Focus on male-male sex in global AIDS fight
amfAR, The Foundation for AIDS Research, has announced the launch of a new global initiative to fight the spread of HIV among men who have sex with men (MSM) in the developing world.
Stigma, discrimination, and lack of access to health services have sparked alarming epidemics that threaten to devastate MSM communities in Asia, Africa, Eastern Europe, and Latin America, mirroring the HIV pandemics that ravaged gay communities in North America and Western Europe in the 1980s.
According to a report from the International Lesbian and Gay Association, male-male sex is illegal in 85 countries, making MSM increasingly vulnerable to HIV/AIDS.
The Joint United Nations Programme on HIV/AIDS, UNAIDS, estimates that fewer than one in 20 MSM around the world has access to HIV prevention, treatment, and care.
The MSM Initiative, which was launched at the International AIDS Society conference in Sydney, will support grassroots MSM organisations, fund critical research, and advocate for increased global attention and funding for HIV/AIDS programs specific to MSM.
“Empowering MSM and other marginalised groups to protect themselves from HIV is one of the world’s most urgent health priorities,” said Dr. Peter Piot, executive director of UNAIDS.
New data indicates that the HIV pandemic among MSM is widespread and worsening.
In Africa, nearly 40 percent of MSM in Kenya and nearly 22 percent of MSM in Senegal are estimated to be HIV positive, compared to 6 percent and 0.9 percent HIV prevalence in the overall adult population.
HIV prevalence among MSM is estimated to be 27 percent in Ukraine, 21 percent in Uruguay, and 15 percent in Mexico.
MSM groups also rarely benefit from international HIV prevention efforts because bilateral funding and grants from the Global Fund to Fight AIDS, tuberculosis and malaria flow primarily through national governments that largely ignore the needs of MSM.
“The frightening truth is that, in many parts of the world, we simply do not know how bad the epidemics among MSM groups may be,” said Dr. Chris Beyrer, director of the Johns Hopkins Fogarty AIDS International Training and Research Programme in the United States.
“Transmission among MSM is still not tracked in most countries, resulting in a significant research gap. More research is urgently needed to inform more effective HIV prevention efforts.”
The term MSM includes those who identify as “gay,” but also encompasses any men who have sexual encounters with other men, including groups whose gender and sexual identities defy Western categorisation.
For instance, in India there are at least three designations of MSM. Kothis are effeminate MSM who are often married to women and have families.
Panthis are masculine men who have sex with kothis, and hijras, who are often castrated, are considered to be a third gender altogether.
“The HIV epidemic in men who have sex with men in India is really bad. It has occurred for a simple reason. We have been totally neglected and invisible,” said Ashok Row Kavi, the founder of the Humsafar Trust, a grassroots MSM group in India.
“The programmes that are working for MSM are those where community-based groups have been empowered to take control.”
Despite various challenges, some progress is being made.
Grassroots movements are forming in Africa, India, Southeast Asia, and other regions where discrimination is commonplace and the epidemic has reached crisis proportions.
The MSM Initiative will provide seed grants to grassroots organisations doing innovative work with MSM groups in the developing world.
“A quarter century into the epidemic, MSM in many countries still do not have even the basic tools to protect themselves against HIV,” said amfAR Acting CEO Kevin Frost.
“We must have the courage to stand side by side with the grassroots organisations on the front lines of this epidemic delivering services and demanding greater action from governments.
With funding and support, these organisations can transform attitudes, change policy, and mobilise funding to reverse the alarming spread of HIV among MSM.”
In addition to directly supporting grassroots organizations, the MSM Initiative will advocate for more research on MSM issues and fund global advocacy efforts aimed at mobilising funding from international donors, national governments, and others.
The advocacy programme will also focus on launching campaigns to end the stigma, discrimination, and violence that threaten the lives of MSM and fuel the spread of HIV/AIDS.
The MSM Initiative has already enlisted partners from a number of leading organisations, including UNAIDS and the Global Forum on MSM and HIV.
It has also received significant financial support from groups including the M.A.C AIDS Fund, the Elizabeth Taylor AIDS Foundation, GlaxoSmithKline’s Positive Action programme, and the Bill Melinda Gates Foundation.
“A coordinated global initiative is urgently needed to reverse the alarming rise in new infections among MSM,” said George Ayala, director of education at the AIDS Project Los Angeles (APLA).
“Working together, we can more effectively fight the denial and discrimination that have made MSM so vulnerable to HIV. We look forward to working closely with amfAR and the MSM Initiative to demand that the world finally takes this issue seriously.”
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