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Homosexuals, prostitutes, and transgendered people of Central America are about to receive another boost from the Obama administration, which is expanding an HIV program initially launched during the William J. Clinton presidency.

But chief among impediments to achieving U.S. policy goals in the region are “conservative gender norms related to sexuality and strong normative preference for heterosexuality,” a revised government planning document says.

Organizations that help “Most-at-Risk Populations,” or MARPs, therefore, will be the beneficiaries of this Phase Two initiative, according to the revised Statement of Work detailing the Central America Project for a Sustainable Response to HIV, or PASCA II.

The U.S. Agency for International Development claims PASCA II is needed largely because the governments of Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama have failed to adequately carry out gender-equal national healthcare policies and inter-governmental agreements.

Despite achieving some HIV-prevention successes, those governments have “fallen short” especially when it comes to fighting stigma and discrimination suffered by homosexuals, intravenous drug users¸ prisoners and so-called “sex workers,” USAID says.

The promotion of “behavior changes to reduce the risk of HIV transmission” has been at the forefront of the PASCA endeavor since 2000, the agency touts.

The SOW offers no indication, however, that the U.S. government ever sought to dissuade –or intends to dissuade – activities long identified as catalysts of the HIV epidemic.

On the contrary, thanks to U.S.-taxpayer funded measures such as “condom and lubricant social marketing,” USAID already has helped spark behavior change among MARPs, the document explicitly says.

The agency hopes to correct Central American governmental shortcomings and further catalyze such changes.

It intends to accomplish those talks by improving the effectiveness of the region’s HIV policies and implementation, stimulating greater investment in resources, and improving private-sector responses to HIV.

USAID designates MARPs as “groups engaged in risky sexual behaviors for HIV transmission, including sex workers, transgendered women, men who have sex with men, and people who use drugs.”

The category of “men who have sex with men,” or MSM, refers to males who have such sexual encounters whether frequently or infrequently. In the U.S. government’s definition, some of these men “may not regard themselves as homosexual or bisexual in any way,” and are “very often married.”

An estimated 18.3 percent of MSM in Guatemala are HIV positive, USAID’s 2012 data indicates.

A transgendered person is defined as someone who “has a gender identity that is different from that assigned at his or her birth.”

El Salvador’s transgendered female population has an HIV prevalence rate of 25.8 percent. That rate among the same population of Nicaragua is 18 percent, according to USAID.

USAID hopes to correct Central American governmental shortcomings by improving the effectiveness of their HIV policies and implementation, stimulating greater investment in resources, and improving private-sector responses to HIV.

The SOW maintains that, ultimately, ownership of these efforts will be transitioned to local, regional, and national entities.

The selected contractor will be tasked with, among other duties, influencing the creation of sexuality and gender-equal workplace policies.

“Due to the widespread rejection of sexual diversity, workplace policies do not adequately address gender identities, sexual orientation, and health status,” the document says.

Other Central American MARPs that the U.S. will try to help in the realm of HIV are “specific ethnic groups” such as the Garifuna, who are descendants of Carib, Arawak and West African people.

While the Garifuna largely are Roman Catholic, many practice a form of Catholicism syncretized with various mystical and voodoo practices.

Some even meld these practices with Islam.

One Garifuna website points out that a Garifuna religious system known as Gubida embraces the belief that followers become possessed by a spiritual entity during “dreams and possession rituals.”

Garifuna, which also is a language, is “alive and well and has even invaded the New York Public School system where Garifuna speaking students now qualify for bilingual and ESL programs and other services in the Garifuna language,” the Garifuna Group of Chicago website says.

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