What is therefore needed is an analysis of Bailey’s data. Why are persons in homosexual relations prone to be in illegal lottery scams? Is it because they are faced with discrimination at the workplace and cannot get or retain a legitimate job? Or are they suffering disproportionately because of the economic hardships? Is it that their lifestyle requires big bucks?

Additionally, some persons who appear to be sporting a homosexual lifestyle have been noticed to shop in groups. Is it that they are proud of the lifestyle and want to flaunt it, or are they afraid of violence and feel safe in a group? It seems to me that there needs to be more research done on persons within this community.

Not surprisingly, Jamaica’s lonely gay rights group, J-FLAG, was concerened that this would give homophobes one more reason to beat the shit out of gay men. Much more surprisingly, Jamaica’s top cop was also upset by the statement; although Bailey refused to retract it, his boss apologised on behalf of the Jamaican police.

It happens that J-FLAG has roped Miss Jamaica and her gay brother into a new campaign that aims to start chipping away at homophobia:

I’m in two minds about it. On the downside, the phrase “unconditional love” implies loving someone despite some hideous deformity in their character. I love my brother even though he’s… (sharp intake of breath, try not to hold your nose)…gay. On the more positive side, it does make sense to try and start from where the target audience is, and it’s clear that most of the target audience in Jamaica are very far from being ok with gay brothers. So far, indeed, that the national TV station has refused to carry the ad.

I’m interested that Rev Dick felt the need to point out that Jamaican political satirist Owen Blakka Ellis, who has had the gall to say that being gay isn’t so bad, was a “returnee from Canada”. Obviously he’d be pro-gay, then, Canada being a paradise for over-entitled whiny gays, seems to be the implication. It’s true that Canada’s at the other end of the gay stigma spectrum from Jamaica.

I have been accused (with some justitification) of being impatient with people who pull the stigma card when they have things so relatively easy. But this beautifully written, nuanced essay about young gay men in Canada from Michael Harris reminded me that “relatively easy” does not mean “easy”. The tornado that was AIDS has been more or less dissipated by treatment in Canada, but the wreckage it left has indeed shaped the landscape for another generation. Read it, please (pdf here).

On the one hand, Canada bans Dire Straits. On the other, it fills the streets with posters aimed at extricating sex workers from social non-existence. Halifax group Stepping Stones is running an ad campaign reminding people that hookers are mothers, daughters, brothers, friends. They are also PhD students, civil servants, dental hygienists, actors and many other things when they’re not with a client, and shiatsu therapists, shrinks, grief counselors, actors and many other things when they are. Oh, and criminals (though it is my burning hope that this won’t be true in Canada by the end of the year).

It’s that criminalisation which creates stigma and the need for campaigns like this; the stigma in turn makes it hard to run these campaigns. The Chronicle Herald reports that ad agency Extreme Group‘s staff used their own grandmothers and Sepping Stones employees for the campaign because “regular” models didn’t want the job.

Also fighting invisibility are sex workers in Ottawa. There, Chris Bruckert and Frederique Chabot worked with members of prostitute group POWER to publish a synthesis of what sex professionals said about their work, and (perhaps more importantly) their work-life balance. Many of the comments reminded me just how hard it is to maintain that balance in any profession which society deems an identity rather than an occupation (film star, Royal, hooker). Here’s Janette, talking about how the police treat her when she’s not working:

“I was showing my new neighbour around, walking him up to the food bank. And as we were walking, one cop turned around and told the young man I was with ‘Do you know you are with a prostitute? You could get in trouble for that’. He yelled at the cop ‘She is my neighbour and I don’t care what she does for a living, she is helping me out. She is still a person’. I was so embarrassed. That did bring tears.”

You can read the whole (.pdf) report here. Stepping Stones have published a similar volume, which I haven’t yet read, called Sex Workers Talk Back.

The song was banned by the Canadian Broadcast Standards Council after a solitary Eljibiti radio listener whined that it bruised their fragile soul.

Every reader my age knows the “MTV” song virtually by heart — boneheaded delivery men being grumpy about the absurd amounts of money made by boneheaded musicians with more mullets than talent. The offending lyrics include the following:

“See the little faggot with the earring and the makeup
Yeah buddy that’s his own hair
That little faggot got his own jet airplane
That little faggot he’s a millionaire”

Our Sensitive Soul found this “extremely offensive” and labeled it “discriminatory”. Since the complainant says they are a member of the Eljibiti Community, I’m assuming they consider it to be offensive to gays rather than to rock stars. But that confuses me. A pop classic which won the Grammy for record of the year in 1986 portrays homophobia as a sentiment expressed by bigoted and resentful boneheads. One person in Newfoundland, who apparently has not mastered the skill of switching off the radio, considers the association of homophobia with stupidity to be offensive. And six adults of sound mind meeting on behalf of the Canadian Broadcast Standards Council spent I’m not sure how much time coming up with a 5000+ word decision that boils down to this: “The song contained a word that referred to sexual orientation in a derogatory way.”

