Here comes Ashok Row Kavi, the Larry Kramer of India

Ashok Row Kavi is a one-man AIDS activist movement. As editor of Bombay Dost, India's only gay magazine, and founder of the Humsafar Trust, he is a lone but powerful voice for many uncomfortable truths in a nation that denies both the large number of people who have HIV and the large number of men who have sex with men. India is the new ground zero of the exploding epidemic, yet of more than 100 registered AIDS service organizations, the Humsafar Trust is the only one to target gay men. Ashok himself is a short, intense man with enormous energy and an accent that can only be described as proper Hollywood British. Space does not permit me to include the many tangents of Ashok's conversation, which ranged from Michel Foucault to the parallels between Hindus and Jews to the beauty of South Indian men.

-- WMH

Ashok Row Kavi: Two things. One, there is a new gay subculture coming up in Asia on a huge scale. We're talking on the order of 100 million gay men -- about 50 million in India and an even larger number in China.

And two, this gigantic subculture is so closeted, and Indian culture is so in denial, that most Indians and the rest of the world barely recognize the degree to which the HIV pandemic has already hit India. We're going to have large numbers of gay men dying before they even realize their identities.

I estimate that the number of men who have sex with men in Bombay, which has a population of about 14 million, is about half a million. Out of that, 60 percent are HIV positive. That is in Bombay alone! Perhaps as many as eight million cases -- women and men -- in the whole country.

In 1992, Bombay Dost did a study of HIV prevalence in collaboration with India's world-renowned National Institute of Virology. We advertised anonymous testing and guaranteed anonymity. We got a reasonably good sample of self-identified English-speaking upper- and middle-class gay men -- "gay" in the Western sense, not just men who have sex with men, otherwise they would not have shown up in the first place. More than 20 percent were positive in 1992. That year the HIV rate among Bombay's female prostitutes was 19 percent.

By 1997, the HIV prevalence rate among female prostitutes touched 58 percent, so how can gay men be very far behind? Even with some of us gay men into safe sex, the figure can't be below 60 percent.

In India, boys are married off no matter what their sexual orientation: A boy is money in the bank, a blank check. You can demand what you want from the girl's parents by way of a dowry if you have a marriageable son with some form of employment.

These sons have to marry girls. They have no identity as gay men. Eighty percent of the gay men in Bombay are married. There is a huge gulf between married gay men and single gay men because single gay men can have a gay identity, as you have in the West, which presupposes individuality. And that presupposes that the basic unit of society is the individual, not the family -- as it is in India.

[Bursts into laughter.] We were doing some proxy research at Zion Hospital, one of the biggest hospitals in Bombay. I was startled by what we discovered in the records. The ratio of men to women coming in diagnosed with AIDS was 32 to 1. Even if you make concessions for the fact that women do not have easy access to health facilities in India and that they come in only when it is too late, even if you reduce these numbers by almost two-thirds -- you still come to a ratio of 12 to 1, which is much higher than if this were a heterosexually transmitted disease.

The main clinic in Bombay asks not one question about male-to-male transmission. When we pointed this out, they responded: "Are there homosexuals in Bombay?" The whole epidemiology in Asia ignores homosexuals. They say homosexuals constitute one percent of the HIV cases.

When the Brazilian government found that its country's ratio [of men to women with HIV] went above 4 to 1, they knew there was subterranean male-to-male transmission. There is no way we can take this as a heterosexual disease, as the Indian government swears it is. As for truck-stop transmission, we made some interesting discoveries while doing HIV prevention among hijrahs at one of the major stops.

Ritually castrated men who dress and live as women. We have millions of hijrahs. India has a clever method of sequestering homosexuals. We mix up homosexuality with gender. If you are effeminate in India, your family often assumes you're gay and forces you to live among the hijrahs, even if you're heterosexually inclined, as many effeminate men are. We shunt you off into a caste. Naturally, we assumed that when these big truckers picked up these little guys in saris, well, you can imagine what we imagined. Picture our shock when we found out that a lot of these guys in saris weren't castrated after all, and were fucking the truckers!

