHCP to educate people on the benefits of timely diagnosis through Voluntary Counseling and Testing (VCT).
Among the 21 new HIV detected cases in which 11 are female, 17 had acquired infections through heterosexual behavior, three from their infected parents and one through blood transfusion.
Fourteen were diagnosed through VCT.
In the 19 years of HIV epidemic, 19 out of 20 Dzongkhags have reported one or more HIV positive cases.
The maximum number of cases was reported from Thimphu where 66 cases were reported followed by Phuentsholing which saw 49 cases.