Give me strength.

The decision makes for amusing reading, dredging as it does through the history of similar complaints. It seems that even more sensitive souls have in the past been upset by songs and skits about cigarettes (fags, to a good British sometime smoker such as myself). Of course the way Canada is going, it’s not impossible that cigarettes will soon be outlawed, with all evidence of their existence digitally excised from old Humphrey Bogart films.

In fairness, I should note that the overwhelming majority of Canadians of all sexual hues commenting on the Globe and Mail’s report of the ban think it is just plain silly. But I think I’ll try be more careful about my “hookers, fags and junkies” shorthand when I next visit Canada, just in case. I wonder if any radio listeners in Newfoundland are offended by any of these words: Big. Girl’s. Blouse.

Apparently, I’m not the only gay man trapped in a straight woman’s body.

Thanks to RH for the tip.

The Canadian ruling is the more complex, because it has given us the right decision for the wrong reasons. A judge has said the nation’s blood transfusion service can refuse gifts of blood from men who have had sex with other men. The right reason for this decision is that it is a cost-effective way of reducing the likelihood that sexually transmitted viruses, in particular HIV, make it in to the blood supply. The reason given (which I think sets a bad precedent) is that the blood transfusion service is not bound by legislation intended to reduce discrimination against people who choose anything other than vanilla sex, because it is not a government agency.

Of course that’s nonsense. You shouldn’t be allowed to discriminate against people on the basis of who they choose to have sex with in the private sector, in NGOs, in schools or anywhere else, unless they are choosing to have sex with someone who doesn’t or can’t consent. But I don’t believe that asking gay men not to give blood is discriminatory. None of us has a right to put out body fluids into a pool from which the public will draw, and the judge, Catherine Aitken, agreed, saying: “Put simply, blood donation is a gift. A gift is freely offered, but also must be freely received, or freely declined….There is no requirement under the law for CBS, or any other blood provider, to accept the gift of blood from anyone.”

I do agree that the exclusion criteria are a little draconian. “A man who has had sex with another man even once since 1977 is not allowed to donate blood in Canada or the United States,” says the blood service. In terms of HIV, what we’re most worried about are brand new infections — people who have lots of virus in their blood but haven’t yet got enough antibodies to HIV to show up on the screening tests that blood banks use. Those are the ones more likely to lead to the “tainted blood scandals” (blerch) that got the voters so exercised about blood safety in the first place. Blood donated by people who’ve been infected for longer will get picked up in the normal screening process so it’s not quite such a drama if they give blood. In most countries, it make it more expensive for the taxpayers who foot the bill, because blood is pooled into batches for testing, and any reactive test, including false positives, mean the whole batch gets thrown out. (Canada tests individual units so that’s less of a problem).

Activists whine say that refusing to accept blood from gay men tars them with the brush of “AIDS victim” and reinforces stigma. “Not everyone who is gay has AIDS”, declared Kyle Freeman when he brought the case against the blood service that precipitated the ruling. Well of course not. Not everyone who is gay has HIV, either. But in Canada, a gay man is around 20 times more likely to be infected than a heterosexual (pdf) (51% of HIV infections are concentrated in the roughly 4% of sexually active adults who are gay men). If gay guys think that fact is stigmatising, they might want to reinvigorate HIV prevention efforts in their community. Screening men who have sex with men out of the pool of blood donors is not discrimination, it is common sense. (As an aside, I find it interesting that no-one seems to be whining complaining about the rights of drug injectors being violated because the blood service won’t accept their blood. Surely their rights are being violated in exactly the same way, even though they are actually less likely to be infected with HIV than gay men in some Canadian cities).

Meanwhile, across the border, American courts continue to chip away at the great edifice of true discrimination against people who choose their sex partners according to their own taste, rather than that of the Sex Police in groups like the Traditional Values Coalition. Hot on the heels of a ruling that repealed a ban on gay marriage in California, another California judge, Virginia Philips, has ruled that the “don’t ask, don’t tell” rule that makes it impossible for openly gay people to serve in the military is unconstitutional. This is very good news indeed; let’s hope the mid-term elections don’t scare the administration and the Senate into prolonging the agony for gay men and women who want to invest their lives waging war on behalf of the citizens of the US.