Exactly. So we had to change our intervention model. You should have heard those hijrahs complain: "And he wanted me to fuck him!"

In The Spartacus International Gay Travel Guide, there are practically no gay and lesbian listings between Bangkok and Europe. Please! In this country, you get bruises every time you board a crowded train. And straight Indians have a superiority complex: "Oh, we don't have any homosexuals, thank God. Homosexuality is the product of a debauched, bourgeois middle class." They're trying to tell people that we homosexuals are a complete import from the West. Where did they get their Marxism from? The Ganges?

I'm a traditional Indian. Hindu culture had gays. There are homosexual gods in the Indian pantheon. The main temple, Skanda-Ayappa, was dedicated to Skanda, the son born of a homosexual relationship between Shiva and Vishnu. Last year four and a half million men visited his shrine.

[Shrugs.] It's very interesting. For one month before the pilgrimage to Skanda's shrine, you must not engage in sex with a woman. The rules don't talk about sex with men. So, you can imagine.

There's a good gay soul in India's heart. In Indian culture, you don't get killed for being gay -- you get marginalized. The word outcast is Indian in origin. As a self-identified gay man, I've refused to get married. That is a willful contradiction of Indian social determinism that I am made to pay for. The price: No social invitations. They all go to my mother.

I was hoping that before a lot more gay Indians die, you people might give us a helping hand. When I go to charity dinners in Los Angeles and New York City, I am fascinated. Gay people in India don't exist as far as you're concerned. You are concerned only with your new combination treatments, which are completely out of the question for most Indians.

I was one of the very few out gay men in a country of 900 million. I was making outrageous claims that there might be one or two other gay men in India, and that not all gay men are effeminate.

In 1989 I went to the International AIDS Conference in Montreal. It was my first exposure to militant gay culture. At that conference, one statistic stuck in my mind: Although gay men in America accounted for more than 60 percent of HIV infections, only 6 percent of the AIDS funding was going to them. That really bothered me.

The same thing was happening -- and still is happening -- in my own country. I said to myself: "We're going to be in deep shit because we don't have any gay identity at all. Americans have some gay identity, and that has gotten them some funding, but we in India have none. Oy vey." We have no identity or subculture. We just have networks of men fucking men. And we don't have a strong women's movement to stop opportunistic gay men from getting married, living a camouflaged lifestyle and giving their wives and children the HIV they pick up from other men. All these factors, combined with the pandemic, made me realize we were going to be in the deep shit we are in right now. We are going to go very fast. [Snaps his finger.] No identity, no movement, no diagnosis. A silent mass death.

Right. They'll be called death by tuberculosis. Sixty percent of all new TB cases in Bombay are HIV-related.

In some places, two percent of postnatal mothers have HIV and HIV prevalence among newborns is 0.4 percent. Those are just the reported cases. Underreporting is a classic Indian trait. Always multiply Indian figures by 12. People can't handle so many deaths. We have patients in Bombay hospitals lying in the aisles and even under the beds. The health system in India is at the breaking point even without HIV. HIV will push it over the edge.

India is used to dealing with corpse disposal. The River Ganga serves a huge population on its banks. Raw sewage is the main difficulty, but there's a peculiar religious angle here in that Hindus cremate their dead on its banks. It is holy duty. But many don't have enough money to cremate their dead, so the bodies are half burnt and thrown into the river, where they float downstream. To avoid the ghastly sight, the government began to breed carnivorous turtles to dispose of the dead. But the turtles have been major casualties of water pollution. The breeding nurseries have had high mortality rates and there just are not enough turtles to manage the growing number of dead. So, it's back to the drawing board.

The HIV rate in the general population is three percent, and the figures double every 18 months. The total number of hospital beds is 360,000. We are one of the very few organizations intervening and building infrastructure. In 1995 we submitted a proposal for $3,000 -- a grand sum in India -- called "Facilitating Access to Public Health Facilities for Self-Identified Gay Men and Men Who Have Sex With Men."

