ISEAN seeks TGF Round 10 funding

[Received from Laurindo Garcia, HIV programs manager of Fridae.com, 2010-08-21]

Dear Expert Reviewers, Supporters, Advisors and Partners of the ISEAN-Hivos Multi-Country Proposal Initiative for MSM, TG and HIV in Indonesia, Malaysia, the Philippines and Timor Leste,

You will be pleased to hear that our Round 10 proposal was submitted on-time to the GFATM Secretariat in Geneva after our Core Proposal Writing Team spent the past week making final preparations together in Jakarta.

While we wait for the decision to come from the GF TRP this December, we firmly believe that the proposal writing process was a significant and valuable experience that galvanised our member community organisations and representatives while solidifying linkages with stakeholders region-wide. 

Some of the significant milestones include:

• Three Regional Consultations for the Proposal Working Group (2 in Jakarta, 1 in Kuala Lumpur) that began in February 2010
• Needs Assessments, national consultations and focus group discussions for MSM, TG and HIV in Indonesia, Malaysia, the Philippines and Timor Leste
• A team of consultants and expert reviewers from around the world contributing their time and energy to develop a multi-country Global Fund proposal in less than 6 months
• Solid support from the world's largest NGO supporter of LGBT issues, Hivos (from their International and Southeast Asia Regional Offices), as well Asia's largest LGBT media and ICT social enterprise, Fridae
• Committed partnerships with the UNDP's Regional Centre
• Technical assistance and support from The Alliance, APCOM, CSAT/Seven Sisters, TSF SEAP and UNAIDS
• Confirmed endorsement from CCMs in Indonesia, Malaysia, the Philippines and Timor Leste on an innovative community-led initiative
• Community organisations and groups among the four countries more engaged at a regional level, with a clear understanding of how cooperation and collaboration can support mobilisation at the national level

We have witnessed a remarkable effort, especially in view of the fact that the first ever Regional Consultation for MSM and TG in Insular Southeast Asia took place in August last year prior to ICAAP IX in Bali - thanks to our friends at GAYa NUSANTARA and APCOM with support from UNDP and UNFPA, and coordination by UNESCO. This is a stellar effort for a network that is only 12 months and 2 weeks old!

PDFs of the Final Proposal, Sections 1-5 and the Performance Framework, can be downloaded HERE.

We wish to thank everyone for the goodwill they have shared with our member organisations, this has benefited the network as a whole - without your assistance and friendship, none of this would have been possible.

In particular we wish to thank our lead proposal writers Paul Adams, Nicholas Bates and Agus Sudaryanto, as well as Saba Moussavi, for their professionalism, tireless commitment, good humour and sleepless nights. Special appreciation goes to Kwasi Boahene, Ben Witjes and Shita Laksmi who are exemplary examples of Hivos' commitment to our community in pursuit of human rights for all.

 In the short-term, there's a more lot in-store:

• We will have a steering committee deliver a report on Governance issues for the network by October.
• In addition we will see the first consultation for young MSM, TG and HIV in Asia and the Pacific this September, where representatives from our next generation of leaders from Insular Southeast Asia will share their ideas for the future with their colleagues from the broader region.
• ISEAN aims to have another consultation of the full network before the end of the year, with the view of formalisation by ICAAP X in 2011.

Regardless of the Global Fund outcome this coming December, ISEAN and its members have a clear vision of what it can achieve.

We are confident that we will see better health and human rights outcomes for waria, mak nyah, pondans, ah kua, badings, baklas, gay men, bisexuals, other MSM and transgender people in our region in the near future.

Expect more news from us soon.

Cheers!

Laurindo

ISEAN Coordinator

Gay men, safer sex, mini-series

[Posted by Paul Causey on MSM-Asia mailing list, 2010-08-14. Embedded Youtube video found HERE.]

Safe sex lesson wrapped in a gay drama

With its raunchy scenes and dialogue, appealing male characters and realistic local settings, the mini-series, Love Audition, is a form of entertainment that the average gay man may find hard to resist.

Enjoying watching such a straightforward depiction of their lives, they may be unaware that the programme is also indirectly educating them about safe sex.

"Our audience hasn't perceived our mini-series as a campaigning tool but a real series they can actually enjoy," said Vitaya Saeng-aroon, a producer of the series shown on the Mango TV satellite channel.

The first season centres on a bet among three friends aged in their early twenties to use condoms whenever they have sex.

Targeting viewers aged 18-24, the series is not shy about portraying the lives of young gay men - nightclubbing, "bitchy" talks, onscreen kisses and some bizarre sexual encounters.

The temptation for characters to skip condom use is high. For example, character Pom's long-term boyfriend cites "mutual trust", while Ae is tempted by an unsafe choice offered by an attractive stranger.

But they have to learn to overcome temptation and find ways to negotiate with their own desire as well as others' libido in a bid to win the bet.

"There has been so little information in the mainstream media about HIV prevention that is specifically tailored at this high-risk group," said Mr Vitaya. "The media has been so reluctant to talk about actual things in a way that both educates and engages audiences."

Feedback he has received so far convinces him that his series works.

"Viewers have enjoyed it, meaning they could have absorbed our key messages at the right moment. We aim for behavioural change," he said.

Funded by the United States Center for Disease Control and Prevention, the first season can be viewed on YouTube.

The second season, supported by the United Nations Educational, Scientific and Cultural Organisation (Unesco), will focus on drug use in the same age group.

The series is an example of an innovative way to engage young people in sex education and how to deal with sex in a safe and healthy way, its producers say.

But in a highly conservative society like Thailand, this kind of approach has rarely been adopted by parents, educators or the mainstream media.

The Public Health Ministry reports a rapid increase in new HIV cases among men who have sex with men. This group accounts for a quarter of new infections.

About half the young people in other groups also refrain from condom use.

Given these trends, health campaigners say it is time to break the taboo on sex and overhaul sex education in a truthful and non-judgmental way that adolescents will find easier to digest.

A recent survey by the Thai Health Promotion Foundation (ThaiHealth) reveals that most youngsters aged 9-11 seek answers about sex from their friends, and lack understanding about contraception or prevention of sexually transmitted diseases.

UNAids in 2008 said about 40% of young people aged 15-24 did not have accurate information about HIV.

Sirikorn, 17, said she and her school friends often talk about sex and sexual desire.

"I'm not shy when talking about it. My friends also share [intimate] details about their boyfriends," she said.

Nattaya Boonpakdee of ThaiHealth said teachers, parents and the media should start "vaccinating" the younger generation against sexual harassment, STDs and unplanned pregnancies by giving them the information they need.

This vaccination must go beyond the traditional promotion of abstinence, she said.

The mainstream media brands sex as a negative thing which shuts the door on communication with young people, who will not be so easily turned away. The entertainment industry can play a role in educating and helping audiences, she said.

Another challenge is to integrate sex education into schools.

Since young people want to know about sex, it is important for teachers to communicate in an accurate and non-judgmental fashion, said Philip Bergstrom, a reproductive and sexual health adviser to Unesco in Bangkok.

