Soliciting A Killer Disease

IT’S a cloaked existence for Raju and other male sex workers. Shrouded in secrecy and hounded by the police, they conduct ‘business’ in the dark corners of dirty railway stations, lonely parks, seedy hotels and filthy public toilets. Often selling their services for as little as Rs 20. Buying STDs and HIV in the bargain. Getting client aggression and police brutality gratis.

 "Yes, it’s a risky business. But it brings in that little extra money which enables one to afford a livable life. Do you want me to beg instead?" argues Raju. "Considering my father doesn’t care about the nine children he has brought into earth. Someone has to feed them." So, young Raju works as a helper in a garage in Delhi’s Model Town area during the day and supplements his income by working as a commercial sex worker catering to a male clientele in the evenings. Oblivious to the health hazards that are a part of his vocation, Raju complains of the more tangible problems that weigh heavy on his mind: "Many clients don’t pay up afterwards and sometimes they are so violent."

 In Mumbai, 23-year-old Jagdish underwent similar humiliation and pain. Last year, he was picked up by a client from Juhu beach who promised him a generous payment of Rs 300 for the night. Having agreed, Jagdish found himself amidst a party of five drunken men in a flat in suburban Kurla. Abused till he was bleeding and unconscious, he was dumped back on the beach in the wee hours of the morning. Till someone informed a member of Humsafar, a Mumbai-based NGO dealing with sexual health and sexual orientation for gays which admitted Jagdish to Cooper hospital where he was administered seven stitches.

But 32-year-old George in Chennai was not even as fortunate as Jagdish. For George, help came too late. A full-time sex worker in the southern metro’s Panagal Park for the past three years, the lanky man was suffering from general ill-health for some time. A visit to the doctor last September revealed he was HIV-positive. Now employed with an NGO (name withheld on request) as an office peon, George laments the fact that he might have infected others with the virus. Speaking to Outlook, a remorseful George said: "I have sinned by bringing death to others. If only I had used condoms. I might have saved myself and many others from this dreaded disease. I wish someone had told me about AIDS." 

Which is just what NGOs working in this area set out to do amongst, what they have identified as, Men who have Sex with Men Commercial Sex Worker (MSMCSW) groups operating in the various metros—only to discover a plethora of other problems that were already plaguing these sex workers. As Anjali Gopalan of the Naz Foundation (India) Trust, a McArthur Foundation-funded HIV/AIDS and sexual health agency working with a variety of people including male sex workers, street children and youth in schools and colleges, found out. Says she: "We realised that concern for safe sex would happen only once the sex workers were helped in resolving their other more immediate predicaments." 

Take Keshav, for instance. Fear of AIDS is the last thing on his mind. An unemployed graduate in his late 20s, Keshav has been a full-time sex worker in Delhi for over five years now. Suffering from an anal fungal infection, Keshav says he would rather have someone fund his cure than lecture him on the use of condoms. "Why doesn’t the government help us organise ourselves so that we can insist on the use of condoms? Instead they pretend we do not exist? Is it our fate to go to unequipped government hospitals where doctors treat us like an abnormal species?" he asks. "We are indeed the lowest of the lows. The police is forever ready to crack down and sodomise, forcing us into being so ridiculously clandestine."

 A victim of such harassment, 14-year-old Shombhu Das in Calcutta has been picked up by the police many times while soliciting for sex at the Sealdah railway station. "Each time they booked him under the Vagrancy Act, took away his earnings and assaulted him sexually," says Sujit Ghosh, a member of Naz’s Calcutta MSM Outreach project. Noting that children like Shombhu are petrified of cops, Ghosh reasons that they’d rather earn a quick buck by hurriedly performing as per the client’s wishes than negotiate the use of a condom.

Dr A.J. Weeramunda of Sri Lanka in his Report on NGO’s working in four Asian Countries—India, Malaysia, Thailand and Sri Lanka cites these reasons as some of the deterrents to safe sex amongst male sex workers. High in his list are "fear of police arrest which stops them (MSMCSWs) from carrying condoms or taking sufficient time to negotiate" and the "lack of unity and unionisation, so that sex workers cannot take a stand against customers unwilling to use condoms".

