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]

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]

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]

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]

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]

Survey for MSMGF's Vienna pre-conference

Participate in Important New Survey on HIV Prevention Strategies Targeting MSM!

June 24, 2010

Dear Colleague,

You are invited to be part of the Global Forum on MSM and HIV (MSMGF) Survey on HIV Prevention Strategies Targeting Gay Men and Men Who Have Sex with Men (MSM)!

We are looking for gay men, MSM and providers from all over the world to take part so that we are able to better understand the HIV prevention knowledge and needs of MSM globally. We are also interested in hearing about the social realities for MSM in your area.

We know that you are very busy, but ask that you please consider taking the time to complete this important survey (it should take about 10 minutes). You can do so by clicking one of the following links: English, Spanish, French, Russian. 

We also encourage you to distribute this e-mail invitation as widely as possible throughout your networks and affiliations.

Thank you in advance for supporting this work. We will be sharing preliminary survey findings at the MSMGF's "Be Heard" Pre-Conference on July 17th in Vienna, Austria. We will also be publishing and disseminating a more extensive report on the findings later this year. Your participation will ensure that we communicate the broadest and most in-depth information possible regarding MSM HIV prevention knowledge and needs.

Should you have any questions, please do not hesitate to Pato Hebert at phebert@ msmgf.org. 

Best regards,

The Global Forum on MSM & HIV

[Posted by Jack Beck on MSM-Asia mailing list, 2010-06-25]

ICASO demands on MDG document

Urgent Action! Endorse Demands for the MDG Outcome Document

June 23, 2010

Dear all, 

The Global Forum on MSM & HIV (MSMGF) participated in the recent meeting of global AIDS advocates described below. Please take a moment to read the series of demands produced at this meeting concerning the Millennium Development Goals (linked below); we urge you to sign on your organization by July 25th!

Any questions can be directed to MSMGF Policy Associate Mohan Sundararaj at msundararaj@ msmgf.org.  

*** 

A group of AIDS activists met in New York June 10-11, 2010, and agreed on a series of demands to be incorporated into the Millennium Development Goals (MDG) Outcome Document (to be approved at the MDG Summit in September 2010). You are urged to add your organization to this set of demands, by sending an email to universalaccess2010 @icaso.org. Endorsements will be collected by email and also at the International AIDS Conference (ICASO booth # 901 in the Global Village). The demands will immediately be used for negotiations, and the full list of endorsements will be sent to all UN Missions in New York, and other key stakeholders by July 25.

Download the English and Spanish pdf versions of the document: English, Spanish 

Thank you!

 [Posted by Jack Beck on MSM-Asia mailing list, 2010-06-23]

MSMGF's policy brief on MSM and HIV

Global Forum on MSM & HIV Launches New Policy Brief, HIV Prevention with MSM: Balancing Evidence with Rights-based Principles of Practice

June 14, 2010

Dear Friends of the Global Forum on MSM & HIV (MSMGF),

The MSMGF is pleased to announce the launch of our newest policy brief, HIV Prevention with MSM: Balancing Evidence with Rights-based Principles of Practice. This document details the current context for the development and implementation of HIV prevention efforts targeting MSM, provides an overview of available MSM-specific HIV prevention strategies, and offers a look at recent guidelines from global health institutions. Recommendations emphasize the importance of respecting the role of MSM in efforts to determine research, policy, and program priorities, as well as other core principles of practice that are often overlooked in policy discussions.

The document is available for download HERE.

We encourage you to share this important policy brief with your networks! Chinese, French, Russian and Spanish translations are forthcoming.

Sincerely,


The Global Forum on MSM & HIV (MSMGF)


[Posted by Jack Beck on AP-Rainbow mailing list]

Abstracts from AIDS 2008

[Posted by Jan Wijngaarden, msm-asia, 18 November 2008.]

Dear all,

The MSMGF team has gone through all abstracts presented at AIDS 2008 in Mexico City and pulled out all those that concern sexual minorities. For your convenience, we have catalogued them on our website both by topic and by region/country. See the links below:

• By topic

By region:

• Asia
• Caribbean
• Eastern Europe and Central Asia
• Latin America
• North Africa and the Middle East
• North America, Western and Central Europe
• Oceania
• Sub-Saharan Africa
• International

We hope you find this resource to be useful. Because we went through the abstracts by hand, there is a possibility we may have missed a few. If you notice that something should be there and isn't, please contact us at and let us know!