The Education Ministry has developed a curriculum and trained teachers in selected schools but needs to go further, he said.

Young people need to be prepared so they can solve problems themselves, without being told about what they should do or should not do, he said.

"Give them the information they need so they can make healthy, smart choices," he said.

Join the survey

Provide Input on WHO Guidelines for Service Delivery to MSM and Transgender People!

Dear all,

The World Health Organization (WHO) is developing guidelines for delivering an evidence-based, essential package of interventions for the prevention and treatment of HIV and other sexually transmitted infections among men who have sex with men (MSM) and transgender people in the health sector. 

The Global Forum on MSM and HIV (MSMGF) has been contracted to systematically solicit civil society input from MSM and transgender advocates in the form of individual telephone interviews with MSM and transgender people as part of the guidelines development process.

Interviews will focus on values and preferences MSM and transgender people may have regarding a range of HIV and STI prevention and treatment interventions. The MSMGF will conduct interviews by phone or Skype and compile input into a formal report that will be publicly available. All interviews will be anonymous - we will not be collecting identifying information.  Interviews will help to strengthen guidelines the WHO develops for MSM and transgender communities worldwide.

To be a part of this process and other MSMGF research activities, please sign up for the MSMGF Survey Panel. You can join the MSMGF Survey Panel by registering at http://www.msmgf.org/index.cfm/id/1/ (it takes about one minute to register).  Once you have registered, an option will appear to sign up for the MSMGF Survey Panel.  Please note that we will not be able to interview everyone who signs up due to time limitations.  Any questions or comments can be directed to contact -at- msmgf.org.

This is a very important opportunity to influence a guidance document that will be used by organizations providing services to MSM and transgender people around the world.  Please circulate among your networks!

Thank you very much!

The MSMGF

[Posted by Jack Beck, Communications Associate of MSMGF, on AP-Rainbow mailing list, 2010-08-07]

MSM care and support

Message from Family Health International, Thailand/Regional Office

Dear Colleagues,

We are pleased to share with you the final meeting report from the “Asia regional consultation on MSM care and support”. The report summarizes key policy and technical recommendations developed by participants related to each priority health sector intervention; guides the selection and prioritization of interventions for HIV treatment, care and support; and directs readers to key resources containing the best available information on the health sector response to HIV among MSM.

We are thankful to consultation participants for their excellent contributions to the meeting and draft report. We hope this report proves useful in further shaping and rolling out critical care and support services for MSM. Please contact us should you have any questions.

Warm regards.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-08-04. Report available for downloading from the APCOM Resource Library, and also HERE.]

Homosexual sex, one of China's biggest emerging challenge

AIDS expert tells China's gay men to face up to responsibilities

by Xinhua writers Du Jie, Shang Yang, Xu Yalan

BEIJING, July 30 (Xinhua) -- A leading international expert on HIV/AIDS Friday challenged China's gay men to front up to their responsibilities in fighting the spread of the disease.

Dr. Ray Yip, director of the China Program of the Bill and Melinda Gates Foundation, said the spread of HIV/AIDS in China through homosexual sex was "one of the biggest emerging challenges" to controling the disease.

Dr. Yip told CNC World, the satellite news television station run by Xinhua News Agency, that HIV transmission through "MSM" (men having sex with men) had boomed since 2003.

This year, the Beijing Municipal Center for Disease Control and Prevention (CDC) announced sexual activity between men and men had become the main channel of HIV transmission in the city, exceeding both heterosexual sex and drug use.

Poor awareness of safe sex among gay men contributed to the sharp rise as many gay men had multiple sex partners, and did not always use condoms.

"We need the MSM group to engage their community to take part in the intervention," Dr. Yip told CNC.

"Will they promote safe sex? Will they be promoting early testing? Will they be supporting people already with HIV? So the key is their involvement in the prevention."

Social pressures forced many HIV carriers to remain hidden, and many were reluctant to admit they were HIV carriers, said Dr. Yip.

They need to show their faces and let their voices be heard, said Dr. Yip.

Homosexuals, sex workers, drug abusers and underground blood donors were all most at risk of infection and the biggest danger to others.

"The prevention of the spread of HIV, regardless of which group, drug users, sex workers or men having sex with men, is the same," Dr. Yip said.

"The key thing is that the high risk behavior needs to be reduced.

"It is those people who don't know they are HIV carriers are dangerous. We need to find them," said Dr. Yip.

However, he said, "China represents one of the few countries in Asia that really takes AIDS seriously."

The Bill and Melinda Gates Foundation had committed 50 million U.S. dollars to support HIV/AIDS prevention efforts in China, supporting both governmental and non-governmental programs focused on the "priorities": prevention services for high-risk groups, HIV testing, prevention and support for people living with HIV, and stigma reduction.

"We fund government programs in about 15 cities across China to work with NGOs who fund high-risk communities, such as MSM, to mobilize and develop their capacity to do the prevention," Dr. Yip said.

The foundation, which cooperates closely with China's Ministry of Health (MOH), was supporting groups that promoted "peer education" such as Zhitong, a volunteer organization.

Luo, the head of Zhitong programs who would only give his surname, said, "We give away condoms and brochures in gay bars and parks, set up a free hotline, and conduct salons or lectures regularly."

The organization, which is financially supported by the Gates foundation and local health agencies, has more than 200 volunteers and claims to have contacted at least 60,000 people.

MOH figures showed that by the end of last year, MSM transmission accounted for 32.5 percent of China's total HIV/AIDS infections, up from only 0.4 percent in 2005.

China had 740,000 people living with HIV/AIDS, 105,000 of whom had AIDS by the end of 2009, MOH data showed.

The Chinese government has lifted the 20-year-old ban on entry of foreigners with HIV/AIDS in a move to eliminate unequal treatment for people living with HIV/AIDS.

Since the end of 2003, the government has carried out a policy of free blood tests for those with HIV, free education for orphans of AIDS patients, and free consultation, scanning tests and anti-virus therapies for pregnant women.

(Note: Su Jing and Li Dongxu also contributed to the story. To view the CNC World interview, please log on http://www.xhstv.com/english_video_online.asp)

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-31]

HIV prevention failing MSM youth

Prevention Is Failing to Target MSM When They're Young Enough

by David Evans

If we are going to prevent HIV transmission in young men who have sex with men (MSM), we must find strategies to reach them when they are in their early teens. So say researchers who presented a study Monday, July 19, at the XVIII International AIDS Conference in Vienna. 

HIV infection among young MSM is often a conundrum. Studies show that they understand what sexual acts place them at highest risk for HIV infection, but many engage in unprotected anal intercourse with other men of unknown HIV status. What is paradoxical and frustrating is that when prevention researchers ask the young men why they engaged in high-risk behaviors, they typically respond that they didn’t think that what they were doing would lead to becoming infected.

