A few days before the world marks the 30th anniversary of the beginning of the HIV/AIDS pandemic, a federal agency released new guidelines that seek to ensure global cooperation in approaching the disease’s continued impact on men who have sex with men.
The Office of the U.S. Global AIDS Coordinator issued its “Technical Guidance: Prevention for Men Who Have Sex With Men” late last month to all participants in the President’s Emergency Plan for AIDS Relief, which provides funding and other resources to fight the disease across the globe.
The MSM guidance is the latest in a series of supporting documents released since the 2009 PEPFAR five-year strategy, which is meant to specifically target at-risk populations.
The report notes that HIV/AIDS is having a “severe and disproportionate impact” on MSM in low- and middle-income countries, estimating MSM are 19 times more likely than other populations to contract the disease in such nations. The study added that institutionalized homophobia in some countries further puts MSM at risk, as many in the population cannot access proper prevention or treatment for fear of arrest or persecution.
The document advises that successful prevention programs must combine “structural, biomedical and behavioral interventions” that are evidence-based and nonjudgmental, proposing that the optimal MSM HIV-prevention program should include community-based outreach, condom distribution, HIV counseling and testing, linkage to healthcare and antiretrovirals, targeted information and sexually transmitted infection resources.
Successful prevention cannot be achieved, however, without the implementation of policies that seek to eradicate antigay stigma, the guidance said.
“PEPFAR programs in all countries should be based on principles of equity, nondiscrimination and voluntariness in order to ensure access to services. Programs should develop strategies to ensure that all MSM are able to receive HIV prevention, care and treatment that is affirming and nondiscriminatory and does not place these men at risk for violence, arrest or other forms of discrimination.”
PEPFAR programs are also encouraged to provide staff training on MSM issues, collect information on this demographic and involve MSM in prevention programs.
Sean Cahill, managing director of Public Policy, Research and Community Health at the Gay Men’s Health Crisis, commended the release of the guidance as drawing needed attention to the role of homophobia in the fight against HIV/AIDS.
“The exclusively heterosexual HIV-prevention campaigns in Uganda and elsewhere have led many African gay men to believe they are not at risk for HIV,” Cahill said. “President Obama’s National HIV/AIDS Strategy notes that we cannot fight HIV in the U.S. without bringing down HIV rates among gay men. This is also true of Africa and the Caribbean. Thirty years into the epidemic, it is critical that we acknowledge that gay men exist in the global south and provide them with HIV prevention education.”
Jen Colletta can be reached at [email protected].