London, July 22 (IANS) Social taboos that indirectly encourage homosexuality in Pakistan are also compounding the problem of controlling a raging HIV epidemic in the country, says a new report. The report, authored by Syed Ali and colleagues from Aga Khan University, Karachi, said “in Pakistan, seven times more men are reported to be infected with HIV than women.

“If unconfirmed reports are to be believed, the prevalence of HIV among homosexual and bisexual Pakistani men is reaching alarming proportions.”

“Although most sexual transmission of HIV results from unsafe heterosexual contact, homosexual and bisexual contact also represent important modes of transmission,” added Ali.

Under Islamic tenets, sex of any kind, other that between husband and wife is strictly forbidden. Homosexual behaviour can lead to stigmatisation, discrimination and ostracisation from family and friends, and even prosecution.

The authors noted “most Pakistanis tend to believe that HIV transmission through illicit sexual activity cannot be a problem in the Muslim world.

“However, statistics, showing that HIV transmission through sexual activity is gradually rising, contradict this popular notion.”

Given that all extramarital sex is forbidden by Islam, the authors say: “One would suppose that the fear of God in itself would be enough to discourage illicit sex among men who have sex with men (MSM),” said the authors.

“Unfortunately, the moral approach only serves to drive the behaviour underground,” they added. In a Muslim state, promoting safe sex is the equivalent of promoting sex, making the management of MSM HIV epidemic even more difficult.

Several subpopulations within MSM are at particular risk of HIV infection. Prisoners, migrants, truck drivers, and pederasts/paedophiles are also at risk.

The authors acknowledge that even relatively conservative countries such as India and Bangladesh have begun to address the HIV prevention more openly.

“In Pakistan, however, socio-cultural and religious taboos hamper recognition of HIV/AIDS as a sexually transmitted disease and limit discussion on sexual health,” the authors concluded.

The issues will appear in the August edition of The Lancet Journal of Infectious Diseases, a special edition devoted to HIV on the eve of the forthcoming world HIV conference in Mexico.