To better understand the context behind this kind of reasoning, D. Dennis Flores III, from Emory Healthcare in Atlanta and his colleagues conducted interviews with 10 young MSM from that city who had recently been diagnosed with HIV. Nine of the men were African American, and one was Latino. Their ages ranged from 18 to 24. The interviews with the young men covered four topic areas: risk behavior, HIV education, the Internet and healthy role models.

As has been found in previous studies, the majority of the young men had viewed themselves as either unlikely or very unlikely to contract HIV in their lifetimes, and half reported experiencing coercion and sexual abuse at the time of sexual initiation.

One 18-year-old participant, Nathaniel, described his own sexual initiation: “I had to be around 13… He worked at my school, he was around 30, a janitor. He was always nice to me for no reason. I mean, I kind of guessed it after a while. He would talk to me. One day I just left school with him. The most we ever did was oral; we didn’t do anything else. But after that, like, he tried talking to me more about leaving school. I really didn’t like him after that.”

Flores and his colleagues found that while all the young men had undergone sex education while in middle school or high school, none reported that these classes included information about gay sex. Moreover, only one of the young men reported having any gay role models while growing up. This meant that relevant sex education occurred on the Internet, which from a sexual risk perspective, can be quite perilous. When these young men went online, most of them saw graphic high-risk sexual encounters, and this behavior quickly became what they perceived as normal and desirable.

“[The Internet] sure has taught me a lot of tricks,” explained 24-year-old Adrien. “Things that I never thought were humanly possible. It gave me a reference. I guess it was kind of revolutionary for me ’cause I’d never seen two men, like, actually get enjoyment out of it. So it was like getting exposed to that was, like, wow, you know…different.”

One of the most important findings, said Flores, was that by the time the young men encountered prevention messages and programs targeted to young gay men, higher-risk sexual activity had already become the norm. For some, they contracted HIV before having ever encountered targeted prevention information.

Flores concluded his presentation by stressing that targeted education, focused on young MSM, should be occurring as early as elementary or middle school and that parents should be taught to be supportive and to teach their sons how to avoid sexual coercion. Moreover, Flores’s team recommends engaging young MSM who are out about their sexual orientation to serve as peer educators and role models for other young men. Lastly, Flores stressed the critical need to use new technologies online to reach young MSM with prevention methods before it is too late.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-30]

LGBT autobiographies

Restoried Selves: Autobiographies of Queer Asian-Pacific-American Activists

Restoried Selves: Autobiographies of Queer Asian / Pacific American Activists presents the first-person accounts of 20 activists—life stories that work against common stereotypes, shattering misconceptions and dispelling misinformation. These autobiographies challenge familial and cultural expectations and values that have traditionally forced queer Asian / Pacific Americans into silent shame because of their sexual orientation and/or ethnicity. Authors share not only their experiences growing up but also how those experiences led them to become social activists, speaking out against oppression.

Many harmful untruths—or “stories”—about queer Asian-Pacific Americans have been repeated so often, they are accepted as fact. Restoried Selves provides a forum for voices often ignored in academic literature to “re-story” themselves, addressing a range of experiences that includes cultural differences and values, conflicts between different generations in a family or between different groups in a community, and difficulties and rewards of coming out. Those giving voice to their stories through narrative and other writing genres include the transgendered and intersexed, community activists, youths, and parents.

The stories told in Restoried Selves reflect on:

• Personal experiences—based on country of origin, educational background, religion, gender, and age
• Populations served by activism, including the working poor, immigrants, adoptees, youth, women, and families
• Different arenas of activism, including schools, governments, social services, and the Internet
• Issues targeted by activism, including affirmative action, HIV/AIDS education, mental health, interracial relationships, and sexual violence
• Institutions in need of change, including legal, religious, and educational entities

Restoried Selves is an essential read for academics and researchers working in Asian American studies, ethnic studies, gender studies, and queer studies, and for LGBTQ youth and their parents, teachers, and social service providers.

[Posted by Paul Causey, AP-Rainbow mailing list, 2010-07-26]

PrEP study gives hope - MSMGF

The Global Forum on MSM & HIV welcomes positive results of PrEP safety trial among MSM

Study gives hope about an expanded prevention tool kit

Vienna, Austria (July 24, 2010) - The Global Forum on MSM & HIV (MSMGF) welcomes the results from the CDC 4323 trial, released by the Centers for Disease Control and Prevention (CDC) during a late breaker session on the closing day of the 2010 International AIDS Conference in Vienna.  This trial, designed to assess the safety of the oral antiretroviral (ARV) drug tenofovir when used as pre-exposure prophylaxis (PrEP), was conducted among 400 HIV-negative gay men and other men who have sex with men (MSM) in the United States.  Preliminary findings from the trial suggest that the use of PrEP presents no significant safety concerns for MSM. 

It is important to note that CDC 4323 is a safety trial; no conclusions can be drawn about PrEP’s efficacy in preventing HIV among MSM by this study.  Other studies are currently underway around the world to determine if PrEP is effective at reducing HIV infection among individuals at high risk for HIV, including MSM.

In addition to clinical safety, CDC 4323 assessed whether those using PrEP might increase their risk behaviors. While analyses of risk behavior data are not yet complete, early results suggest there was no increase in risk behaviors among MSM taking PrEP during the first nine months of their participation in the study.

PrEP entails the administration of oral ARV agents before exposure to HIV in order to reduce risk of infection if exposure occurs. Although no conclusive evidence currently exists regarding PrEP’s ability to prevent HIV infections, CDC 4323 goes a long way towards lending additional assurance that the strategy may be well tolerated among MSM, should it prove effective. 

Key thought leaders have universally agreed upon the need for multiple, safe and effective HIV prevention approaches. Safety results released today offer hope for an expanded prevention portfolio, one that includes a broad range of peer-led behavioral and community-level approaches that are anchored with concerns for the broader health and human rights of MSM.

MSM continue to shoulder a disproportionate disease burden when it comes to the HIV epidemic in all regions of the world.  Prevalence among MSM is higher than that of the general population in nearly every country that reliably collects and truthfully reports HIV and AIDS surveillance data. On average, MSM are 19 times more likely to be infected with HIV than the general population in low- and middle-income countries. And in resource rich countries, MSM are up to 40 percent more likely to be infected with HIV than the general population, as is the case in the United States. Stigma, violence and discrimination facing MSM worldwide work to aggravate the situation;  homosexuality is criminalized in nearly 80 countries in stigmatized in countless others.

News about the CDC 4323 safety trial follows the positive results of CAPRISA 004, a proof-of-concept study that found a 39 percent lower HIV infection rate in HIV-negative women living in South Africa who used a 1% tenofovir vaginal gel when compared to women who did not. While more exciting progress on ARV-based prevention interventions is anticipated in the near future, we must continue to stress the importance of a comprehensive and balanced approach to the fight against HIV, one that addresses both the unacceptably high HIV sero-prevalence among MSM and the ongoing human rights abuses they endure.

