By Tim Frasca
When I first came to Chile 15 years ago, I went to the southern city of Concepcion, a city of almost a million inhabitants, and set out to look for a gay cafe whose existence had been whispered to me in the capital.
The description I had been given of a brightly-lit, run-of-the-mill, down-town dive could have fit dozens of cheap restaurants and bars, and after several hours of aimless wandering on the lookout for the random local queen to orient me, I stuck my head into one nondescript fluorescent beer hall and saw a poster of James Dean on the wall.
This instantly set off my gay-dar, and I went in. Five minutes later, a lissome lad of 19 was asking me for a match, that is, cruising me.
This incident is significant in part because few Chileans, including gay ones, have more than a vague idea who James Dean was, which is what made his photo a useful coded icon for homosexuals in provincial Chile during the years of anxious semi-clandestinity of the Pinochet dictatorship.
Western gay culture has been absorbed in South America along with other imported products, from fast food to "The Simpsons," and it´s full of distortions and adaptations.
But now it-s here and it-s queer -- a visible gay subculture in Chile -- and it-s also being hit by a tsunami of HIV infection. Unfortunately, response to the epidemic is light years behind North America or Europe, which is what makes the latest fashion in AIDS circles about "men who have sex with men," or "MSM," particularly nefarious and deadly for gay health.
The phrase MSM, recognized as an imperfect and decidedly ugly term even by its sponsors, denotes a brand of homosexuality that broadens its definition beyond the occidental version, where you have out gay men living amidst gay social circles or even in gay neighborhoods, going to gay bars, reading gay newspapers, getting haircuts from gay hairdressers -- oops, everyone does that -- hiring gay travel agents to travel to gay resorts with gay friends and signing domestic partnership agreements with advice from gay lawyers.
In the "South," places like Sri Lanka and Brazil and Zimbabwe, a.k.a. "developing countries," the "MSM" concept suggests homosexual behavior not associated with a gay identity and involving straight-identified men, often married with children, for whom homosexual relations can be indulged as a whim, an adventure, a drunken urge, or a substitute for heterosexual relations.
They describe situations that would be likely to result in a fat lip or worse in the North, a result that-s not unheard-of here. Still, there does appear to be something woollier and more picaresque about many Latin American men as sexual beings than Euro-Americans, for whatever interesting reason.
But the MSM concept denies the existence of anything resembling a gay community -- even as fledgling communities of self-identified gay people are beginning to emerge. This is particularly dangerous, given that these communities find themselves currently at the epicenter of a growing HIV epidemic throughout South America.
This denial has its own sorry history and political logic: recognizing the existence of gay men at risk for HIV transmission would mean that governments might have to do something to address the problem.
It was more convenient to keep local gays invisible and continue to aim prevention propaganda at straight couples and heterosexual youths.
MSM fits perfectly into this strategy, since it diverts attention away from open gays men to traditional family men with a wild streak.
Case in point: back in the early 1990s, even though homosexual transmission accounted for 90 percent of all HIV cases, the Dutch gave Chile-s health ministry a million dollars for prevention work.
Not a dime of it went to gay-related efforts.
Nearly ten years later, gay-related projects get only about five percent of the National AIDS Commission-s prevention budget, even as gays account for 60 percent of HIV cases by the government's own account (we believe it-s closer to 80 percent).
The result of this official neglect is a seropositivity rate which we have estimated, on the basis of a study published in 1997, at around 20 percent for gay-identified men in the capital area.
Meanwhile, the much anticipated "heterosexualization" of the epidemic hasn't really occurred, despite its announcement at regular intervals.
Although there are slightly more cases of heterosexual transmission being reported, rates of new AIDS cases have been steady for years and suggest a continued concentration of infection in fairly closed circles -- that is, gay ones.
And yet, until recently the only cause for official alarm about HIV is the non-gay infection rate: When the Assistant Minister for Health released the epidemiological figures two years ago, he voiced particular concern about a couple dozen IV-drug-related HIV cases.
But he had nothing to say about the thousands of gay men with HIV and those still being infected. When we criticized him, he responded that linking homosexuals and AIDS would be discriminatory.
The international AIDS community is playing into this steady abandonment of the public health responsibility for gay men.
At the Geneva World AIDS Conference in July, gays were officially absent from the opening ceremony, except for inclusion in the laundry list of population groups hit by HIV.
Eventually some gay people would make an appearance in other roles: an HIV-positive man speaking for the PWA cause; a representative for local groups talking about community mobilization. Even the Swiss minister looked a little fey to me.
But the indispensable role that gay people have played in the epidemic -- the people who invented safe sex, who have led the fight for HIV mobilization from Tibet to Tuscaloosa (and who were out in such force as volunteers and delegates in Geneva that you couldn-t buy "Pour Homme" anywhere for a week afterward) merited no mention.
Even those of us who have done research around male sexuality are slipping into the subtle neck brace of MSM and dropping the political hot potato of defending out gays.
In Geneva, the MSM panelists talked about a range of odd cross-category cases of homoeroticism with a variety of sexual identities, while out gay men got short shrift.
The discussion was interesting enough, but over at the UNAIDS offices situated in Geneva I was shocked at what I heard.
One trend-setter for world AIDS policy parroted the MSM line about what "really" goes on in developing countries: men in South America aren't "gay" per se, so you can't direct services to them as a category. How convenient for governments which had no intention of doing so in any case!
As for the argument of cultural uniqueness, let me invite any gay man from the northern climes to spend a weekend in the bars and discos of Santiago, and then tell me that he doesn't recognize the scene.
The city is bursting with 18-year-old men who call themselves "gay," dance together, hold hands, kiss, and want to find a partner, move in together and get this straitlaced, conformist, intolerant society off their backs.
And, miraculously enough, gays in Santiago and elsewhere have picked up the safer sex message, at least up to a point. In a study we (the Chile AIDS Prevention Council) conducted in the capital, three-fourths of our sample of 400 gay men said they used condoms, and over half said they used one the last time they had penetrative sex.
This consciousness of gay-community norms, achieved despite widespread neglect and constant police, workplace, media, and family harassment, attests to the existence of a large out gay community--one that MSM wants to pretend does not exist.
As a linguistic fad, MSM arose in response to a real phenomenon, and programs should be developed that address the men described. In fact, the large numbers of "bisexual" and dubious "heterosexual" men who used to appear in official epidemiological statistics suggest that closeted or straight-identified men with homosexual practices are an important population for AIDS prevention work.
Given the difficulties of identifying and reaching them, however, the obvious starting point is a deepening of the gay prevention norms that have been absorbed partially in the out gay world up to now.
In any case, "MSM" should not be used as a category that subsumes and thus erases gays. Instead, gay-identified people in the South also should be supported in developing their own forms of community and adapting a gay consciousness and culture to their particular conditions.
And they should be helped by their Northern counterparts to reduce HIV infection with gay-specific tools -- without the patronizing exceptionalism bolstered by a misguided social science.
Tim Frasca is General Coordinator of the Chile AIDS Prevention Council, where he began as a volunteer in 1988. He covered Chile as a correspondent for U.S. and British news media from 1983 to 1993. Corp. Chilena de Prevención del SIDA: email@example.com
Since this article first appeared, the Chilean government has increased funding for gay-related efforts.