If can be difficult to imagine a world suddenly so equitable that in the next four years 90 percent of all people living with HIV have had a chance to learn they have the virus, 90 percent of those are receiving treatment, and the quality and consistency of that treatment is good enough to make the virus undetectable in 90 percent of them. Thinking about the obstacles to health care confronting men who have sex with men only makes what experts say has to happen to end HIV as a global health threat more unimaginable and more important still.
Consider the findings of UNAIDS 2014 GAP Report that gay men and other men who have sex with men worldwide are 19 times more likely to be living with HIV than non-sexual minority members of the general population, while access to HIV prevention services actually fell across 20 countries between 2009 and 2013 — from 59 percent with access to 40 percent. And, highlighting shortfalls in investments where they are needed most, the report notes that across and within many countries, men who have sex with men and have higher incomes are “several times” more likely to access antiretroviral treatment than those at lower income levels. With obstacles to mainstream health settings that include the effects of criminalization, discrimination, and abuse of sexual minorities, the report showed, levels of HIV testing, below 55 percent globally, “are insufficient to link gay men and other men who have sex with men to care in sufficient numbers to effectively reduce HIV transmission.”
Those numbers and the conditions that keep them low, are among the reasons an advisory group called the Global Platform to Fast-Track HIV Responses among Gay Men, Bisexual Men and Other Men Who Have Sex With Men (called the Global Platform for short), met in Geneva in mid-January. Brought together by UNAIDS and the Global Forum on MSM & HIV, the group is a response to UNAIDS “fast-track” 90-90-90 targets, and an effort to inform them, with advice on the needs of some of those most affected by HIV and least served by responses to the pandemic.
The group is the first of its kind, MSMGF head George Ayala noted in an announcement of its meeting, in a global response, he said, that has “shamefully failed gay and bisexual men and other men who have sex with men.” The group, he added, is a “first step in correcting the situation.”
The group, men who have sex with men including people living with HIV, program planners, prevention experts, and human rights advocates, has a short-term goal of informing language that better expresses the needs of men who have sex with men in the 2016 Universal Declaration on HIV/AIDS, along with clear achievable goals. The group also intends to raise awareness on the impacts and obstacles surrounding HIV and men who have sex with men as high-level meetings on the global pandemic approach. The group’s long term aim is to knock down some of those barriers.