[Posted by Jack Beck of MSMGF, MSM-Asia mailing list, 2010-07-25]

Exploring PrEP to prevent MSM HIV infections

Gay Men Don't Engage in Riskier Sex When Taking AIDS Pills, CDC Study Says

By Simeon Bennett

Gay and bisexual men didn’t have riskier sex or suffer serious side effects while using Gilead Sciences Inc.’s Viread in a study of whether taking pills to prevent HIV infection would loosen inhibitions or harm health.

Gay and bisexual men who took a daily pill -- either Viread or a placebo -- were no more likely to take greater sexual risks on the assumption they were protected than those who didn’t take one, researchers from the U.S. Centers for Disease Control and Prevention said at the International AIDS Conference in Vienna today. The study also compared the rate of side effects between those who received Viread and those who got a placebo, and found no significant difference.

The study supports efforts to test whether drugs approved to treat AIDS patients can also be used to prevent infections in the first place. That theory, called pre-exposure prophylaxis, or PrEP, was partially validated this week when a vaginal gel containing Viread was shown to reduce infections by 39 percent among women in South Africa.

“It is encouraging to hear there were no serious safety concerns and that the men in the study did not appear to increase risk-taking behaviors while taking a pill,” said Mitchell Warren, executive director of the New York-based AIDS Vaccine Advocacy Coalition, in an e-mailed statement. “Much more safety, adherence and risk data will be needed before PrEP can be implemented if it is proven effective.”

400 Men

The study involved 400 HIV-negative gay and bisexual men in San Francisco, Atlanta and Boston. About half received either Viread or placebo immediately, and the other half started nine months later.

There were seven HIV infections overall, and none in the group that took Viread. The trial wasn’t designed to test whether the drug prevented infections and no conclusions about its effectiveness can be drawn from the study, the researchers said. The distribution of infections could be due to chance, said Lisa Grohskopf, a CDC researcher who presented the results.

“PrEP is one of the most-promising new prevention approaches being explored, and if effective, could help address an urgent need for additional solutions to help slow the HIV epidemic in the U.S. and around the world,” the CDC said in a statement.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-24]

Circumcision unlikely for MSM HIV prevention

Circumcision Unlikely to Have Major HIV Prevention Benefit Among Gay Men

by Tim Horn

Circumcising men who have sex with men (MSM) is likely to have a negligible effect on the rate of new HIV cases in the United States, according to a survey conducted in San Francisco in 2008 and reported Thursday, July 22, at the International AIDS Conference in Vienna.

Clinical trials in South Africa, Uganda and Kenya have indicated that heterosexual men who undergo circumcision are 60 percent less likely to become infected compared with uncircumcised men. Ever since these findings, public health leaders have sought to promote circumcision as a proven, cost-effective method. In Vienna, ambassador Eric Goosby, the U.S. global AIDS coordinator, and David Okello of the World Health Organization, along with Bill Clinton and Bill Gates, lent their voices to support male circumcision in Africa.

Circumcision is thought to reduce the risk of HIV transmission by removing cells in the foreskin that are most susceptible to infection by the virus.

Whether or not circumcision of adult males in the United States, notably men who have sex with men, will influence the incidence of HIV in this country remains a matter of debate. As recently as March, an analysis of data collected in the United States and other Western countries indicated that circumcision will not necessarily prevent transmission among MSM.

To explore this further, Jonathan Fuchs, MD, MPH, of the San Francisco Department of Health and his colleagues conducted a survey of MSM in San Francisco measuring HIV prevalence, circumcision status, condom use with insertive and receptive anal intercourse, and willingness to be circumcised.

Of the 521 MSM surveyed, 115 (21.1 percent) were HIV positive and 327 (62.7 percent) were already circumcised, leaving 69 (13.2 percent) for whom circumcision may have an additional preventive benefit.

Among those for whom circumcision may confer a protective effect—those who predominantly engaged in insertive anal intercourse (21.7 percent reported “topping” at least 80 percent of the time, without condoms, with their five most recent partners)—only three (0.5 percent) were willing to participate in an MSM circumcision trial. What’s more, only four (0.7 percent) were willing to get circumcised, even if it proved to be a safe method that did reduce the risk of HIV transmission.

Extrapolating these findings to the entire MSM population of San Francisco—an estimated 65,700 people, Fuchs indicated—only 500 men would potentially benefit from circumcision.

Fuchs and his team concluded that circumcision as an HIV prevention strategy would apply to few MSM in San Francisco and thus, even if effective, would have limited influence on HIV incidence in this population. However, if shown to be an effective prevention strategy for MSM, the researchers argue, circumcision could potentially benefit MSM populations with low rates of circumcision and condom use among those who engage in predominately insertive anal intercourse.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-24]

MSM ignored at IAC 2010?

Xtra West Article: Are Men That Have Sex With Men Being Ignored By The International AIDS Conference In Vienna Austria? [blog]

Vienna AIDS pre-conference on men who have sex with men a great idea INTERNATIONAL AIDS CONFERENCE / But also a missed opportunity

Phillip Banks / Vancouver / Monday, July 19, 2010

Last night marked the opening of the 18th International AIDS Conference in Vienna, Austria. From July 18-22 more than 20,000 people from all over the planet will converge to discuss the good, the bad, and the ugly of the global HIV crisis.

In the next few days, research findings will be shared, interesting programs and services will be presented, and more models, frameworks, and strategies than you can shake a stick at will be unveiled to the world.

And if Bill Clinton was telling the truth, we can expect some good news to come out of all of this too. Unfortunately, I’m not so sure the good news is going to apply to gay men.

Too many International AIDS Conferences have come and gone in the last decade without enough attention being given to the situation facing gay men and other men who have sex with men.

This isn’t unique to gay men. Over the years many different groups have had to fight to get the world’s attention.

It seems scientists, world leaders, international organizations, donors, and the conference host itself — the International AIDS Society — are all unable or unwilling to practice what they preach: to respond to the HIV epidemic based on the best available evidence.

If they did, they would be hard pressed to continue to ignore the new, growing, and resurgent HIV epidemics among gay men and other men who have sex with men around the globe.

In an effort to give some serious attention to HIV among gay men, the Global Forum on Men who Have Sex with Men (MSMGF) organized BE HEARD, a pre-conference event on July 17 here in Vienna.

At this one-day event 650 men and women from all corners of the globe came together to address the worsening global AIDS crisis among gay men.

The day featured presentations, workshops, and discussions among activists from every continent and more than 100 countries. Topics covered government denial and neglect; inadequate funding; limited access to prevention, treatment, and care; heartbreaking human rights abuses; and the resulting HIV-related deaths among gay men.

This situation was reiterated throughout the day by a number of high-level experts in the HIV field. Plenary speakers included Michael Sidibé, executive director of UNAIDS; Michel Kazatchkine, executive director of The Global Fund; and Stephen Lewis, the previous United Nations Special Envoy on HIV in Africa.

One after another they stepped up to the podium and told the crowd how bad the situation is for us, how it is made worse by a serious lack of human rights in jurisdictions around the globe, and how, finally, we could count on their support as we fight on.

BE HEARD gave men a chance to get together and hear about challenges of HIV in our communities. It was an incredible opportunity to connect with men on the frontlines from around the world.

