Here comes Ashok Row Kavi, the Larry Kramer of India
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.
-- WMHWilliam M. Hoffman: What do you want the readers of POZ to
come away with from this interview?
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.You've just filled hundreds of Air India planes.
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.How many cases of HIV are we talking about?
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.Where do you get these stupefying statistics?
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
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.You're intimating that the route of HIV transmission is mainly
gay. I always imagined India as a bastion of heterosexuality.
Surely, with a population of more than 900 million, not all the
women are using turkey basters.
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.Sounds like a form of social security.
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.The only thing I've heard about HIV in India is that it's
spread along the trucking routes by female prostitutes.
[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.What are hijrahs?
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!The Indian rope trick!
Exactly. So we had to change our intervention model. You should
have heard those hijrahs complain: "And he wanted me
to fuck him!"Same complaint all over the world: "Where can a girl find a
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.Gay men?
[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.What brings you to the United States?
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.How did you become interested in the epidemic?
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
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.And these deaths won't be called death by HIV.
Right. They'll be called death by tuberculosis. Sixty percent of
all new TB cases in Bombay are HIV-related.How much has the AIDS pandemic hit women and children?
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.You'll soon have corpses lying in the streets.
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
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."Would be hard to put that on a building.
Looks good on the proposal. Very scientific. The government
finally came through this year. Too little, too late.How did AIDS first come to your attention?
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.What has been the reaction to your outspokenness?
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.With so much male-male sex going on, how can Indians not
realize the danger from HIV?
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.What is treatment for HIV like in India?
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?So people in India die at early stages of the disease?
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
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.Considering the number of people with HIV in India, there
seems to be a concerted effort to hide this from people.
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.
LETTER FROM INDIA
A Tour Beyond the Taj Mahal
Though much has changed in India since I
first traveled there in 1986, the culture, in my eyes, has remained
unchanged for 5,000 years. Twelve years ago there was very little
HIV in India. Today, WHO estimates there are five million Indians
with HIV, and if the trend continues, it will soon have the highest
seroprevalence rate of any country in the world.
What I find most intriguing about India is that reality there is
not what it appears to be. There is always another layer of truth to
be explored. Take AIDS, for example. Statistics on India's epidemic
are sketchy and contradictory. Even the clinical definition of AIDS
varies from state to state. However, one consistency in all the
government reports and journal articles is the near-total silence
about same-sex behavior as a route of transmission. Perhaps India's
antisodomy law, a legacy of the British, is so effective that sex
among men doesn't happen like it does everywhere else in the world.
Diary entries about my own experiences there, however, suggest
1997: After several months in India, I become somewhat adept
at knowing when I'm being cruised and when I'm just being stared at
as a novelty. Never have I been in a more cruisy place than Calicut.
It's more cruisy than Fire Island on a Sunday afternoon in June. The
men hike their ankle-length lunghis above their knees and, like
dancers at the Follies Bergeres, sashay them before tucking them in
at the waist while strutting down the street. There aren't many
Calicut is one of the world's oldest ports, and I'm told that in
the days of Columbus, Indian sailors would only be hired if they
were paired with a lover. That evidently cut down on shipboard
fights. Now it's a point of embarkation for Indians going to work in
the Gulf countries, so a lot of the population is transient.
As the sun sets over the Arabian Sea, I watch as pairs of men
disappear into the shadows of the coconut tree-lined beach. Groups
of boys and men sit together laughing, smoking and cuddling on the
steps leading to the sea. Two men jump off a motorcycle and walk
past me a couple of times until I finally say hello. Ten minutes
later I'm sandwiched between them on the bike, heading back to their
place for a drink. They take me to a big house on a hill. One of
them has a wife and four children who are away visiting an auntie.