Hope you all have a wonderful week!

Jack

Announcement: Survey for Gates Foundation donors meet

[Posted by L Ramakrishnan, ap-rainbow, 24 October 2008]

On October 30th, the Bill & Melinda Gates Foundation is hosting a meeting of donors who focus their grant making on HIV, LGBT, sexual and reproductive health, and human rights. The purpose is to identify opportunities for collaboration to support the needs of MSM living in developing countries.

Prior to this meeting, we are conducting a quick, informal survey of advocates and implementers working around the world on issues pertaining to MSM. We would greatly appreciate your feedback and will provide any responses you wish to give to the funders attending this meeting. Your responses are anonymous, even if you provide your email address for further information.

You can fill out the survey by clicking on this link

The survey closes at 1pm Eastern Standard Time (GMT -5) on Wednesday Oct 29th.

Thank you for your responses.

MSM "Faith Encounter"

[Posted by Aditya Bondyopadhyay on ap-rainbow Yahoo! Group, 10 September 2008]

Dear Colleagues,

Please find the report of the meeting of MSMGF and APCOM representatives with reps from Faith Based Organisations in the Mexico AIDS

Conference as prepared by the World AIDS Campaign, the facilitator of the meeting. Quiet aptly it is called “MSM Faith Encounter”..!!
Best regards to all,

Aditya Bondyopadhyay

[Attached document available here]

HIV rising fast among MSM now as was then

Invisible men: action urged for gay men in the global South
AIDS Map News, 4 August 2008

"This epidemic never ceases to surprise us. In every major city in Asia we have looked at, there are now epidemics of HIV among men who have sex with men (MSM) – epidemics that remind me of what we saw in the USA and Europe in the 1980s. HIV is now rising as fast in those men as it was then. This was the warning given by Peter Piot, retiring Director of UNAIDS, at the satellite meeting on gay men/MSM preceding the 2008 World AIDS Conference in Mexico City.

The Invisible Men: Gay Men and other MSM in the Global HIV Epidemic, a mini-conference organised by the Global Forum on MSM and HIV brought nearly 500 delegates from every continent to a two-day meeting featuring plenaries, 24 breakout sessions and posters on research, advocacy and HIV programme development for MSM, largely in the global South.

The meeting happened in advance of a World AIDS Conference which is widely expected to foreground MSM issues as never before.

David Wilson, head epidemiologist at the World Bank's Global HIV/AIDS section, put Piot's words into context with a wide-ranging plenary speech covering HIV epidemiology amongst gay men/MSM in all continents.

He told the conference that when populations of MSM were surveyed, the prevalence of HIV amongst them was without exception higher than in the general population, even in countries with large generalised epidemics.

The lower the HIV prevalence in the general population, the greater the disparity between this and the prevalence in gay men. Thus in the only four countries so far surveyed in Africa (Kenya, Senegal, Sudan and South Africa) gay men were 3.8 times more likely to have HIV than the general population; in Asia, 18.7 times more likely; and in the Americas, 33.3 times more likely.

Prevalence was high in gay men even in countries with virtually no HIV in the general population; a survey from Alexandria in Egypt, for instance, had found 6.5% prevalence in gay men in a country where general prevalence is 0.01%.

Concurring with Peter Piot, Wilson said that HIV prevalence in MSM in some parts of the world appeared to be rising sharply. Annual surveys from Beijing, for instance, showed that HIV prevalence in gay men had risen year-on-year from 0.8% in 2001 to 5.8% in 2006, and had jumped from 17% in Bangkok in 2003 to 28% in 2005 (in 1990 the rate amongst gay Thais was 3%).

These apparently new epidemics were occurring in countries that had often successfully reduced HIV prevalence amongst female sex workers (FSWs) and their clients, he added. In South America, HIV prevalence was dramatically higher in gay men than female sex workers, ranging from 7% to 27% according to country while nowhere exceeding 7% amongst FSWs.

In Thailand, for instance, HIV prevalence amongst FSWs and their clients had peaked in 1993. In a survey done in Mombasa, Kenya, comparing FSWs and MSM, HIV prevalence was higher in FSWs (32% versus 23%); but HIV incidence was considerably higher in MSM (8.6% a year versus 3.2% in FSWs).