But it was also a missed opportunity.

This gathering of global gay activists did not need to spend the limited time they had together presenting statistics and program models to each other. If we really want to be heard, we should have spent that time strategizing about how we are going to use this international platform to demand action to end HIV in our communities.

Gay men need to dust off their whistles and take a page from the playbook of sex work activists, treatment activists, or the emerging activists from Eastern Europe. They aren’t afraid to make some noise because there’s too much at stake for them.

As the 18th International AIDS Conference starts, there’s too much at stake for gay men too.

Only one in five gay men on the planet has access to HIV prevention, care, and support. Top level officials pay lip service to epidemics among gay men but they offer us no good news.

George Ayala, executive officer of the Global Forum, said only 2 percent of scheduled events at this year’s AIDS conference will address the needs of men who have sex with men.

Gay men have been silenced at this conference and if we don’t make some noise, we’ll remain invisible.

There was a time when gay men refused to sit quietly while people in positions of power and authority apologized for our situation but provided no solutions or commitments.

In those days, gay guys demanded action. We demanded money. We demanded laws to protect our dignity and our human rights.

In those days we refused to be silent.

There is an opportunity for leadership here from the MSM Global Forum. It needs to decide if it wants to play nice with the big boys and girls, or throw down the gloves.

The conference is just getting started. Before it’s over I hope gay men do what needs to be done to Be Heard.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-21]

CAPRISA breakthrough gives hope for MSM

The Global Forum on MSM & HIV Stands with Global HIV Advocates in Congratulating CAPRISA on Prevention Breakthrough

Study gives hope for new and effective prevention tools for women, men who have sex with men and other vulnerable populations

Vienna, Austria (July, 20, 2010) - The Global Forum on MSM & HIV (MSMGF) stands with HIV advocates around the world in congratulating scientists at the Center for the AIDS Programme of Research in South Africa (CAPRISA) on their new groundbreaking CAPRISA 004 trial results.  CAPRISA 004 is an efficacy and safety trial that tested a1% tenofovir gel to prevent HIV transmission. Major findings included a 39 percent lower infection rate in those who used the gel compared to those who did not.  Conducted in HIV-negative South African women, this was the first-ever trial to evaluate the efficacy of an antiretroviral-based microbicide; it is great cause for optimism regarding biomedical prevention approaches.

ARV-based HIV prevention entails, among other approaches, the use of microbicides as vaginal or rectal gels to reduce the chances of HIV transmission during sexual intercourse.  We celebrate CAPRISA 004’s positive results as an important development for women’s advocates, who have highlighted the urgency of developing products that give women increased control over their own sexual health.  The study is significant for the health of men who have sex with men (MSM) as well, with a growing global movement advocating microbicides research for rectal use. 

It is important to note that CAPRISA 004 is a proof-of-concept study and that no microbicide, ARV-based or not, has yet been proven to effectively halt HIV transmission.  The results and implications of the CAPRISA 004 trial must be confirmed through further research.  In addition to efficacy trials, studies must be conducted to assess feasibility for potential roll-out and scale-up among different regional contexts and populations, including MSM.  

Microbicides have the potential to become a formidable weapon in the fight against HIV among vulnerable populations.  The CAPRISA 004 study focused solely on vaginal microbicides. More rectal microbicide research is needed in order to better understand their potential health benefits for MSM. Additionally, the complex and diverse challenges that MSM face around the world in regard to access, stigma, and criminalization have shown us that no one prevention technology can be a silver bullet.  Microbicides must therefore be understood as but one evolving part of an integrated prevention spectrum that employs a comprehensive range of already available, evidence-based approaches, from condoms and lubricants through structural interventions. 

In order to ensure that such emerging HIV prevention technologies meet their full potential for reducing new infections, new science must be paired with strong advocacy. Each global region is different and requires a culturally competent and nuanced approach, but the need for action remains universal. We applaud these scientists for their efforts to enhance the tools at our disposal; it is now everyone’s responsibility to ensure that these tools are developed and released into a world that can use them. While more exciting progress on ARV-based interventions is anticipated in the future, we must continue to stress the importance of a comprehensive and balanced approach in the fight against HIV – one that emphasizes targeted rights-based primary prevention strategies for communities that are especially vulnerable to HIV infection combined with treatment and support services for all people living with HIV.

[MSMGF eblast forwarded by Paul Causey, MSM-Asia mailing list, 2010-07-21]

UNDP reports legal environment on MSM and HIV

Report Launch: Legal environments, human rights and HIV responses among MSM and TG in Asia and the Pacific: An agenda for action

On Tuesday, July 20th, UNDP/APCOM presented a ground breaking study on Legal environments, human rights and HIV responses among men who have sex with men and transgender people in Asia and the Pacific: An agenda for action. This report and its key findings were delivered during the session on Criminalizing Homosexual Behaviour: Human Rights Violation and Obstacles to Effective HIV/AIDS Prevention at the XVIII International AIDS Conference in Vienna. A press conference was held on Wednesday, July 21st with Jeff O’Malley, Global Director of UNDP’s HIV Group and Shiv to launch the report.

The report clearly documents how both punitive and protective laws, policies and practices impact comprehensive HIV response. To support the findings and recommendations, the report maps out recent judicial, legislative and policy developments  and community responses at the global, regional and national levels. Together, these findings demonstrate why it is necessary for stakeholders across the spectrum to adopt a rights-based approach to universal access and proactively address policy and legal barriers to effective HIV responses. Finally, the report recommends that each government, development partner and UN agency take bold and effective policy measures to reach out to communities and individuals at risk, particularly those living with HIV.

The study method involved a yearlong review of legislation, cases, published research and grey literature, consultations with community representatives, technical experts and UN agencies, and analysis. A list of participants in the series of community and high-level consultations convened by UNDP to inform the report is provided at Annex II. Inputs were also collected from community representatives; with UNDP and UNAIDS country offices;  UNAIDS and WHO regional offices, with USAID and AusAID, and with some government partners. It’s important to acknowledge that the study has produced more than a report – it has also generated a process, a series of regional consultations within themselves help to raise awareness and build capacity of stakeholders in understanding the issues, and regional and national meetings were held to look at the legal environment and discuss implications.  The study also benefited from technical expertise with inputs from lawyers, parliamentarians and judges from the region.  The recent Punitive Laws, Human Rights and HIV prevention among men who have sex with men in Asia Pacific - High Level Dialogue held in Hong Kong on May 17, 2010 was the last of a series of regional consultations.  The work in this area has been highly  covered by both the international media and local news agencies, and has produced an editorial and full length article in Lancet.

A big thanks to all of you who participated by providing inputs and comments to the report.

Please download the full report HERE.

The following supporting publications can be downloaded HERE.

