Shooting the Messenger: Jamaica's Brendan Bain Controversy Continues

Brendan Bain, D.M., M.P.H., FRCP; former head of head of the Caribbean HIV/AIDS Regional Training Network (CHART). Photo by Steve Shapiro/2011 Caribbean HIV Conference, used under a CC license.

Brendan Bain, D.M., M.P.H., FRCP; former head of head of the Caribbean HIV/AIDS Regional Training Network (CHART). Photo by Steve Shapiro/2011 Caribbean HIV Conference, used under a CC license.

The controversy over Professor Brendan Bain's court testimony in the Caleb Orozco case (in which the plaintiff was suing the Attorney General of Belize over the unconstitutionality of the criminalisation of homosexual relations) continues. After Bain, who was head of the Caribbean HIV/AIDS Regional Training Network (CHART), stated that men who have sex with other men are at higher risk for contracting HIV, the University of the West Indies took the decision not to renew his contract.

The professor's full testimony is here. The aspect of his statement that appears to be fueling the contention involves his reference to a report which found that:

The relative risk of contracting HIV is significantly higher among men who have sex with other men (MSM) in Belize than in the general population. This is also true in several other countries for which data are available, including countries that have repealed the law that criminalizes anal sex and countries where the law still applies.

On Monday there was a protest at the Mona campus in support of Professor Bain. The protesters said that the University had violated Bain's right to free speech and had inadvertently cast doubt on the justice system:

In the Facebook group, “I Support Dr. Bain”Miguele Smith commented on the video:

It is unjust on all levels for C.H.A.R.T to continue being in support of Professor Bain’s removal as Head of the organization, for how can an organization lose confidence in an individual of such high esteem and unquestionable professional character for giving an expert opinion? It must have meant that they wanted Professor Bain to state falsely on the issue. It is obvious that the Gay lobby groups are adamant in achieving their goal of having the buggery law repealed and legalizing same sex practices. If this were not so then the expert testimony given by professor Bain would not have been viewed as a threat that could influence the courts verdict to rule against the position of the gay activists and gay lobby groups of having the buggery law repealed. This issue gives insight to the level of indignation that plagues our society and highlights the blatant attempt of such lobby groups to craft a paradigm shift and silence those who oppose their goal even scientific evidence itself.

Many other quarters have been coming to Bain's defense. The Trinidad and Tobago Medical Association, for instance, called the non-renewal of Bain's contract as head of CHART a case of “shooting the messenger”, adding that there is “irrefutable evidence that MSMs [men who have sex with men] are at a higher risk of contracting (and spreading) HIV/AIDS.”

Jamaican writer Kei Miller posted an in-depth review of the issue, motivated in part by the fact that Dr. Bain has been a close family friend:

It is perhaps an inconvenience to know so well, so personally, people whose public selves you wish to engage with, and sometimes to challenge, for if you take a counter opinion you can no longer throw whatever invective you might have otherwise casually thrown at them – ‘close-minded’, ‘bigots’, ‘bible-thumpers!’ Instead you know too well their integrity, have experienced first-hand their love and compassion and so you must acknowledge that they (like you) are people in search of the truth, and people brave enough to speak that truth as they understand it.

He immediately acknowledged the complexity of the issue and the many layers that needed to be peeled away and understood before the truth could be arrived at:

We might stop for a moment to appreciate that this is how the story has been framed and understood by several Jamaicans. What many of us have understood is that a good man has been fired for having the moral and intellectual integrity to stand up and say not only what he believed, but to do so while standing on the solid ground of his research. And if we appreciate that this is how the story has been framed, that this is what many of us have understood, then we might appreciate why across the length and breadth of this little buggered island, so many of us are feeling deep pain and sometimes anger over the whole issue.

Miller also referred to a key aspect of Professor Bain's testimony in the court case:

It is difficult to find anything objectionable in the affidavit – but not impossible. There is one very curious statement which he offers in the preface and which in a way frames all of the evidence he then gives. He says:

‘Some Public Health practitioners have hypothesized that decriminalizing the practice of anal intercourse among consenting adults would lead to a reduction in the incidence rate of HIV infections among MSM. To date, published data have not substantiated this hypothesis.’

This single statement will have several of his colleagues and many others who work as HIV/AIDS researchers scratching their heads in perplexity.  I wish he had expounded on it and not just left it hanging there, a sentence that seems to go dramatically against what most of his colleagues would argue. For what is certainly true is that the rate of HIV/AIDS infection is highest in countries that have their buggery laws firmly in check. So where does this new conclusion come from? The very reports that he cites throughout his paper all come to the conclusion that the buggery laws must be repealed with great urgency to help in the fight against HIV. But Uncle B doesn’t mention this.

Miller referred to a situation with the Jamaica Coalition for a Healthy Society, which he says “lost serious moral and intellectual ground when they kept on invoking the research of Prof Chris Beyrer, one of the world’s leading HIV/AIDS specialists, and used it to support their cause of keeping the buggery law in place”:

It was Beyrer himself who finally had to write a heartfelt letter to the Gleaner (you can read it here) almost begging the group to stop being irresponsible and contorting his research, reading it out of context, and not showing the conclusions he had reached. That conclusion – once again – was that the buggery laws must be repealed to help in the fight against HIV. So when Bain seems to be employing a similar tactic, selecting sections of someone else’s research, speaking authoritatively from it, but not acknowledging the conclusions from that research, indeed suppressing it, then we might understand why certain groups might begin to get nervous.