I'm not one to read "gay" into a place if it's not there. In
India, same-sex behavior runs a close second to cricket as the
national pastime. The gay cruising spots in Indian cities are well
known and busy. Truck stops offer not only female sex workers, but
male sex workers as well. Hotels usually have massage or "towel"
boys available to exchange pleasure for the equivalent of $2 or $3
U.S. of rupees. Because private space is at a premium, consensual
sex between men often happens in spaces not particularly conducive
to negotiating safe sex. People get it where and when they can,
whether that means going to sex workers or having sex in public
toilets, cinemas, parks or even in crowded trains in the light of
day. In addition to the danger posed by HIV, the police are usually
nearby. They wield India's antisodomy law to harass, extort, molest
and rape those caught or suspected of engaging in same-sex acts.
By ignoring same-sex behavior, politicians, funders and
researchers ensure that HIV will spread not only among men who have
sex with men (MSMs), but to their wives and children as well.
Interventions aimed at MSMs aren't created, and there's very little
information about the risks involved in same-sex behavior. So, many
homosexuals assume they aren't at risk. Owais Khan, who runs a Men's
Sexual Health Hotline in New Delhi, says, "Even of the men who
self-identify as gay, 90 percent are married. And safe-sex -- if
they know about it -- is not common."
The invisibility of gay men in India is also perpetuated by gay
men themselves. There are plenty of rich, influential gays who could
make a difference but choose not to upset their comfortable lives.
Coming out would distress their mothers and shame their wives,
adversely affect the family business and, worst, make it difficult
to get inexpensive sex.
1997: It is unusually cold in Calcutta. We sit on the park
bench and she gazes up at the night sky. The moon draws a line on
the profile of her classic Bengali features. It is a beautiful,
serene face. Her name is Hiroo and she sways to the music from the
traveling circus that has settled in the park for the winter. My
Bengali is hopeless, so Ranjan interprets for me. She never would
have spoken to me anyway, except to sell some sex. She trusts Ranjan
though -- he's been doing AIDS education for years. "She had the
operation two months ago," Ranjan tells me. "The last time I saw
her, she wore a sari, but she was a man then." A doctor had done her
surgery, and it had gone quite well. Her hijrah community paid the
doctor's 5,000 rupee fee. She gives the community two thirds of the
money she makes from dancing at festivals and weddings and selling
"Business will be slow tonight," Ranjan tells me. "It's cold and
it's Ramadan. The men are trying to be pure." Still, he says that
Hiroo and the other sex workers in the park will probably have nine
or 10 clients that day, and earn the equivalent of $1 U.S. from each
of them. Although he's done AIDS education with them, he says condom
use is rare at best.
"Tomorrow I go to Delhi to dance in a festival," Hiroo says.
"Tonight I must earn the money for the fare. It's an early train, so
I must go." She stands and I see her eyes for the first time. A
sweet smile crosses her face as she covers her head with her sari
and disappears into the night.
Although valiant efforts at prevention are being made by a
handful of grass-roots organizations across the country, their
resources and energies are stretched thin. Angeli Gopalan is one of
the best known women in India battling AIDS at the grass-roots
level. She operates the NAZ Project, a non-governmental organization
in Delhi, on a shoestring budget, and has created an effective
program. She has the kind of knowledge and savvy needed to cajole
bureaucrats while courting funders and bringing services to
communities. Her office acts as a kind of think-tank for the movers
and shakers in the South Asian AIDS world.
1998: Angeli sat cross-legged as her staff buzzed in and out
of the room. The flurry of activity came to a halt when Tahira
finally arrived. She was visiting from Pakistan, and came to talk
about the Karachi Reproductive Health Project. "Our objective is to
improve women's sexual health. We train women to train other women.
Men are more free to go to a doctor and talk about sexually
transmitted diseases, but women lack the freedom to travel to
clinics and the ability to talk about such private matters.
"When we go into communities, we find that women don't want to
hear the standard 'reproductive health' rhetoric -- they want to
hear about incest, homosexuality, sexual harassment, molestation,
bestiality. They know these things happen in their communities but
they never knew they could talk about it.
