Usually, we hear about female sex workers. But did you know that there are also male sex workers?
Although the precise number of men who have sex with men (MSM) in Lahore is unknown, according to the Pakistan National AIDS Programme, on the basis of findings by international agencies in 2002, they number around 38,000.
This number includes male transsexuals or 'hijras', who live in large family groups and have devised their own, unique system of leadership, inter-marriage and complex rituals, and a significant number of masseurs, like Pervaiz, who can be found in many parts of Lahore and other major cities, congregating at selected spots as dusk falls each evening.
Many of these male workers are masseurs. Clients pay US $8 to spend a few hours with the male sex workers, and will either pay for a cheap room or bring the workers to their apartments. But you may ask: what is the problem here? The problem is that due to taboos of homosexuality, these male workers are often marginalized, and thus, vulnerable to HIV/AIDS:
While such behaviour is strictly illegal, homosexuality is fairly widespread in Pakistan. Under the country's Islamic laws, sodomy carries a penalty of whipping, imprisonment or even death – but the fact on the ground is that it is also for the large part silently accepted.
This uncomfortable compromise means there are strongly entrenched taboos about talking publicly about sex between men, and the result is that levels of awareness about the risk of HIV infection among male sex workers is extremely low.
The social marginalisation of communities such as the hijras and the fact that few male sex workers have access to healthcare or contact with awareness-raising programmes, makes them all the more vulnerable.
And though the number of reported HIV/AIDS cases in Pakistan is low, this vulnerability to HIV/AIDS is frightening:
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), at the end of 2005 Pakistan had a total of between only 70,000 to 80,000 HIV-infected persons, from a population of 150 million. As such the prevalence rate is low (0.1 percent).
However, the World Bank, UNAIDS and other international agencies have consistently pointed out that because of the existence of various high-risk behaviours, coupled with a lack of awareness, and the fact that 50 percent of the population remains illiterate, the possibilities of a full-blown epidemic remain very real. Among the behaviours considered to be high-risk is sex between men.
UNAIDS reports that according to a study conducted in 2005, HIV prevalence was 4 percent among MSWs and 2 percent among hijras. Other sexually transmitted diseases occurred far more frequently, again suggesting a high risk of HIV infection.
How do you combat social forces that function as unwritten laws? In Pakistan, homosexuality is illegal. But even if you were to abolish the anti-sodomy law, you can't abolish social norms and taboos with the stroke of a pen. That's the thing about social norms: they are so embedded in society and daily life that they cannot be easily extricated from the social fabric. In some ways, it is easier to break the law than it is to break social forces. Furthermore, the topic of MSM raises a lot of other complex issues: poverty, literacy, awareness, healthcare, social work, sex education, and views on gender and sexual orientation in Pakistan. Add this to the uncomfortable silence shrouding the MSM phenomenon- on the one hand, it is accepted, but on the other hand, no one speaks about it- and there can dire consequences.