 - Punitive Laws, Human Rights and HIV prevention among men who have sex with men in Asia Pacific - High Level Dialogue Report (2010)

- WHO: Priority HIV and sexual health interventions in the health sector for men who have sex with men and transgender people in the Asia-Pacific region (2010)

- ICAAP IX Symposium: Overcoming legal barriers to comprehensive prevention among men who have sex with men and transgender people in Asia and the Pacific (2009)

- Developing a Comprehensive Package of Services to Reduce HIV among MSM and TG Populations in Asia and the Pacific: Regional consensus meeting (2009)

[Posted by Edmund Settle, MSM-Asia mailing list, 2010-07-21. The full report can also be downloaded HERE.]

Microbicides, researchers and advocates

Below are series of exchanges on MSM-Asia mailing list about microbicides, trigger post was a note forwarded 2010-07-19 by Clifton Cortez that announced successful trials of a vaginal microbicide CAPRISA 004.

REPLY-NOTE FROM JIM PICKETT

Thanks Clifton.

For people who would like to stay update on rectal microbicide research and development - I'd humbly suggest you join IRMA - International Rectal Microbicide Advocates - of which I am chair. 

We are the only advocacy group in the world with this focus, and we have nearly 1000 members on 6 continents - a wide array of advocates, scientists, policy makers and funders. Joining means signing up for our listserv - so if interested, send me an email and we will sign you up. 

Meanwhile, you may be interested in our new report - From Promise to Product - Advancing Rectal Microbicide Research and Advocacy. It provides an overview of current scientific activities, advocacy activities, etc. You can find it on our website - www.rectalmicrobicides.org.

Thanks!

Jim

REPLY-NOTE FROM CLIFTON CORTEZ

Folks may have heard about the USAID-funded research that has led to a potential breakthrough in vaginal microbicides as an HIV prevention tool. This link sent by Billy Pick in USAID/Washington has all the latest and greatest to keep us updated on the state of anal microbicide research.

Best,

Clif Cortez

http://irma-rectalmicrobicides.blogspot.com/2010/05/whirlwind-of-anal-lubricants-lets-get.html

ORIGINAL FORWARDED MESSAGE FROM USAID

Microbicide Gel Shows Reduced Risk of HIV Infection in Women

Today, I am proud to announce that USAID has supported the first successful trial to prove that a microbicide can effectively and safely reduce the risk of transmission of HIV from men to women.

The CAPRISA 004 trial provides solid evidence that the use of an antiretroviral-based microbicide gel, 1% Tenofovir, can significantly reduce the risk of HIV infection. Finding a woman-controlled method of prevention is critical in the fight against HIV/AIDS. Worldwide in 2008, some 6,200 adults were newly infected with HIV every day, and 48 percent of those infections occurred in women.

This finding would not have been possible without the collaboration of governments, scientists, communities, and 889 courageous women in Durban, South Africa, who volunteered for this trial. This group effort was a model of how USAID works with host nations and partner organizations.

These results are the first step toward establishing the effectiveness of antiretroviral drugs for HIV prevention. Ongoing and similar studies supported by the National Institutes for Health, and other organizations, will confirm these results. USAID will continue to work with PEPFAR, multilateral agencies, and partner countries to ensure the full impact of this advance can be offered to women and girls worldwide and especially in low-resource settings. 

The CAPRISA 004 collaborative approach, led by in-country investigators, is a model for future research studies.  It builds research capacity, contributes to sustainable health systems, and exemplifies how President Obama’s Global Health Initiative intends to leverage technology and innovation to improve health around the world.

I am proud that USAID is at the forefront of innovation in science, and I congratulate the staff from the Bureau for Global Health for their work on this important effort. With the support of President Obama and Secretary Clinton, we will continue to put science, technology, and innovation at the forefront of our development work.

Please see USAID’s Global Health Bureau’s factsheet on microbicides, to learn more about our work in microbicide research and the CAPRISA 004 trial.

Rajiv Shah

Point of Contact: Any questions concerning this Notice may be directed to GH/PRH Jeff Spieler, (202) 712-1402.

Call for EOI: APN+ MSM working group

CALL FOR EXPRESSIONS OF INTEREST FOR
CORE GROUP OF APN+ MSM WORKING GROUP

The APN+ MSM Working Group is an integral part of APN+ and works in the interests of HIV+ MSM in the Asia Pacific region with the following vision:

“Positive MSM will be accepted equally in their communities free from stigma and discrimination and their human rights will be respected, including their right to a fulfilling sex life. All positive MSM will have access to the means to maximise their health, including equitable access to MSM friendly prevention, care, treatment and support services.”

The APN+ MSM Working Group was formed in early 2007 and now wishes to move to a more formalised structure in order to ensure good governance and effective implementation of its mission and work plans. Central to this new structure is the establishment of a Core Group.  This is a call for Expressions of Interest (EoI) to serve on this Core Group. Core Group members must be HIV+ MSM. Preference will be given to those who work with positive MSM communities in their own countries. The business of the Core Group is conducted in English and so an ability to communicate in English is essential.

Terms of Reference of the MSM Working Group is available on the APN+ website. In particular please note:

“The Core Group of the APN+ MSM Working Group will come from the four sub-regions of the Asia Pacific. Ideally members should be nominated by their national PLHIV networks, but in cases where that is not possible a nomination may be made by the Coordinator and endorsed by a member of the APN+ Steering Committee. Core Group members will serve a term of two years, with an ability to be re-nominated for a second two year term if appropriate. The APN+ MSM Coordinator will handle the nomination process, which will be overseen by the APN+ Executive Director, and any membership of the Core Group would require endorsement by the APN+ Steering Committee. Members of the Core Group are expected to communicate regularly with APN+ and positive MSM in their locations, contribute actively to discussions and promote the Working Group and its activities.”

Please send Expressions of Interest (EoI) indicating experience, skills and current work to the APN+ MSM Working Group Coordinator by JULY 31st 2010. It is preferred that nominations are made (endorsed) by the National PLHIV network of your country where possible.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-20]

MSM "combination prevention" reduces HIV epidemics

Providing prevention for men who have sex with men could significantly reduce HIV infections in many countries

BY Gus Cairns (NAM)

A mathematical model developed by the Bloomberg School of Public Health at Johns Hopkins University shows that developing effective ‘combination prevention’ programmes for men who have sex with men (MSM), including both biomedical and behavioural interventions, would significantly reduce the scale of the HIV epidemic in many countries.

In areas like Latin America, where the epidemic is mainly driven by sex between men, providing comprehensive prevention to MSM could cut overall HIV prevalence by almost 50%, a pre-conference organised by the Global forum for MSM and HIV heard.

The findings, by researcher Chris Beyrer, were presented at the Be Heard! pre-conference for MSM attended by around 700 delegates.

Stephen Lewis, the former UN special envoy for HIV/AIDS in Africa, who also addressed the meeting, hailed the model as the first evidence hard enough to persuade reluctant politicians that they had to address the prevention needs of MSM in their countries.

Beyrer’s model was made possible by the increasing number of prevalence surveys of HIV in MSM from a number of countries. A literature search, combined with proactive networking with key opinion leaders, unearthed data from 138 prevalence studies of HIV in MSM from 50 different countries, covering most areas of the world with the notable exceptions of most of the Middle East and central Asia.