Thanks to Sarah Chown for nudging me to write about this.

An appeal would fly in the face of the data (which show that Insite reduces overdoses and many of the other frankly nasty things that happen to people who live with addiction to injectible drugs). It would fly in the face of pragmatism — up just one flight of stairs from the safe injecting room is a drug treatment centre which works to help people get off drugs when they’re ready to try. Detox is never an easy thing to achieve; our best bet is to have really strong links between services for current injectors and services that help them stop. But most of all it would fly in the face of any remaining self-respect that Canadians might have about their political system. Because although the newspapers talk of “the Harper government” doing this or that, Canada actually has no government right now, or at least none that answers to the normal description of parliamentary democracy. What right, then, does Harper have to be prosecuting court cases that waste tax dollars and lives?

Harper’s bully boy tactics may work for Insite in the end, though. HealthCanada is typically mealy-mouthed about an appeal, saying: “While the government respects the court’s decision, it is disappointed with the outcome. The government is reviewing the decision carefully. Until this review is complete, it would be inappropriate to speculate on future action on the part of the government of Canada.” But it’s very clear that a Liberal government would not keep banging its head against the wall of common sense that Insite represents. And by sending parliament packing until March, Harper may just have signed the death warrant for his own “government”. That would be good news for Insite users and other Canadians alike.

Thanks to Miriam for bringing this to my attention while I’m in distant Vietnam.

The fact that raids on over 800 brothels didn’t net any traffickers doesn’t mean that there isn’t anyone in the UK selling sex against their will. But (I’ve said it before and in today’s Guardian I say it again) trying to wipe out the sex trade completely only makes things worse for the minority who are forced into it.

There is little one can do to change the minds of those who object, viscerally, to the commodification of sex. And the numbers will always be open to dispute, as they are with any illegal activity. But a lot of good researchers have spent a lot of time and effort trying to get a handle on trafficking in the sex trade — you can find excellent references here and here, and there’s a pretty good discussion thread over at Badscience. It’s like the massive, hidden HIV epidemic in the Middle East — if we haven’t found it after two decades of looking, maybe it really isn’t so massive after all.

For those who don’t have time to read the whole Guardian article, I’ll pull one key quote from a cop:

The head of the UK Human Trafficking Centre, Grahame Maxwell, who is chief constable of North Yorkshire, acknowledged the importance of the figures: “The facts speak for themselves. I’m not trying to argue with them in any shape or form,” he said.
He said he had commissioned fresh research from regional intelligence units to try to get a clearer picture of the scale of sex trafficking. “What we’re trying to do is to get it gently back to some reality here,” he said.
“It’s not where you go down on every street corner in every street in Britain, and there’s a trafficked individual.
“There are more people trafficked for labour exploitation than there are for sexual exploitation. We need to redress the balance here. People just seem to grab figures from the air.”

**UPDATE** The Guardian has published more interesting contributions to the debate, including the opinions of people who sell sex for a living.

With Halloween coming up, and in contrast to the hysteria around migrant sex workers, I offer this seasonal celebration of migrant pumpkin pickers in Canada, courtesy of Ickaprick.

Note the rueful way the Canadian researchers lament the absence of US participation in the North American Opiate Medicate Initiative. In their excellent paper in the New England Journal of Medicine researchers from Vancouver and Montreal thank “the many U.S. scientists who contributed to the early design discussions but ultimately were unable to participate in the trial” because of what they ellipitcally call “financial and logistic barriers”.

This trial was being planned at the same time that the Traditional Values Coalition, defender of all that is Right and Good in America, were sticking the Republican Rottweilers on the National Institutes for Health for funding studies of sexual and drug-taking behaviour. No surprise, then, that US scientists had to drop out of the study. There is no reason in the world to believe that heroin prescription wouldn’t work as well in the US as it does in Canada, the UK or any other country at reducing consumption of street heroin, keeping people in treatment and cutting crime among that hard core of users that have tried and failed to get off smack by using methadone or just saying no. But in the current climate (yes, even with the Obama administration in occupation) there’s really not much point in doing studies in the States — no amount of evidence will lead to a policy change. As Virginia Berridge points out in an interesting editorial in the same issue of NEJM, drug policy is more a matter of history and culture than it is of science. America, founded on puritanism, has always been less tolerant of opiates than the Brits, who used them to fuel an unequal trade with China and some properly great literature.