Looks good on the proposal. Very scientific. The government finally came through this year. Too little, too late.

I reported the first case in 1986. It was a man who came in for a cardiac operation, a man of Indian origin from Africa. There was a huge hue and cry in Bombay. Within a year and a half, the great minds had agreed that AIDS was imported from Africa and that the disease was foreign. Officials went into the red-light district and forcibly collected blood from female sex workers. I hate that word workers here -- they are sex slaves! They determined that some of the prostitutes had HIV and claimed that they were going to infect the population of India. Notice how the prostitutes are marginalized -- as if they were infecting everyone, when we know how difficult it is for men to contract HIV from women. The government wasn't willing to face the fact that the disease was being spread mainly by men.

Basically, the first reaction is shock. The second reaction is, God, we actually have homosexuals here? We thought such decadent behavior was only in America. The third is, they are bad boys, let them die. Fourth reaction: But I think I may have a relative who is that way. Fifth reaction is, they are good boys gone bad and should be converted into good family men. And the sixth -- OK, we cannot convert them into straights, so why not help them help themselves? There is no homophobia in the Western sense. The usual first reaction is that a single man is a sad case of wasted male material.

Sex between men is often not thought of as sex. We have many people in my country in very little private space, so we have lots of sex going on in parks and toilets. I give a college course called "Condom Sense," and I end with a special workshop on how to put a condom on in the dark. I blindfold the students to give them a sense of how to do this. Surprisingly, the women listen carefully because they know that sex is furtive. But when we distribute condoms outside the public toilets where men are having sex with men, they say: "Why are you giving this to me? These are for contraception." You say: "What the hell were you doing inside?" They say: "That was musti, man -- that was fun. We're just fooling around." The women pick up on the use of condoms, but men who don't think they are having sex don't.

Forget about Western ideas of medicine -- too expensive. No one knows the dosages of the medicines, which are prescribed according to your Western metabolisms anyway.

There is little access to clean water in India. You cannot ask a poor man to boil water every day: There is no money for fuel to boil the water. We have little access to clean air. The whole environment is degraded. How do you expect the immune system weakened by HIV to cope with this?

The average life span between diagnosis and death is 18 months. People get diagnosed very late in the course of the disease and often come down with symptoms like diarrhea, which is endemic in India anyway.

Life is cheap. India is a country in which machine-made goods are more expensive than hand-made goods. Five million children go blind doing embroidery. No one cares. Our elite is very good at mouthing socialist slogans. The whole fucking lot of English-educated ass-lickers live in this fantasy about revolution. I've heard ministers say "I don't care about HIV. My children are in Canada." That's when I pray that Canada is devastated by HIV. Those fucking bastards know how to mouth the World Bank phraseology, but they don't do a fucking thing. The only ones in India fighting this epidemic are community-based organizations, and there are numbers of them, thank God. No one else gives a shit. This is my message to the world: Only gay organizations will be able to tackle the AIDS pandemic in India. The grass roots.

In 1995, the World Bank gave India a $90 million low-interest loan to fight AIDS. Three years later it was returned by the government -- with only $30 million spent. I privately pleaded with the Bank not to give the money to the government, but no one listened. The money wasn't used because of an ideological debate: The Communist Party argued that AIDS could not be an Indian problem because AIDS equals Western debauchery. So the loan lapsed, unused. The government showed us reports: The Calcutta red-light district reported 100 percent condom use. Sure! Our small group of middle-class, self-identified gay men in Bombay isn't even showing 50 percent use. We have condom-wearing competitions every week. It's bloody tough to change human behavior.

We are a very clever, old culture. We know how to marginalize, how not to see something that is too uncomfortable. We pretend that HIV will go away. We don't want to face it. But HIV might make us face reality. That's the way I see it.

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