Attempting to decipher the intended meaning himself, he wrote:

On closer inspection, and using all my skills as a literary scholar, the sentence is a slick and a slippery one. For though it might seem to leave hanging in the air the possible implication that the evidence REFUTES it, this is absolutely not what he says. He simply says the evidence does not, TO DATE, SUBSTANTIATE it. And we must give him credit, for Bain, throughout his affidavit, is making an extremely important and a nuanced point – that the repeal of the buggery law by itself may not lead to less HIV/AIDS infections among MSM, but that there are other behaviorial issues to tackle.

He also tried to bridge the divide between the different factions:

The inconvenient truth that most Christians do not want to hear is that this supposedly powerful gay lobby are not a bunch of paedophiles and degenerates hellbent on legalizing their immorality. They are men and women who have slowly let go of the terrible effort it takes to hate themselves, and who know all too well the social and medical consequences that such a culture of hate can produce, and who are now brave enough to challenge that culture of hate.

The inconvenient truth that gay lobbyists do not want to hear is that the counter Christian lobby are not a set of self-righteous, unintellectual people who simply want to advance their hatred of others. Amongst the group of Christian lobbyists are doctors like Brendan Bain who have worked quietly over the years, with love and empathy, to attend to some of the most vulnerable in our society.

KairoFocus fully supported Dr. Bain:

 We must also note how Dr Bain's report calmly and professionally states or summarises clinically observed and statistically soundly investigated facts that should not be in serious dispute, and draws out findings that are very carefully broadened from the Buggery law — and BTW, this is about a sexual act that is generally reasonably seen as insanitary and dangerous, not a disposition —  to the full range of people at risk. Any sexually promiscuous person or anyone who interacts sexually with such a person is at risk in our region, or anyone who carelessly handles blood or other body fluids. (Intravenous drug use is not a significant factor in the Caribbean . . we smoke or drink, we don't “jook” here. [And, we should stop the smoking and drinking to excess too.

He was skeptical of the University's reasoning in this matter:

Now, too,  if what I suspect is going on behind the scenes is even half-way so (and notice protesters speaking of selling out for thirty pieces of silver . . . ), we had external forces with financial leverage over UWI, who sought to use radicals as a front lending apparent legitimacy to holding UWI to ransom to suppress research and analysis based findings identified by Dr Bain, on the real causal factors for the prevalence and patterns of HIV/AIDS in our region. 
That is, grant money may well have come to WI with some ugly, hidden, enslaving chains attached. 

Which is a wake-up call on what sort of money we should accept, from whom, for what . . . our souls are not for sale.

I therefore have a word for my Alma Mater:
It is time for us to stop, pause and rethink, UWI administrators.

Trinidadian poet and activist Brendan O'Brien argued that those in policy making positions should follow best practice, regardless of their personal beliefs: 

The refusal to acknowledge the medical merit of the decriminalization of same-sex behaviour in curbing the epidemic of HIV/AIDS and other STIs in the developing world is a refusal to curb the epidemic overall. 

Organizations committed to HIV prevention and the care of those affected have a mandate to support policies that work. When medical practitioners insist upon not supporting those policies in their capacity as members of those organizations, those organizations are within that mandate to sack them. It would work the exact same way, for example, if a global coalition of pediatricians dedicated to ensuring young children get vaccinated chose to sack a doctor who insisted against the evidence that vaccines cause autism. 

O'Brien argued that while Dr. Bain's facts were correct, his policy proscriptions were wrong: 

Bain is right when he says that MSM, especially in the Caribbean, are at high risk of contracting STIs such as HIV. After all, he got those facts largely from Beyrer. 

Bain is wrong when he says that the solution is to continue criminalizing same-sex behaviour. Such a legal position makes it even more difficult for MSM to get or choose to seek treatment in a society that already holds a dangerous social stigma against LGBT persons. Bain is therefore woefully underinformed as to the policies that the majority of public health professionals are in support of – policies that CHART was committed to supporting – or was willing to lie by omission as it pertains to the facts related to the issue, since he was willing to quote Beyrer’s numbers, but not Beyrer’s conclusions.

But did Professor Bain actually say that? Miller explained:

Bain’s affidavit takes a neutral tone and is absolutely grounded in research, but it would be disingenuous for us to ignore what the affidavit is being used to advance. We especially know what it is being used in service of, not so much because of what it says, but because of what it doesn’t say, the conclusions that are not included, the voices shouting from these reports that buggery laws need to be repealed, that are carefully silenced.

For many stakeholders in the fight against HIV/AIDS who are working hard to create environments in which people might practice better sexual health, that might encourage an especially effeminate man not to feel awkward and guilty to walk into a pharmacy and buy condoms and lubricant, an environment where people might seek treatment when needed – for these stakeholders to support a position that argues for the maintenance of punitive buggery laws is not only unhelpful to their work, but is unethical.

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