new report says the rate of HIV infections among men who have sex with men is
many times greater than HIV infections in the general population. The report by the American Foundation for
AIDS Research, or amfAR, was released this week at the 2008 International AIDS
Conference in Mexico City. As VOA's
Rosanne Skirble reports, activists are calling for targeted prevention programs
and resources, especially in low- and middle- income countries, where the problem
is most acute.
amfAR report looks at the response of 128 countries to a 2006 United Nations
initiative promoting universal access to HIV prevention, treatment and
care. But the amfAR report focuses on
one HIV-infected population group: men
who have sex with men, better known by the acronym MSM. The term describes this group's sexual
behavior, and does not imply a homosexual lifestyle.
co-author and Johns Hopkins University epidemiologist Chris Beyrer says a
review of all published HIV data shows that MSM makes up a large and growing
portion of the AIDS epidemic in every region of the world.
Latin America, the odds ratio, the elevated risk compared to the general
population, was 33 times. That was the
most extreme that we saw."
says in Asia, men who have sex with men "are 18 times more likely to have
HIV infection, and in Sub-Saharan Africa, where general population rates (of
HIV infection) are the highest, men who have sex with men were still more than
three times more likely to have HIV than adults in the reproductive age
CEO Kevin Frost says criminalization of male-with-male sexual activities is
driving the MSM epidemic in many countries, making it "enormously
difficult" to reach the population.
says 86 countries criminalize sex between men.
In seven of those countries it is a capital offense. "That kind of
institutionalized homophobia makes it very difficult to address the AIDS
epidemic in those men."
amfAR report links MSM prevalence to the failure of many countries to launch
any kind of MSM-targeted response, as described in the U-N's 2006
call-to-action on HIV-AIDS programs.
The report found that nearly half of all countries did not provide any
data on MSM in response to the U.N. initiative. Among those nations that did, 71 percent have not launched any
Kevin Frost says that must change. "History, if it has taught us anything
about this epidemic, it has taught us that if we are going to be effective in
our response, our response has to be comprehensive," Frost says,
"meaning it has to address all the populations at risk, whether that is
men who have sex with men or drug users or sex workers."
report concludes that despite the upward trend in MSM-related HIV infections,
resources to deal with them are scarce.
Latin America, for example, where the AIDS conference is being held, MSM
represents 25 percent of the people living with HIV. But MSM programs get less
than one percent of total spending on HIV/AIDS prevention.
Chris Beyrer says it's essential that funding priorities be adjusted and is
using the data to advocate for resources. "When you find this kind of a
problem and you have the evidence, you want evidence-based approaches to
prevention for these men: increased surveillance, health care access,
antiretroviral therapy, condoms, and lubricants. And that has to be paid for."
calls for stepped up efforts in this area by national governments and major
donors like the Global Fund to Fight AIDS, Tuberculosis and Malaria; the World
Bank; and the U.S. President's Emergency Plan for AIDS Relief, or PEPFAR.
epidemiology has told us this is the most at risk group, and when we look at
the services we see that they are … among the most underserved groups."
says failure to provide health care, prevention and treatment for the MSM
population amounts to nothing less than a denial of basic human rights to
health care and, ultimately to life itself.