They reveal that, with two exceptions – Namibia and South Africa – HIV prevalence is higher in MSM than in the general population. In lower- and middle-income countries taken as a whole, MSM are 19 times more likely to have HIV than the general population, and 44 times more in developed countries.

Beyrer identified four different kinds of epidemic based on the proportions of MSM and injecting drug users (IDUs) in the population.

‘Scenario 1’ countries have epidemics mainly restricted to MSM; these are mainly in Latin America with a few outliers like Ghana.

‘Scenario 2’ comprises countries where HIV in IDUs predominated: Russia and eastern Europe.  Here, recent data show that HIV prevalence in MSM is three to seven times that of the general population, though only a quarter of that in IDUs.

‘Scenario 3’ were the countries with generalised epidemics in Africa, though, even here, MSM in countries like Malawi and Kenya have two to three times the HIV prevalence of the general population.

In ‘scenario 4’ countries, most of them in Asia but including outliers like Senegal and Egypt, the one middle-eastern country with data, there is a complex mix of transmission between heterosexuals, IDUs and MSM.

Based on these data, Beyrer devised a model of the MSM epidemic in each scenario that included what could be fed in about STI prevalence, number of sex partners, condom use and – importantly – antiretroviral provision to people with HIV.

He fed in what would happen if a programme of ‘combination prevention’ including both HIV treatment and outreach and community-based behavioural programmes were made available to MSM. He then computed what would happen to the annual number of new HIV infections, not just in MSM but in the whole population, in four selected countries: Peru, Ukraine, Kenya and Thailand.

He also computed what would happen if the status quo persisted and what would happen if all current prevention support – including ARV treatment – was removed. The model lasted from 2007, on which year figures were based, to 2014.

In Peru, providing comprehensive prevention programmes for MSM would make a dramatic difference, with new cases falling from 15,000 in 2007 to 8000 in 2014, compared with an increase to 26,000 if the status quo was maintained. In Thailand the annual number of new cases, currently 33,000, would fall to 20,000.

Comprehensive prevention would make less difference in Kenya, where it would only take 3000 or so infections away from an expected 85,000 new cases in 2014, and in Ukraine, where it would only make a difference of about 1500 from an expected total of 35,500 new cases in 2014.

In Ukraine, however, there is a significant overlap between the MSM and IDU populations, and adding in comprehensive harm-reduction programmes would lead to a 40% drop in new cases to 22,000.

Beyrer ended his presentation on a very personal note, making a plea for comprehensive prevention for MSM by showing a slide of a lover who had died in 1990. “Enough with young men needlessly dying,” was his closing remark.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-20]

Reaching MSM through the Internet

Internet proving a key way to reach men who have sex with men in Africa, Asia and beyond

Roger Pebody

In the last few years, the scale of the HIV epidemic amongst men who have sex with men in Africa, Asia and Latin America has become clearer. There is now a body of data on HIV prevalence and on risk behaviours, but attention is now shifting to the inadequate amount of prevention work that is carried out with men who have sex with men in many countries.

In advance of the main AIDS 2010 conference in Vienna, activists and researchers gathered for Be Heard!, which turned out to be the largest pre-conference meeting organised by the Global Forum on MSM & HIV yet. The sessions covered a wide range of issues, especially human rights, but several workshop speakers highlighted how the internet has become central to their work with men who have sex with men.

For example, Yves Yomb from Alternatives-Cameroun explained how  – in a context where homosexuality is penalised, blackmail and police harassment are common, the media are homophobic and funding for work with men who have sex with men is limited (MSM do not figure in Cameroon’s national strategic plan for HIV) – his organisation needed to be creative in finding ways to support men who have sex with men.

The internet is commonly used by men who have sex with men in Cameroon to find sexual partners. Moreover, the net is a relatively safe space where sexuality can be addressed in a frank and honest way. Peer educators surf the most popular websites used for sexual networking, where they befriend and inform men about HIV and other issues which men ask about. As access to condoms and lubricant can be difficult, men met online may be invited to come to the organisation’s centre to get supplies. They may then also find out about the other healthcare services and support groups that Alternatives-Cameroun provides.

Tudor Kovacs of PSI Romania similarly explained how he used a sexual networking site to build a support network of HIV-positive men who have sex with men (an extremely marginalised and, until then, invisible group in Romania). He searched GayRomeo for Romanian profile names which included key words such as +ve or HIV. There were only six, and these men were sent a short private message inviting them to form a group (“a safe corner” to chat and be themselves). Those who joined could invite others in too, and the group slowly grew in this way. The agenda for online discussion and the rules for interaction were developed by the group members themselves, with Kovacs primarily acting to mediate and defuse conflicts.

Although the group began as being online only and with all members’ anonymity protected by pseudonyms, many group members later took up an invitation to participate in weekend meetings. These were described as an “overwhelming experience”, with excellent peer support given. Moreover, group members decided themselves to switch to a system where email addresses were visible. Kovacs suggested that one aspect of the group’s success was that the group was presented as a way of getting to know more people, rather than providing support.

In another example where face-to-face activities intersect with online work, Nada Chaiyajit and Christopher Walsh explained their work with Mplus in Chiang Mai, Thailand. The organisation works with various groups including men selling sex, transgender people and younger men who have sex with men. It lets their existing contacts know that staff will be present on various social networking sites and MSN Messenger at specific times, where they are available to interact and answer questions. This multiplies the opportunities for the group to support their clients and extends the relationship with them.

Mplus has also developed short animated videos covering health issues and legal rights. They can be used as an information referral during online work, but are also loaded onto mobile phones or MP3 players, to be used during outreach at parks, public toilets, go-go bars and brothels. The videos often act as a catalyst for further discussion and questions from the client. Another advantage of the format is that the animated videos have been relatively simple to translate into other languages used by clients (a majority of the men selling sex are migrants).

Moreover, the videos were developed with a lot of user involvement and close attention to local understandings of health and sexuality. As with the projects in Cameroun and Romania, this online outreach work relies on having peer educators with a good understanding of local subcultures and the social environment.

Working on a different scale, Stuart Koe explained how he is incorporating health work into www.fridae.com (a large gay dating and lifestyle site in southeast Asia and China).

He suggested that it was essential for HIV prevention to happen online as, for many men, this is their primary means of meeting sexual partners. In the context of negative social attitudes, the web allows anonymity and confidentiality. Stuart believes that health promoters should not try to create new web platforms, but should work with the commercial websites which are already popular and widely used. Moreover, within social networking sites, micro-communities formed around specific subcultures or sexual interests naturally form, and can be reached with targeted prevention work.

He believes that too many online health activities at present are modified versions of traditional health interventions, and do not take advantage of the potential of the web. He gave as examples static “brochure websites” and outreach work in chatrooms, which he considers too labour-intensive to scale up.

Some of the health work that Fridae has done includes an interactive quiz testing knowledge of sexual risks, an online community for men with HIV, the world’s second-largest sex survey of men who have sex with men and a low-cost service providing condom and lubricant deliveries.

