Despite the socio-cultural, religious and legal environment that frowns on the practice of same gender sexual relations also referred to as homosexuality, the phenomenon of men who sleep with other men (MSM), is gradually gaining a foothold in the country. The situation which provides a threat of a looming disaster in future for this high risk group, is made even worse considering that many of the men who engage in the practice also have female partners and wives and for this reason could increase the risk of HIV infection to their partners. The revelation came to light at a one-day seminar in Accra for workplace representatives on sexually transmitted infections (STl) and HIV intervention programme for men who sleep with men. The seminar was organised by the Ghana Business Coalition against HIV and AIDS (GBCA). While the then homosexuality has over the years assumed a vulgar connotation, male homosexuals are now commonly referred to as gays and females as lesbians. According to sources at the Ghana AIDS Commission (GAC), due to the sensitive nature of this topic, it was difficult to put a figure to the number of male homosexuals in Ghana, however conservative estimates put it to about 13,450. The Chairperson of the Stigma Reduction Group of the GBCA, Ms Joyce Steiner, noted that "the circumstance of men sleeping with their fellow men occurred in almost all cultures but to varying degrees and that though it was a predominant mode of HIV infections in certain parts of the world, there was need for the breakdown of socio-cultural barriers and religious beliefs that tend to discriminate and stigmatise same gender sex,” since such behaviour she noted rather pressurized the actors to practice in secret. As a step to check prejudices, stigmatisation and discrimination, Ms Steiner called for the avoidance of finger pointing, biases, evasion and other ways of making same gender sex practitioners to feel bad and unwanted. She said rather, efforts must be made to support and understand the ways of the actors to remove the feeling of suspicion and unacceptance among the general population. Another area in which stigmatisation and discrimination against MSM had had negative effects is the H IV/AIDS pandemic. Early in the pandemic, the assumption that HIV/ AIDS was a "gay disease" contributed to the delay in addressing the massive social upheaval that AIDS generated. Understandably, MSM have been disproportionately affected by this disease. But the association of HIV/AIDS with MSM and the inaccurate belief that some people held that all MSM were infected served to further stigmatise gay people. It is held that some people frequently have sex with members of the same sex yet still see themselves as heterosexual. For example people in sex-separated environments like the prisons may engage in homosexual behaviour despite being heterosexual outside these environments. Following from this, Mrs Comfort Asamoah of the West Africa Programme to Combat AIDS and STls (WAPCAS), advocated for certain key behaviours to be promoted among MSM. These include the use of condoms and lubes for all penetrative sex, reduction in the number of sexual partners, faithfulness to one's partner, prompt treatment for symptomatic sexually transmitted diseases, getting tested and knowing one's HIV status and disclosing test results to ones partner. According to Mrs Asamoah, in spite of the initial difficulties there had been successes in the association's dealings with MSM. She also said there had been increased knowledge of STI and HIV infection among their ranks, high use of condoms and lubes, while health workers at STI clinics have been sensitised to offer friendly service to MSM. This in particular, she said, had emboldened some MSM to go to STI clinics without fear. The Director of Technical Services of the GAC, Dr Richard Amenyah, said the public health of MSM was very important because the HIV prevalence among their ranks was about 25 per cent as against 1.7 per cent of the general population. "If you have a group that bas a prevalence much higher than the national prevalence then it calls for attention," he said. He said due to the criminalised nature of the MSM activity, the GAC faced the challenge of addressing the HIV prevalence in the country in total as it had to deal with the concerns of MSM, who as a result of stigmatisation and discrimination tend to lead double lives. "In order that they do not infect themselves and others, it is important to reach them with services, counselling, testing and clinical care for opportunistic infections and treatment with anti-retroviral drugs to those who qualify," he added. Experts say support for MSM in the family, at school, and in the broader society helped to reduce risk and encourage healthy development. Heterosexuals can make a point of coming to know gay people and make their coming out safe by working with them in the communities to combat prejudice and discrimination. When MSMs feel free to make public their sexual orientation, they may cease to go under cover and help to stem the spread of HIV. An executive member of the GBCA, Prof. Sakyi Awuku Amoah, said it was important that people became knowledgeable of what HIV/AlDS is, as failure to do so has led to stigmatisation and discrimination which continues to fuel the pandemic. Source: The Mirror/Ghana