Latypov, Alisher, Tim Rhodes, and Lucy Reynolds. "Prohibition, stigma and violence against men who have sex with men: effects on HIV in Central Asia". Central Asian Survey, vol.32, no.1 (2013): 52-65.

Latypov, Alisher, Tim Rhodes, and Lucy Reynolds. "Prohibition, stigma and violence against men who have sex with men: effects on HIV in Central Asia". Central Asian Survey, vol.32, no.1 (2013): 52-65.

• Central Asia is considered a hotspot of the global HIV/AIDS epidemic, largely due to sharing needles during drug use. However, transmission between men-who-have-sex-with-men [bacha] and their female partners is also an important factor due to low rates of knowledge about infection (52).
• Getting any information about bacha in Central Asia is extremely difficult, as society is very closed towards HIV in general and their are still strong negative associations of homosexual male activity, limiting the number of people willing to come forward and participate in studies (53).
• Traditionally homosexual relations were condoned as courtly practice within Central Asian society, as bachchabozlik -- performances of 'dancing boys' ending in pederasty -- was seen as an acceptable from of aristocratic amusement. This practice was rightly condemned by the Russians and the Jadid reformers as sinful and depraved (54).
• Despite condemnation, many Russian colonists and administrators seem to have participated in the practice alongside local aristocrats, as demonstrated by the reprimands of the Russian government during that time and records indicating the sale of slave boys to Russian officials (54).
• The Soviets finally ended the practice by making the practice illegal under anti-sodomy laws in 1922. They especially stressed the primitive and backwards nature of the institution, which they wanted to abolish and replace w/ Soviet modernity (54). These laws were included in the 1926 penal code for UzSSR and TjSSR (55).
• Anti-sodomy laws were added to the criminal codes of all Central Asian republics by 1934, alongside increased associations of consensual male homosexual relations w/ the previous practice of ritual pederasty (55).
• The decriminalization of consensual male same-sex relations in Russia took place in 1993, and was followed by decriminalization in 1997 in Kazakhstan and in 1998 in the Kyrgyz Republic and Tajikistan. Sex between consenting males remains illegal however in both Turkmenistan and Uzbekistan (55).
• Societal perception of homosexuality in Central Asia is overwhelmingly negative, with gay men facing physical and verbal abuse, loss of employment, and other forms of open discrimination if their sexual orientation in uncovered. Pressure is especially intense from family members, w/ it being seen as betrayal, and many gay men are forced into marriage to prevent shame from extending to the family (57).
• The relationship or homosexuals with the police is extremely bad. Many police officers are aware of societal shame which accompanies homosexuality and will use threats of exposure to extract bribes from gay men. Some men also report being coerced into performing sexual favors for police officers on threat of exposure, or being raped while in detention on the assumption that they will not report the incident and risk their reputation (57).
• Male-on-male rape is almost very reported to the authorities -- with 88% of identified rape victims saying they did not report the crime. This is likely due to shame and distrust of police (57).
• Infection rates for STDs in Central Asia are fairly high for prison populations due to cultural stigma around condom usage. If a condom is used during conjugal visits, the assumption is made that either the man has participated in sodomy in prison or that the woman has been unfaithful. This is significant, considering that rates of sodomy, drug use, and STD infection are significantly high within prisons (58).
• In Kazakhstan, the general population's rate of HIV infection was 1%, but this increased to 10% among drug users (58). Some studies show bacha as making up 2% of the total, although shame of using such services means the percentage is probably higher (59).
• Some studies show bacha to make up roughly 1% or 2% of the adult male population in the Kyrgyz Republic. This group is significantly more likely to engage in unsafe sexual practices, using condoms far less than heterosexual partners. Only around 1% of respondents has HIV-positive (59).
• Many bacha in Tajikistan also engage in sex with women, with almost 75% reporting that they had had sexual relations with both men and women within the same time period. This may indicate bisexuality or the importance of keeping up appearances within a conservative society (60).
• According to Turkmenistan, there is no HIV/AIDS in Turkmenistan. No further questions (60).
• HIV infection rates among bacha in Uzbekistan are significantly higher than elsewhere. Infection rates have been reported at 7% and 10%, greatly exceeding rates elsewhere. However, condom use among Uzbekistani bacha is higher, but only 39% of those interviewed used condoms regularly. Access to HIV-clinics is available, but not widely used due to shame and fear of damage to one's reputation (61).
• While HIV epidemics in Central Asia are driven by drug usage, the unsafe sexual practices of bacha in Central Asia leave open other possible means of transmission. Good information about HIV/AIDS infection rates among bacha is difficult to find due to deep discrimination against homosexuality in Central Asia, but we can say that discriminatory attitudes drive a subculture of unsafe sexual practice which risks becoming an avenue of HIV/AIDS transmission (61).
• Discrimination and fear of exclusion or violence stop infected individuals from seeking treatment, furthering the risky position of the group and preventing effective resolution of the issue. It also prevents heterosexual men from seeking necessary aid, as clinic visits are associated with homosexual relations (61).
• The continued illegality of male homosexual relations in Uzbekistan and Turkmenistan also alienates affected populations and discourages people from seeking resources to prevent infection and transmission. The author believes that this also contributes to the growth of gay subcastes within prisons, leading to more intense forms of abuse -- although this is doubtful considering the effective non-enforcement of the anti-sodomy law in Uzbekistan and Turkmenistan (62).
• "Without long-term well-designed anti-stigma and discrimination campaigns targeting various audiences, as well as parallel national and regional advocacy activities aimed at legal reform and policy change, there is a serious likelihood that many of the on-going prevention interventions will have only a very limited impact" (62).