An enthnographic survey conducted by the WHO-funded Community Action Network (CAN), a Chennai-based NGO working with AIDS high risk groups, has revealed 72 different pick-up points and locales in the southern metropolis for sexual activity involving homosexuals. "About 32 per cent of the total MSM population in the city is into it for the money. So, even a highly conservative estimate would imply at least 1,500 male sex workers in Chennai proper," says Ezhil Pari, project manager for the agency’s MSM intervention programme. CAN also has identified 10 ‘brokers’ in Chennai who are known to provide foreign and upper-middle-class clientele with male sex workers.

In the capital, members of the Naz foundation have already located 11 public sites where male sex workers solicit on a regular basis. "From toilets near crowded temples to the rocks and bushes in south Delhi parks, it happens everywhere. And now that we have been working with them for over 11-months we are getting to know of many more places," says MSM Park Outreach Co-ordinator Vijay Raj Kumar. Naz is, in fact, planning to come up with a sexual mapping of the city in the near future.

Something that the foundation’s Calcutta branch has already accomplished. They have identified around 25 public sites around and within the city where male sex workers solicit regularly. The Dhakuria Lakes, Curzon Park and the railway stations being the most active areas. "Most of these sex workers come from the city slums and nearby towns like Siliguri and Cooch Behar," says Ghosh. Adding that they are generally adolescent boys, including street children, and young men who indulge in oral and anal sex for as little as Rs 15.

THEYare highly susceptible to AIDS and need to be educated about the risk to their lives. But it’ll take some time before the Calcuttans even acknowledge the existence of something that hurts the bhadralok sensibility, let alone help resolve the problem," observes Ghosh. Pawan Dhal of Counsel Club, the only homosexual group in Calcutta, adds that things might have been a little easier to tackle had the gay movement in the Bengali metro been a "little more organised like in Mumbai".

But Mumbai has its own set of peculiar problems. Hype and hooplah about the megapolis’ high gay life without parallel awareness about safe sex, says Ramesh Menon of the Mumbai-based Humsufar Trust, might be attracting too many youngsters into the commercial sex circuit. A group of 20 students from a south Mumbai college recently left a message seeking ‘jobs’ as male sex workers in the Trust’s active voice mail service. "These are young kids and look what they are getting into for a quick buck," says Menon. "They have to be educated." 

And yet others in the circuit have to be cured even before they are educated. Like a volunteer doctor attached with Naz’s MSM project discovered. The Trust’s outreach programme where social workers meet up with MSM workers in a south Delhi Park twice a month has the doctor treating many painful ailments. "STDs, piles, anal fissures, funneling and fungal infection in the anus, paraphimosis where the foreskin doesn’t come back are the commonest problems," the doctor says. "And by the time they approach me these problems assume complicated proportions because many have already been to quacks." The doctor recalls a horrendous case where an MSM worker approached him in excruciating pain because a quack had ‘disinfected’ his piles with a liberal use of phenyl.

But since there is no space for physical check-ups, the doctor has to treat most of his patients with general syndromic and palliative medicines to give them some relief. "We are thinking of setting up a drop-in centre in the future but for now this is all we can do. Of course, we are also distributing and advising the use of condoms to safeguard them from HIV infection," Gopalan avers.

Some MSM workers have started showing up regularly at the Naz Outreach meetings to collect their share of condoms. "One of the sex workers we have been talking to has actually started buying his own condoms," says a pleased Kumar. And, though monitoring is difficult, Chennai-based CAN’s survey reveals a mammoth rise in the "percentage of condom usage by MSMs (commercial and non-commercial) during the last sexual encounter" amongst those attending their intervention programme—from 11 per cent in January, 1994 to 82 per cent in January, 1996. Says Pari: "An unnaturally high figure perhaps. But we have to take their responses to our queries as real."

Just as male sex workers are real. Their problems are real. And the AIDS threat to them and their clients, many of whom go back to their wives at home, is real.