|Adolescent Sexuality and the HIV Epidemic (UNDP, 1999, 24 p.)|
|2. UNEQUAL LIFE CHANCES & HIV INFECTION|
While male-to-male sex exists in every culture, the activities concerned are rarely understood as 'homosexual', still less as 'gay' (McKenna, 1996). More likely than not, they will not be widely talked about, or named only within local vernaculars often inaccessible to outsiders (Aggleton, Khan and Parker, 1998). That said, in many countries of the world a not insubstantial number of young men have their first sexual experience with other men, and for some this may be the beginning of a longer lasting bisexual behavioural repertoire. For example, 50 per cent of male university students recently interviewed in Sri Lanka reported that their first sexual experience had been with another man (Silva et al, 1997), and there are well documented studies of behavioural bisexuality among men in countries as diverse as the Philippines (Tan, 1996), India (Khan, 1996), Morocco (Bourshaba et al, 1998), Brazil (Parker, 1996), the Dominican Republic (de Moya and Garcia, 1996) and Peru (Caceres, 1998). While it would be quite wrong to see male bisexuality as a purely 'adolescent' phenomenon or triggered by men's lack of access to women, the restrictions many cultures place on socialisation between the sexes may have an important role to play in facilitating this alternative means of sexual expression.
For a few young men, trading or selling sex to other men may offer a means of survival in otherwise difficult circumstances. In countries as diverse as Sri Lanka (Ratnapala, 1998), Thailand (McCamish and Sittitrai, 1997), Mexico (Liguori and Aggleton, 1998) and Peru (Caceres, 1998), male prostitution or sex work may take this form, with young men selling sex in order to provide for themselves and their families. While not all male sex workers are ignorant of the risks of STIs and HIV infection, and some may be better informed than other young people of a similar age, the risks associated with trading or selling sex in circumstances which are not of your own choosing are very real. Not only is such behaviour illegal and/or heavily stigmatised in many societies, the ability of young men to communicate and negotiate for safer sex with older male partners may be limited by inequalities of status and power (e.g. Fordham, 1998) Where anal sex is practised, the unavailability of condoms and lubricant may compound the risks some young men face (e.g. Khan, 1998).
Much less is known about current patterns of homosexual and bisexual behaviour among young women, although such behaviours should be assumed to occur not only during youth and 'adolescence', but also for some women as part of a longer lasting lifestyle. The role of such behaviour in contributing to, or protecting against, HIV-related risk requires further investigation. It seems reasonable to suppose, however, that the stigmatised, denied and marginal status of their behaviour makes it difficult for young homosexually active women in developing countries to access the full range of information or resources to protect their sexual health