Progress made in curbing the rate of new HIV infections in many countries worldwide has not been observed similarly among men who have sex with men, experts said during the 19th International AIDS Conference in Washington.
"The consistent pattern, in developed and developing countries, in low- and middle-income countries, is of expanding HIV epidemics" among MSM, said Chris Beyrer, a Johns Hopkins University epidemiologist.
The transmission risk is greater through unprotected anal intercourse; transmission is more rapid through MSM networks; stigma and discrimination limit access to prevention and treatment services; and MSM are less likely to fully suppress the virus. "All of those structural barriers allow for continued transmission. We must address those structural and social realities" and develop new biological interventions for MSM, said Beyrer.
The largest resource, the Global Fund to Fight AIDS, TB and Malaria, "is essentially country-driven, and many countries have not included MSM in programs," said Australian Don Baxter, co-chair of the Global Forum on MSM and HIV.
"In the fourth decade of the HIV pandemic, we still have countries in the world which do not have HIV statistics for [MSM]," said Paul Semugoma, a Ugandan physician. "Less and less gets to the MSM because of the stigma, because they are criminals." "We have to end the invisibility [of MSM] in service delivery and decision-making," he said.
Brazil, South Africa, and India "pretty much are paying for their own MSM programs on a scale that is likely to be effective," Baxter said. However, Uganda has threatened to shut down an LGBT clinic recently opened, "because they think it is going to promote homosexuality," Semugoma said. Baxter called on the World Bank to fill the financing gap for countries that are ineligible for Global Fund support.
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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.