The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program released a technical guidance document addressing prevention programs for men who have sex with men (MSM) as part of PEPFAR’s overall prevention strategy on Thursday. Originally to be released at the International AIDS Conference in Vienna in July 2010, the guidance was delayed for nearly a year.
According to the report, MSM in low- and middle-income countries are on average 19 times more likely to be infected with HIV than the general population, with infection rates among MSM now surpassing 30 percent in countries like Jamaica and Thailand.
“With the guidance now available, we will be looking closely at its implementation and how MSM prevention programs are funded,” said Executive Officer of the Global Forum on MSM & HIV Dr. George Ayala in a press release. He stressed the importance of enforcement and accountability at a Hill briefing on Tuesday commemorating International Day Against Homophobia and Transphobia. The event highlighted many of the challenges MSM face in accessing HIV services, especially in the more than 70 countries around the world that criminalize same-sex activities. Addressing these and other key barriers to services for this population – including stigma, discrimination, and human rights abuses – is a highlight of the PEPFAR guidance.
Comprehensive prevention services for MSM and their partners are defined in the report to include: community-based outreach; distribution of condoms and compatible lubricants; HIV counseling and testing; active linkage to care and treatment; targeted information, education and communication; and sexually transmitted infection prevention, screening and treatment. The document also includes recommendations for ensuring confidentiality and other means of optimizing HIV prevention for this unique population, as well as outlining activities that PEPFAR will support through country budgets.
“This guidance is the first step to a scaled, comprehensive, and evidence-based program that can truly address the epidemic among MSM,” said Foundation for AIDS Research (amfAR) CEO Kevin Robert Frost in a press release. “The challenge now is for PEPFAR to put these guidelines into action and to show real results in bringing down HIV incidence among a group that is so vulnerable to infection.”
The amfAR release outlines “next steps” for the Office of the Global AIDS Coordinator, which runs the PEPFAR program, including ensuring PEPFAR country teams implement and scale these programs to have measurable impact, and doing a much better job at monitoring expenditures and programming for MSM.