By KEVIN J KELLEY Special Correspondent THE EAST AFRICAN A new United Nations report cites injected drug use and sex between men as important factors in East Africas Aids epidemic. A prevalent male attitude of supremacy over women is also identified as a key reason why the Aids virus continues to spread in Kenya, Tanzania and other African countries. The findings are contained in Securing Our Future, a report by the UN Commission on HIV/Aids and Governance in Africa, issued last week to coincide with a special General Assembly session on the epidemic. The commission is headed by Kenneth Kaunda, former president of Zambia, and by Pascal Mocumbi, former prime minister of Mozambique. Referring to East Africa, the commission makes note of several recent studies indicating that sex between men could be an important factor in several of the epidemics in this region, despite the widely held assumption that sex between men is alien to African societies. More than 700 men sell sex to other men in Mombasa, according to a study cited in the UN report. That implies there is a reasonably large population of male clients [in Mombasa] willing to pay for sex with men, the UN adds. Homosexual activity may be widespread in Kenya, the report suggests. Several other studies have been able to easily locate and enrol men who have sex with men as participants, the UN commission points out. Rates of HIV infection appear to be above-average for men in Kenya who have sex with other men. For example, a study in Kilifi of men who have sex with men found HIV to be present in more than 38 per cent of those tested. Lower rates among men who engage in homosexual acts have been measured in other parts of Kenya, the UN report adds, citing a figure of 11 per cent among men at counselling sites. The overall HIV infection rate in Kenya is currently estimated at 4.6 per cent for adult men and 8.7 per cent for adult women. Abuse of gay men may be contributing to the spread of the Aids virus in Kenya, the UN report suggests. It points to a study in Nairobi in which one in four homosexual or bisexual men said they had been treated aggressively or humiliated in public in the previous 12 months. Many women in turn face elevated risks of contracting HIV as a result of the higher infection rate among men who have sex with men. According to the UN Commission, many men use their greater status, incomes and access to other resources to buy, coerce or exchange sex from women and girls. In turn, men justify their behaviours on the basis of cultural and social values that encourage having multiple sexual partners. Women married to men who have multiple sex partners may become infected with HIV as a result of their husbands behaviour, over which they wield little if any control, the UN report says. For many women, marriage and fidelity are no protection against HIV. Rape inside marriage is commonplace in Africa and carries a heightened risk of HIV infection for women, the commission adds. Women are obliged to have intercourse any time and under risky conditions: e.g., male spouses having sexual relations with other women, becoming infected with sexually transmitted diseases, and demanding sex under the influence of alcohol. Trauma caused by forced sex increases the likelihood of HIV transmission, the report says. Intravenous drug use represents an increasingly important factor in the Aids epidemics in Kenya, Tanzania, South Africa and Mauritius, the UN commission further finds. It points to research showing that high-risk behaviours are common among those who inject drugs, with the consequence that HIV infection rates are higher than for the general population. About 80 percent of intravenous drug users interviewed in Malindi, Mombasa and Nairobi said they had used needles after someone else had used them, the commission reports. And up to half of the intravenous drug users tested in Mombasa and Nairobi were found to be HIV-positive. In some urban areas on the Tanzanian mainland, injecting drug use has also emerged as a potentially important factor in the HIV epidemic, the report states. In a 2005-2006 study in Dar es Salaam, for example, 58 percent of nearly 100 female heroin users surveyed were found to be HIV-positive. The corresponding figure for the 319 males included in the Dar study was 27 per cent. The overall HIV infection rate has been declining in both Kenya and Tanzania in recent years, the UN study notes. Uganda, however, is experiencing a late increase in HIV prevalence, it adds. About 1.7 million Africans were newly infected with HIV last year, bringing the total number living with the virus to 22.5 million by far the highest prevalence of any region in the world. An estimated 40 million Africans have died from Aids since the epidemic began to be closely tracked in the early 1980s.