As the first Pan Pacific HIV/AIDS conference drew to a close GayNZ.com spoke with JVR Prasada Rao, regional director of UNAIDS, the global body charged with coordinating and fostering effective responses to the HIV/AIDS epidemic. What, we wondered, is being done for gay men, or those who don't identify as gay but nevertheless have sex with men, in the Pacific islands? Jay Bennie: We have heard surprisingly little at this conference about the scale of the HIV epidemic amongst gay or bi men in the Pacific. Not even any data on how many men who have sex with men in the Pacific nations already have HIV. JVR Prasada Rao: Unfortunately that surveillance is very, very poor. No, we don't have any data on how many of these men have HIV. JB: Does UNAIDS believe there is a need to address the particular issues of men who have sex with men within work on to prevent the spread of HIV/AIDS? Rao: Yes. These men are one of the most vulnerable communities and they are a priority for UNAIDS. Efforts to address HIV infection amongst gay men in the Pacific have not had enough prominence for some time... Pacific Island nations have a very big problem with recognising this group. There is going to be a regional conference, probably in India, in mid-2006 to discuss the issues of male sexuality and issues relating to homosexual sex. And there is currently an initiative to identify agencies within the United Nations system which will be responsible for the issues of gay men. We will be promoting opportunities and financial support for people to come and participate in that conference. We hope that people who make decisions relating to the sexual health of men who have sex with men will participate in that. JB: But are there actually gay or gay-aware people in some of these Pacific nations who will respond and participate? Rao: This is just a first step we are taking, we need to provide resources and build up opportunities so people can come to the conference and bring back the information. Then we will try to build organisations in the Pacific Islands of men who have sex with men. JB: In general what what is your impression of the place of men who have sex with men in Pacific Island cultures? Rao: In quite a few Pacific countries men having sex with men and homosexuality are not even recognised as behavioural factors in the fight against HIV/AIDS. In fact, there are countries which have laws against homosexual acts... homosexuals are criminalised in several countries, although this situation is not confined to the Pacific. But change can only be brought about through community action, when people get together and when there are communities that strongly support these people. We may not be able to change the law overnight but at least we will be able to create an environment which is more conducive to effective functioning and results. JB: We've been hearing throughout this conference that behavioural change programmes work best when they are directed from the bottom up... yet at that local level HIV organisations seem to be very heterosexual in focus. And we've also heard that quite a lot project and programme funders such as church groups are not comfortable with homosexuality. How are gay and gay-focussed groups going to even get off the ground in that environment? Rao: We are dependent on local action. I don't think there can be global or regional prescriptions for this. We need to look at opportunities in each country individually. We need to look at ‘champions,' we need to look for people who can embrace the cause and then take it forward. I think conferences like this one and the men's conference next year are an important opportunity for men who have sex with men to come together in this region and then take the messages back to their own countries. JB: Before HIV appeared New Zealand, we had a long-standing gay pride movement which was working for the law change which became so necessary to build self-esteem in gay men, which was in turn vital to underpin safe sex education. That process took fifteen years or more... do Pacific Island nations have that luxury of time? Rao: No, we can't wait that long in the Pacific Islands because of the urgency of HIV. Without HIV you could take more time to build change, but with homosexual sex being a very important risk factor we have to act much faster than that. In New Zealand you generated general community support for change and I think in the Pacific Islands they have to look for public support also. The environment around them needs to be conducive for them to pursue their activities. That is a message we will be trying to give at next year's conference. We will not just be addressing the HIV issue by itself, we will be trying to address it within the much broader concept of mens' sexual health. JB: Here in New Zealand we have many Pacific Island kiwi men who openly identify as being gay, or at least as men who have sex with men, and who are aware of the risks of HIV. Might they be a resource for starting the ball rolling in the Pacific region? Rao: Very definitely. I think we would all like to see those men reach back into their countries of origin to be part the process by which we can address the sexual health issues of men who have sex with men in the Pacific. JB: Churches, politicians and other leaders in many Pacific states are very conservative and even obstructive in their approach to sexuality and sexual health matters. What would you like to see them do in the face of the gathering storm of HIV? Rao: I would like them all to put aside their intolerance of sexual minorities such as homosexual men, to work to understand the needs of their at risk communities, particularly high risk groups like men who have sex with men. It is important that they take a constructive approach and actively support sound initiatives to address the threat of HIV/AIDS in their communities. Jay Bennie - 28th October 2005