"Epidemics amongst FSWs are old epidemics which are slowing down, whereas epidemics amongst MSM are gaining momentum," he added. In countries where the initial burst of HIV occurred among injecting drug users (IDUs), there was evidence of spread from IDUs to MSM; in a study in Vietnam, for instance, HIV prevalence amongst MSM in general was 5-9%, but amongst MSM who also injected drugs it was 26-28%.

A surprisingly high rate of injecting drug use was also found in a new survey of MSM in Malawi in southern Africa (see separate report). This also found that bisexuality was the rule rather than the exception, and Wilson added that in surveys done in Asia, the proportion of MSM who also had sex with women ranged from 22% (in China) to 70% (in Cambodia). Conditions therefore exist for epidemics amongst MSM to seed a new wave of infection amongst women.

Gay men were less well-served by prevention interventions than any other vulnerable group, Wilson added. UNAIDS has calculated that 60% of FSWs, 46% of IDUs and 40% of MSM had ever been reached by any prevention programme. Programmes for gay men could be highly cost-effective, he added; it had been calculated that the estimated cost per Disability-Adjusted Life Year (DALY) gained for different interventions in Asia was $3 for work with FSWs (because they were comparatively easily reached and condom uptake was efficient), $39 for harm-reduction programmes in injecting drug users, and $74 in programmes for MSM. This compares with an estimated $2600 per DALY gained in HIV awareness programmes directed at general youth.

Evidence for the effectiveness of HIV prevention amongst MSM in the global south was only just beginning to be gathered, he added, but after the introduction of condom and HIV awareness programmes for MSM in Indonesia in 2002, condom use had doubled (from 30% to 60% in the last episode of anal sex) by 2004.

A poster to be presented at the main conference later this week will show that HIV and STI prevalence in MSM in Senegal has declined between 2004 and 2007, significantly in 21-25 year olds, that the proportion of MSM ever participating in HIV prevention programmes has increased from 23% to 60%, and that reductions in HIV risk behaviours correlate significantly with participation in prevention programmes (Wade).

Structurally, MSM work is being taken on for the first time ever by one of the United Nations bureaux, namely UNDP, the United Nations Development Programme, with the founding Executive Director of the International HIV/AIDS Alliance, Jeff O'Malley, chosen to direct it. Up till now, no UN agency has been willing specifically to take on working with MSM.

O'Malley asked, rhetorically: "How could it be that the AIDS world at large only just seems to have re-discovered yesterday that there is an HIV epidemic amongst MSM and trans people - in the global South as well as the global North?"

He continued: "The Washington Post thinks that the Mexico conference might be the conference that puts MSM and HIV on the world stage, just as the Durban conference did for the epidemic in Southern Africa."

He commented that "UNDP's democratic governance programme has prioritised the promotion of human rights of marginalised and excluded populations – and they are committed to ensuring that includes sexual minorities."

Piot agreed. He concluded his speech by saying: "In many countries we may be reaching a tipping point where working with MSM is becoming possible and we may see results due to advocacy."

Reference

Wade A et al. Reduction in risk behaviors amongst MSM in Senegal after targeted prevention interventions. XVII International AIDS Conference, Mexico City. Poster abstract THPE0349. 2008.

The Pink Pages for the Mexico IAC

MSM Guidebook to the International AIDS Conference: The Pink Pages

Linked above is the compilation of presentions, symposia and workshops pertaining to gay/bisexual/MSM and transgender people featuring at the upcoming AIDS2008 conference.

If you are presenting at the conference and find any missing entries please let the folks from Global Forum on MSM and HIV know at contact@msmandhiv.org.

MSMGF's new website

The Global Forum on MSM and HIV's (MSMGF's) new website is now up and running at www.msmandhiv.org.

The new MSMGF site features a different format than the older version; all information and resources are now organized by region, with internationally relevant items listed on the homepage for easy access.

This site was designed to grow organically over time, with emphasis placed on the value of participation from our users (you!). We will continue to send out our regular eblasts with all new material added to the site, but we also invite you to submit new articles, papers, presentations, media and anything else that you feel is important to share with other users.

We also invite you to register your organization in our new MSMGF directory, so that those who wish to connect with others for collaboration can easily identify who is doing what and where.

Thank you for being a continued part of the effort for health and human rights for MSM all over the world. We hope this website will facilitate your work!


The Global Forum on MSM and HIV