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ABSTRACT: This is a review study on stigma, violence and HIV among men who have sex with men (MSM) in South Asia. India, Bangladesh and Nepal are selected for the review to represent eight countries of South Asia because India covers about eighty percent of total population of South Asia. Similarly, Bangladesh has the highest population following Islamic religion, which can represent other countries in South Asia where the majority of people follow Islamic religion. In addition, Nepal and India has the only open border where the movement of Nepalese-Indian people is always seen. The reports published and available online by organizations, such as WHO, USAID, UNHCR, World Bank, and the reports and research papers published by different organizations and national governments in these countries were reviewed for this study. Only literatures published and available online from 1993 to 2013 were included for this study. MSM are found in Nepal, India and Bangladesh and India has the highest number of MSM in the South Asia region. Different words are used for MSM in this region: Metis, Panthi, Dohori, Kothi, and Double Decker. In South Asia, where culture and tradition create strong beliefs, marriage between same sexes is not socially and culturally accepted. Except for Nepal, none of the other countries in South Asia have legalized same sex marriage or relationships at the national level. These countries that have not legalized same sex marriage or relationships have punishments ranging from imprisonment to death penalty. In all of these countries, MSM are surrounded by stigma and face discrimination and violations of human rights. Discriminatory acts and violations of their human right are seen in their house by their family members, by the people living in the society, and in the school and workplace. Many people in these countries have negative attitudes towards MSM. To be socially accepted, MSM will sometimes marry (4) women and bear child at the same time that they have relationships with other men. Sexual harassment, rape, and beatings by police are the common forms of violence against MSM in South Asia. Law enforcement harassment and discrimination by health care providers hinder them in accessing services. Lack of proper education and low employment opportunities are the causal factors for many of MSM being engaged as sex workers making their wife vulnerable for HIV/AIDS and other sexual infections. The violence, stigma and discrimination faced by MSM are often rooted in homophobia and also a fear of gender identities not acceptable to traditional gender norms. Violence against MSM is a manifestation of stigma and discrimination. Those who enact violence against MSM feel they have should have greater power and control based on perceptions that his/her gender is of a higher social status than that of the victim. Literature says that stigma, discrimination and violence against MSM increase their vulnerability to HIV/AIDS. Though different strategies and interventions are being used for programs specifically for this group, fear of being exposed about their own identity and the behavior of some health practitioners means that MSM have problems accessing many health services. Proper budget allocation for programs targeting this group of people in all the countries in South Asia, coupled with appropriate training, enforcement of laws against discrimination and violence acts, and legalization of one's sexual identity is necessary to improve the health status of this group |
