HIV prevention programs worldwide are missing MSMs, survey finds

Dec 4 2010

An online survey of men who have sex with men (MSM) and their health service providers shows that the majority of respondents said most "gay men worldwide don't have access to HIV testing, counseling or free condoms and lubricant, a new study finds," according to a report by the Global Forum on MSM & HIV (MSMGF), HealthDay/Businessweek reports.

The results of the global online survey of 5,000 MSM and MSM service providers, three-quarters of whom said they were from low- and middle-income countries, were released to coincide with World AIDS Day on Wednesday (Preidt, 12/2). The online survey was published in Chinese, English, French, Russian and Spanish, and included "a total of 3,875 MSM and 1,009 MSM service providers participating - another 375 participants did not identify themselves as MSM or provider," according to an MSMGF press release.

"Initial analysis of the survey's results indicates that fewer than half of MSM worldwide have access to even the most basic HIV prevention and services," the release states (11/29). "Only 39 percent of respondents said they have easy access to free condoms and only about 25 percent said they have easy access to free lubricant, while another 25 percent said free lubricant was unavailable," according to HealthDay/Businessweek. "The survey also found that access to other essential services was difficult or impossible, including HIV testing (57 percent), HIV education materials (66 percent) and HIV treatment (70 percent)" (12/2).

"Since the beginning of the epidemic, it has been widely recognized that condoms, lubricant, testing and treatment, when combined with community-led behavior change and support programs, are the most reliable tools available in the fight against HIV among MSM," executive officer of MSMGF George Ayala said, according to the press release. "More than 25 years in, it is inexcusable that MSM around the world continue to have such restricted access to these basic lifesaving resources," he added.

"With the excitement surrounding the promise of pre-exposure prophylaxis (PrEP), it can be easy to forget that we already have a rich selection of prevention measures that we know work right now," said Patrick Hebert, Senior Education Associate at the MSMGF. "Today's findings reinforce the fact that we can't even get condoms and lube to more than half of MSM around the world. We must look seriously at barriers that prevent MSM in different country contexts from accessing these proven prevention tools," Hebert said (11/29).

The survey also examined MSM "knowledge about emerging technologies like PrEP, which involves taking antiretroviral drugs before exposure to HIV in order to prevent infection. While men in North America, Western Europe and Australia reported more knowledge about emerging prevention strategies than men in Africa, Asia, the Caribbean, Eastern Europe, and Latin America, large numbers of men in all regions of the world expressed confusion about these technologies," suggesting the need for stronger education and communication to MSM population about the concept of PrEP, according to the press release.

"Regional differences also emerged regarding experiences of stigma and discrimination. On every measure of stigma related to homophobia, men in Africa, Asia, the Caribbean, Eastern Europe, and Latin America reported higher levels and harsher forms of stigma and discrimination than men in North America, Western Europe and Australia," the release states (11/29).

Zambia's HIV Treatment Program; Companies Collaborate For HIV Education In Africa 

IRIN/Plus News examines "Zambia's formula for success" at increasing the population's access to antiretrovirals (ARVs). "Crispin Moyo of the ministry of health said about 78 percent of Zambians eligible for [ARVs] were receiving them by mid-2010 - just 2 percent shy of the universal access target of 80 percent ARV coverage," the news service writes. "The scale-up of ARV provision has been one of the fastest in Africa, according to the Global Health Workforce Alliance, an international consortium of governments, civil society organizations and U.N. agencies. From a starting point of just two clinics distributing free ARVs in 2004, there are now about 420 health facilities providing treatment, said Michael Gboun, a monitoring and evaluation (M&E) advisor at UNAIDS in Zambia," according to IRIN/Plus News.

The article features comments by Izukanji Sikazwe, a consultant to the national ARV program, who describes how task-shifting, donor aid and politics have contributed to the scale-up of in ARVs in the country.

Sikazwe also attributed Zambia's success on ARV distribution to the integration of its national system: "Training on any treatment guidelines was all standardized … partners bought into that and worked within that national framework. [Implementation] wasn't fragmented ... and the messages we were sending were the same," Sikazwe said. "All partners are putting funds into one basket, and goods are procured from this one basket. One system at a national level lets you know exactly how much of something you have, where it is, and where it's needed," Sikazwe added (12/2).

In related news, "Access Bank Plc in conjunction with Discovery Channel Global Education Partnership (DCGEP), PEPFAR, Chevron and Discovery Communication" recently announced they are partnering on an educational initiative on HIV/AIDS targeting populations living in sub-Saharan Africa, Vanguard reports (Eboh, 12/2).

According to a DCGEP press release, "[a] feature-length film is the cornerstone of the project and combines the best of fiction and non-fiction storytelling to unravel the mystery of HIV and empower millions with the knowledge they need to make informed health decisions." The release continues notes that the partners, which also includes PEPFAR, have "pledged 94% of the funding needed to produce the film." DCGEP launched an online campaign on World AIDS Day to generate funding to further support the production of the film titled "INSIDE STORY. … After production is complete, a comprehensive roll-out for the film will include national broadcasts across Africa, theatrical screenings and grassroots efforts from NGO partners, schools and governments" (12/1).