They have also adapted the dating and sexual networking functions of the site so that if someone wishes to declare themselves HIV-negative in their profile, they have to supply the date of their last test. If the test was more than a year ago, their status will appear as 'not tested recently'. If it was within the last year, their status will appear as 'negative at last test'. Then a year on from the test date, Fridae will email the man to remind him to test again and give details of local clinics.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-19]

Mapping at-risk groups in Pakistan

The HIV/AIDS Surveillance Project mapping approach: an innovative approach for mapping and size estimation for groups at a higher risk of HIV in Pakistan.

AIDS. 2010 Jul;24 Suppl 2:S77-84

Authors: Emmanuel F, Blanchard J, Zaheer HA, Reza T, Holte-McKenzie M,

OBJECTIVE: We developed a mapping approach to gather data on distribution, number of settings, operational typologies and estimated size of female sex workers (FSWs), male sex workers, hijra sex workers and injection drug users in Pakistan.

METHODS: Data were collected across 12 major cities in Pakistan. Broader methodological steps involved dividing each target city into smaller geographical units and collecting data within each zone from secondary and tertiary key informants, also known as level 1. Level 2 ensured involvement of the communities themselves in validating these estimates, followed by triangulation of the finalized results. Rates for each subgroup per 1000 adult men or women were computed and rolled up into provincial estimates to be summed up into national estimates.

RESULTS: FSWs formed the largest group reported, with estimates of 79 127 and five different subtypologies. Injection drug users were the second largest group, followed by male sex workers and hijra sex workers with estimates of 31 555, 19 320 and 14 702, respectively. We estimated approximately 167 501 FSWs in Pakistan, with an overall national rate of 4. 4 FSWs per 1000 adult women. A total of 71 911 male sex workers in addition to 39 262 hijra sex workers were calculated with rates of 1.7 and 0.9 per 1000 men, whereas injection drug users had an overall estimate of 102 042.

CONCLUSION: This relatively simple methodology provides a scientific and systematic approach, which can be used in the region to estimate population sizes, understand geographical distribution of these groups and recognize the various operational typologies and dynamics of these populations for developing effective prevention strategies.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-19]

Lessons from the front lines

MSM Groups Confront Hostility and HIV with Resolve and Creativity

New report from amfAR and MSMGF showcases lifesaving efforts of community-based groups to reach men who have sex with men (MSM) and demonstrates the impact that small programs are having on the global HIV epidemic among MSM.

With recent data showing rapidly escalating HIV epidemics among men who have sex with men (MSM) in many countries around the world, community-based organizations are filling the gap in HIV prevention, education, and treatment services that governments and other large donors have been unable or unwilling to address, according to a new report from amfAR and the Global Forum on MSM & HIV (MSMGF).

The report, “Lessons from the Front Lines: Effective Community-Led Responses to HIV and AIDS Among MSM and Transgender Populations,” will be released at the pre-conference event, Be Heard!, organized by the MSMGF in Vienna on Saturday, July 17, in advance of the 18th International AIDS Conference.

“The ways to address HIV among MSM are not a mystery,” said amfAR CEO Kevin Robert Frost. “We have hundreds of examples of small organizations that effectively and efficiently deliver prevention and treatment services.”

Read the complete article HERE.

Download the PDF of the report HERE.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-18]

MSM, TG and Digi-Tech

Call for Papers for Special Themed Issue

Building the HIVe: Increasing social and political science representation in the HIV field by MSM and TG communities deploying digital technologies

This special themed issue of Digital Culture & Education (DCE) will showcase the diverse ways that men who have sex with men (MSM) and transgender (TG) communities deploy networked and mobile technologies to intervene in HIV public health and education practices in ways to confront stigma, realise health, sexual and human rights, and improve HIV/AIDS prevention, treatment, care and support. This call for papers targets participants from the Global Forum on MSM and HIV’s (MSMGF) pre-conference entitled, “Be Heard” and the XVIII International AIDS Conference in Vienna, but also invites contributions from activists, artists, researchers, and service-providers not attending. The ambition is to share and learn from effective practices in using digital technologies to scale up Universal Access to HIV-related prevention, care, treatment, and support for sexual minority communities worldwide.

Editors: Gurmit Singh, University of Leeds; Christopher S. Walsh, The Open University; George Ayala, The Global Forum on MSM and HIV

Despite the change in behaviours and sexual practices due to networked and mobile technologies, there remains a lack of willingness to rethink current paradigms for HIV interventions aimed at changing individual behaviours. Effective prevention programmes must now respond to digitally-based and -driven sexual-social behaviours in a global network society geared towards maximising sexual pleasure. The ubiquity of networked, mobile technologies, and the proliferation of social networking tools, combined with the realisation that HIV is a profoundly social disease, challenges current disciplinary biomedical approaches to HIV. Yet, there is a lack of necessary investment in social and political science research on the public health added value of deploying the Internet and mobile technologies by MSM and TG communities for HIV/AIDS prevention, treatment, care and support.

This special themed issue presents dynamic interventions that draw on the capabilities of networked and mobile technologies, to build the ‘HIVe.’ The HIVe is an open, non-hierarchical, fluid ecology of HIV activists, practitioners, researchers, and scholars, that actively advocate, disseminate, and promote localised and successful intervention-based practices and challenges. The HIVe exploits the Internet and mobile technologies to advance the impact of the social and political sciences for Universal Access in MSM and TG communities. This special themed issue of Digital Culture & Education (DCE) begins a journey to build the HIVe by developing, exploring, and substantiating the creative and effective merging of HIV and ‘e’ around sexual-social practices and networks, which can shape and influence the future of interdisciplinary and interconnected public health, human rights and education programmes and policies.

Submissions from gay, lesbian, bisexual and transgender community-based organizations that deploy networked and/or mobile technologies in their programmes and interventions are particularly relevant. These manuscripts could be case studies, impact evaluations, or community-based applied research narratives, that illuminate potential openings for advocacy and for policy change in approaches to community-based HIV interventions. Submissions can include “traditional” print texts on empirical research, as well as non-traditional approaches and formats (e.g. descriptions of artefacts, digital storytelling, audio-visual art, etc.).

Potential research and practice questions are:

* What are the characteristics of community-driven social and political science approaches in concentrated epidemics that add value to the effectiveness of public health interventions using networked and mobile technologies for HIV prevention, treatment, care and support?

* What strategic and theoretical insights from these emerging community-based social and political science approaches can be woven together to conceptualize and build the HIVe – a systems-based model for HIV prevention, treatment, care and support, that draws together community development, public health, digital culture and education, and technology?

DCE is committed to building research literacy in social and political science approaches and encourages submissions from developing country authors, from non-scientific and non-native English speaking backgrounds. The journal will offer targeted online mentoring to authors who submit papers of high potential for consideration.

Interested authors should send their manuscripts to the editor of Digital Culture & Education by October 1, 2010.

[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-15]