MSM still marginalised in AIDS response

Widespread and worsening HIV infection rates among men who have sex with men (MSM) threaten to devastate this marginalised group, researchers warned this week at the fourth International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention, in Sydney.

The American Foundation for AIDS Research (amfAR), a US-based research group, announced on Tuesday that in many parts of Asia, Africa, Eastern Europe and Latin America, stigma, repressive laws and poor access to health services were fuelling alarming epidemics.

In Africa, nearly 40 percent of MSM in Kenya and nearly 22 percent in Senegal are estimated to be HIV positive, compared to 6 percent in the rest of Kenya's adult population and 0.9 percent in Senegal's. In Ukraine, HIV prevalence among MSM is estimated at 27 percent, and in Mexico at 15 percent.

Laws criminalising sex between men exist in 85 countries, and widespread stigma often prevents MSM from using HIV/AIDS services. "One in 20 men who have sex with men have access to appropriate HIV prevention, treatment, care and support services," Kevin Frost, amfAR's chief executive officer, told journalists on Tuesday. "This is a massive failure of the HIV/AIDS response, globally."

The research group has launched an initiative to support grassroots organisations, fund research and advocate increased global attention for AIDS programmes targeting MSM.

UNAIDS deputy executive director Michel Sidibe stressed that this was one of the world's most urgent public health needs. "You can't talk about fighting the pandemic if we are still marginalising groups. We have to empower MSM and make sure they have the right to access basic health care."

Although countries have begun to recognise the needs of more easily identifiable high-risk groups, such as sex workers and injecting drug users, MSM were still being ignored.

To make matters worse, amfAR noted, MSM projects rarely benefited from bilateral funding and grants from the Global to Fund to fight AIDS, Tuberculosis and Malaria, as the money flowed mainly through local governments.

According to Frost, more research into MSM was crucial, as not enough was known about HIV epidemics among this community. "In China, for example, 80 percent of men who have sex with men are married ... this is an enormously complex situation, which needs to be looked at."

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