HIV prevalence rising among gays[made for each other]

LERATO MALEKE
Correspondent

HIV/AIDS prevalence among gay men and men who have sex with men (MSM) is growing with prevention, treatment, and care programmes meant to reverse the pandemic often neglecting this population.

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Stigma and discrimination against gay men and MSM flourish with impunity in countries that receive significant donor funding for HIV/AIDS. National planning documents and donor funding agreements mention MSM, but little programming actually exists. Epidemiological surveillance that could help inform programs serving MSM lags far behind strategic information collected on other populations, and little to no attention, according to studies, is paid to the needs of transgender people.These are the findings of the second report in the series, Achieving an AIDS-Free Generation for Gay Men and Other Men Having Sex With Men (MSM) by BONELA in partnership with amfAR and the Johns Hopkins Bloomberg (School of Public Health).
The study was specifically focused on Botswana, Malawi, Namibia, Swaziland, Zambia, and Zimbabwe.The report examines the financing and implementation of programmes for gay men and MSM in a region at the heart of the HIV pandemic through a combination of desk research and in-country consultations conducted by civil society advocates with implementers, policy makers, academics, and people living with HIV.
While the global conversation focuses on novel approaches to HIV treatment and prevention, gay men, other MSM, and transgender individuals (GMT) struggle to obtain the most basic health services. They are isolated, criminalised, blackmailed and beaten, reveals the report.
Despite this, GMT communities in Southern Africa have shown great resilience and determination. Each country studied, numerous community-led programmes supported by both large and small donors, are making substantial inroads against pervasive stigma and discrimination. These six Southern African states have made significant progress in reducing the number of new HIV infections among their adult populations, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS). Over the past 10 years, the number of annual new infections has dropped substantially, with declines ranging from 25 in Swaziland to as much as 63 percent in Botswana.
The report says this is not a small accomplishment, which comes as a result of persistent, concerted efforts by national governments, donor countries, programme implementers, researchers and civil society.Further, the report states that the same level of effort is required to change the trajectory of the HIV epidemic among GMT.
"Human rights violations permeate every facet of life for these men and women, and lack of robust engagement by donors, implementers, and governments has only perpetuated further abuse," argues the report. The report recommends efforts to increase donor and national government engagement in preventing and treating HIV infection among GMT and that comprehensive human rights programming that addresses stigma and discriminations must be included.
The report has also found a striking incongruence between donor policy and funding patterns. The top funders of HIV/AIDS programs globally-the US President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) have clear policy commitments to addressing the epidemic among GMT. PEPFAR's Blueprint for an AIDS-Free Generation and the Global Fund's Strategy in Relation to Sexual Orientation and Gender Identities (SOGI) make a concrete case for the need, type, and scope of investments in programs serving GMT. However, the report shows that funding and implementation come nowhere close to upholding these policy commitments.
Though PEPFAR and other financing mechanisms under the the US Department of State have gone to great lengths in recent years to target new funding opportunities to programs that support GMT, resources allocated do not approach potential need, so says the report. The six countries mentioned in this report comprised 10 percent of total PEPFAR funding between 2007 and 2011, but four of the six's annual budgets contained no programming for MSM. When included, budgeted amounts were difficult to decipher, frequently miniscule, and often shared among multiple populations, reducing the certainty that MSM were reached at all. There was also no mention of transgender individuals.
The Global Fund has one of the most progressive donor policies in relation to GMT, delineating clear responsibilities for every actor within its financing model. However, the report says of the $1.5 billion in funding allocated to these six countries since 2001, only 0.07 percent was for programs specifically targeting GMT.Moreover, the majority of this support is concentrated in just one of these six countries (Namibia).  The report argues that this percentage may not reflect the full demand from targeted programs in these countries as some proposals containing strong programs for MSM and other key populations were not approved for reasons other than technical merit.
The report advocates for national governments to decriminalise same sex sexual practices and support programs that reduce stigma and discrimination against marginalised groups. Donors also have been urged to actively support such efforts through diplomatic channels and funding for civil society groups working on these issues.Among other things, national governments have been encouraged to develop implementation plans that operationalize national strategic frameworks, a step that would increase the likelihood that the commitments to GMT in those documents are actualised.

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