"It's also important to have male groups -- to tell them what we
are talking about and why -- because we're looking for a change in
attitude toward women. Women's empowerment will only come if the men
realize that women have rights. The communication must be two ways."
Another woman with a vision and ability to break through
bureaucracy is Dr. Latha Jaganathan, who runs a donor-based blood
bank in Bangalore. According to Jaganathan, although the voluntary
blood-donor movement started more than 30 years ago, a large
proportion of the blood used in India still comes from commercial
blood sellers. Safety is very difficult to monitor.
1997: "Blood donors are usually from lower economic groups and
get paid so little -- 50, 60 rupees. No records are kept. People can
sell at one commercial blood bank and the next week go to another.
You can usually make them out by the track marks. The government
makes statements like 'there is 100 percent blood safety in our
state' because it gave out one testing kit. The funding is there,
but there is no monitoring. What we need in terms of safety is fewer
blood banks and larger facilities where the volumes of blood could
be tested efficiently.
"When the National AIDS Control Organization (NACO) was created,
it started looking at blood safety because, of course, it's easier
to say 'blood' than 'sex.' Ministers made speeches about how blood
safety is being improved, but no one would say anything about sex.
When they did start talking about sex, they'd say things like
'prostitution should be banned' and 'we live in the country of
Rama,' which had nothing to do with what was happening practically.
A couple of weeks before World AIDS Day, everyone wakes up and
decides something must be done. So they get someone to make a
speech. 'Who will attend?' 'Don't worry, we'll get the nursing
students to sit there.' Then they decide what to have for tea."
It seems, too, that the more marginalized a community, the less
likely it is to receive the education and resources needed to avoid
risk. Often, the first thing low-caste Hindus and poor Muslims learn
about AIDS is that they have it. Although statistics show a rapid
increase in the rate of children with HIV, few efforts exist to
educate them about AIDS. Jaganathan conducted surveys which showed a
tremendous increase in sexual activity as soon as children leave
home to go to college. She decided it was important to try to
educate them at an earlier age.
"The children have so little information. Girls don't know why
they are having periods, boys think masturbation will make them
unable to have children. We taught the teachers about AIDS and how
to discuss these issues. But they're too embarrassed to do it.
"When we did a workshop at a Catholic school, a rich benefactor
told us not to talk about sex or condoms. That left us with very
little practical information to give the children. Afterward, two
young nuns who had been sitting in the back came to me and said, 'We
know they won't let you talk, but we're the ones these children come
to when they're in trouble. We're the ones who visit the homes. How
do we talk to those whose uncles raped them? How do we treat their
gonorrhea? What do we do when their rectums and vaginas are torn and
"When I wanted to incorporate more AIDS education into our
programing, I went to one of the state ministers for AIDS policy.
His response was 'Ooohhh, Madam Doctor, so many people on our
streets are injured by automobiles. Why not forget about this AIDS
business and work on trying to make the streets of Bangalore safer?'
"There are many NGOs doing good work, but we need more government
support. The money is there, but the will is not. They keep saying
condoms are freely available, but we keep finding that they are not.
They won't put condoms in the public toilets, and men are too
embarrassed to go to the shops to get them. In Thailand they've
achieved almost 100 percent condom use among sex workers -- why
can't we do that here?
"And all the risk groups are not being dealt with. For instance,
homosexuality -- well, it's illegal, so people don't come out. In
Bombay it's somewhat different -- you must know about Bombay Dost
and Ashok Row Kavi -- so something is being done there. First the
government said there was no AIDS in India, then they said there was
no sex, now they say there is no same-sex behavior. So the message
goes out that you only get HIV from female sex workers. There was an
article I read a couple of days ago in The Times of India that said
70 percent of people interviewed on the street didn't even know what
So you see: Sex happens in India. It happens among all ethnic
types and religions. It happens among all social classes and castes.
It happens among men and among women. Sex is carved into India's
temple walls and written into its ancient literature. And its
continued denial invites the spread of HIV infection.