One finding that surprised the Canadian researchers: while most people in the study obviously knew if they were taking methadone (orally) or heroin (injected) a small number of users were randomly assigned to inject hydromorphone instead of heroin. Neither they nor the study staff knew who was getting the real thing and who was getting the semi-sythetic cough suppressant. Amazingly, not one of the people shooting up cough medicine for a year could tell they weren’t taking smack. As the researchers pointed out in slightly mealy-mouthed research-speak, “the benefits of injectable opiod maintenance might be achievable without the emotional and regulatory barriers often presented by heroin maintenance”. Meaning that we might get away with prescribing drugs to help chronic users stabilise their lives if we could just stay out of the headlines. The “SMACKING UP YOUR TAXES TO SUPPORT JUNKIES!” type headlines.

A finding that didn’t surprise the Canadian researchers: people who were injecting drugs, even on prescription, were much more likely to OD than people on methadone — mostly because the heroin doesn’t mix so well with some of the other drugs they had been taking (crack cocaine use didn’t change for any of the study groups in Canada, although it fell in all groups in the UK). BUT, as the researchers point out, all but one of the overdoses happened in the study clinic, where staff were able to administer nalaxone and provide other support so that users got through the overdose ok. If they’d been out shooting up street smack, the chances are they wouldn’t have been so lucky. Which is one more reason to support supervised injecting facilities such as Vancouver’s impressive Insite.

One thing the Canadian researchers didn’t report was the relative cost of the different approaches. The UK study reported that heroin maintenance cost about £15,000 per person per year, about a third of the cost of a year in jail. But it took a report on the BBC to tell us that we could put three people on methadone for a year for the same amount. The question is: how many of them would still be on treatment at the end of the year?

(The Beeb story has an interesting video interview of one of the users of the programme, but sadly no embed code).

If you’re a gay man in Canada who knows you’ve got HIV, there is a very high chance indeed that your infection will be monitored, and that you’ll be on treatment if you need it. And that in turn means that your viral load will be kept low, and you’ll be very much less infectious than you might be if you didn’t get regular checks and treatment. While I’d obviously like to see more positive people being able and willing to talk openly about their infection, the truth is that the chances of getting infected by someone with well-managed HIV is very slim, whether or not they tell you. And whether or not you bother to ask (because let’s face it sex does, usually, take at least two, each of whom can choose to take responsibility for themselves). But of course if you don’t KNOW you’re infected, you can’t be prosecuted for not disclosing. The criminalisation laws provide a strong disincentive to get tested. That means there’s more untreated virus around, and that in turn means more HIV transmission.

I could go on about the other logical inconsistencies in the piece — if not disclosing is murder, then are doctors who know a person’s status but don’t tell that person’s partner accessories to murder? etc etc. But I’m not going to, because I’m in Vancouver and have a whole day of good science at the Canadian Conference on HIV/AIDS research to look forward to. In honour of my visit to Canada, though, I thought I’d post for your listening pleasure these priceless phone messages left by the flower of Canadian manhood for some woman who tried to slough off his letching with a business card. Hard to imagine why, instead of calling him back (“I’m practically the only man in this city who has not a single thing wrong with him”), she sent the messages in to a Toronto radio station.

*UPDATE*
Rick Kennedy of the Ontario AIDS Network sent me the following clarification:

According to the 2003 ruling in the William case “Once an individual becomes aware of a risk that he or she has contracted HIV, and hence that his or her partner’s consent has become an issue, but nevertheless persists in unprotected sex that creates a risk of further HIV transmission without disclosure to his or her partner, recklessness is established”.

To date, no one has been charged on the basis of this ruling. If you go to the Ontario AIDS Network website, to the
HIV debate section and download the excellent Powerpoint presentation by Glenn Betteridge you will find a detailed explnation of current status of the Canadain law.

So I did. Glenn’s presentation is here and there’s lots of other useful information about criminalisation on the Ontario AIDS Network site. Thanks, Rick.

And thanks to Javi for the phone number…

If we want treatment to work as effective prevention, we need to do more to indentify cases soon after infection. That means doctors knowing their patients may be at risk for HIV, which in many countries means knowing if their patients are gay. I’ve written before about doctors’ squeamishness about sexual history-taking, and I think gay men, drug injectors and sex workers might want to let on to their doctors that they are gay. But reading this excellent post from Ickaprick, I can see why people don’t want to, at least in Canada.

The most interesting thing for me about the post (read it, do) is the stereo-type swapping. You want freedom of religion, so that you can deny me freedom of choice over my sexuality. Make anyone out there think about the voting patterns behind Prop 8?