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• Islam, sexual diversity and access to health services

  Posted: 16 May 2013 15:07:22 GMT

  This discussion paper examines why Islam matters in prevention efforts for HIV, what Islam and Muslim scholars say about MSM and transgender people, as well as how this impacts on the lives of MSM and transgender people and their access to health services.

  While Islam allows for difference of opinion, and the religious leaders disagree on many social issues, most orthodox Muslim scholars are vehemently opposed to homosexuality. However there are many progressive Muslim scholars with varied positive opinions about gender and sexual orientation. This discussion paper urges human rights organisations and policy makers to create a database of progressive religious leaders and lobby for their support.
  
  The discussion paper includes 13 key recommendations for consideration of human rights organisations and defenders, gender activist and policy makers, including:

  • develop an understanding that it is necessary, when working on MSM and transgender issues in countries where there is a Muslim context, to incorporate a theological approach in their work
  • use positive religious text in media (TV, radio, blogs, publications) to oppose harsh orthodox approaches that are not respectful of human rights and choice of lifestyle
  • provide training to relevant stakeholders, including health service  providers, on how to best work with MSM and transgender people  within a Muslim context
  • develop programmes for Muslim religious leaders on HIV and MSM to influence and encourage positive messaging during Friday congregational prayers
  • develop strategies to reach those who are not openly MSM so that they can be empowered with research and Islamic information on sexual orientation and gender through training and educational programmes.
    

  

• Re-strategizing the MSM Response: Data for Action

  Posted: 15 May 2013 09:02:21 GMT

  As the epidemic rises in the Asia Pacific region, the UNAIDS Data Hub have prepared the following presentation providing an overview of the issues, commitments and areas for action. The regional profile presents data collated from published sources in the Asia-Pacific region according to the five areas: - HIV prevalence and epidemiological status - Vulnerability and HIV knowledge - Risk behaviours - Socio-economic impact of the epidemic and National response. The data sources include Epidemiological fact sheets, Demographic and Health Surveys (DHS), Behavioural Surveillance Survey (BSS), United Nations General Assembly Special Session (UNGASS) Report, AIDS Indicator Surveys (AIS), Multiple Indicator Cluster Surveys (MICS) and others.

• Global AIDS Response Progress Reporting 2013: Construction of Core Indicators for Monitoring the 2011 UN Political Declaration on HIV/AIDS.

  Posted: 15 May 2013 09:02:18 GMT

  The purpose of this document is to provide guidance to national AIDS programmes and partners actively involved in the country response to AIDS on use of core indicators to measure and report on the national response.

• Emerging HIV Risk in Papua New Guinea.

  Posted: 15 May 2013 09:02:15 GMT

  PNG’s HIV epidemic is predominately driven through heterosexual transmission. That said, other modes of transmission observed include vertical transmission and male-to-male sex. A few sporadic cases of HIV have been diagnosed whereby the mode of transmission has been reported as tattooing and injecting drug use. The data on those who have been diagnosed with HIV as a result of injecting drug use is sparse. It is unclear for example if such people are indeed ethnic Papua New Guineans or if in the case of expatriates the virus was contracted via injecting drug use practices outside of PNG. There have been other anecdotal, but unverified, reports of injecting drug use occurring in PNG and concern has been raised over this being a possible route of transmission that with the potential of contributing to the epidemic.

• Funding Scientific Innovation: Global Investments in HIV Treatment Research and Development in 2010 and 2011

  Posted: 14 May 2013 09:03:10 GMT

  Development of new, simpler, more effective and affordable compounds will continue to be essential for attaining the goal of putting at least 15 million people on ART by 2015, as set forth in the 2011 Political Declaration on HIV and AIDS. To this end, pharmaceutical industry leaders moved seven compounds into phase III studies in 2010 and 2011, and seven compounds into phase II. The focus of development is on compounds that can be taken as a single pill once daily, thus simplifying treatment, improving adherence, and reducing the risk of stockout-induced resistance to individual drugs.

• Investing In Communities Achieves Results: Findings from an Evaluation of Community Responses to HIV and AIDS

  Posted: 14 May 2013 09:03:03 GMT

  Before the scale-up of the international response to the AIDS pandemic, community responses in developing countries played a crucial role in providing services and care for those affected. This study is the first comprehensive, mixed-method evaluation of the impact of that response. The evaluation finds that community response can be effective at increasing knowledge of HIV, promoting social empowerment, increasing access to and use of HIV services, and even decreasing HIV incidence, all through the effective mobilization of limited resources. By effectively engaging with this powerful community structure, future HIV and AIDS programs can ensure that communities continue to contribute to the global response to HIV and AIDS.

• Setting the scene: assessing and planning with harm reduction partners

  Posted: 09 May 2013 16:24:40 GMT

  Community Action on Harm Reduction (CAHR) is an project spanning China, India, Indonesia, Kenya and Malaysia that aims to expand coverage to more than 230,000 people who inject drugs, their partners and children, with a wide range of services (HIV prevention, treatment and care, sexual and reproductive health and other services) by 2014.
  
  This report summarises the results of site assessments on HIV and drug use in China, India, Indonesia, Kenya and Malaysia, and describes the assessment and planning tools that were used. The assessments were that were conducted by the International HIV/AIDS Alliance and their teams of experts in four technical areas: HIV prevention services for people who inject drugs; HIV and drug-related policy and environment; organisational development issues; and monitoring and evaluation of interventions.
  
  The report concludes that the CAHR project implementation benefited considerably from the assessment process and the success of using the tool also created potential for its further use in other contexts. The assessment team was able to capture unique and insightful information, much of which was rapidly translated into action points and implementation plans within CAHR, as well as broader strategic recommendations. Furthermore, conducting the assessment exercise allowed the teams to develop a technical support plan spanning the CAHR project timeframe and focusing on the most challenging areas identified during the assessment.

• Creating space: common issues, lessons learnt and ways forward for people involved in the development of LGBTI organisations

  Posted: 29 Mar 2013 09:02:44 GMT

  Over the years, the many people involved in this sector have gathered an enormous wealth of implicit knowledge on how these organisations work, how they relate to each other and how they develop themselves. This publication captures some of their practices and will make their organisational lessons learnt more explicit. Making these lessons more accessible will support practitioners who are involved in one way or another in the development of LGBTI organisations, whether they be activists, funders, capacity enhancers, networkers, programmers, lobbyists or whichever other role or combinations of roles. After reading (parts of) this publication, the reader will hopefully feel inspired, enlightened, challenged, disturbed or motivated. Any of these feelings, in combination with the lessons learnt and the tips and tricks in this publication, will hopefully trigger further positive change in the LGBTI entity, organisation or movement in or with which they are involved.

• Top 10 in 2011: Key Global Policy Developments Concerning MSM & HIV

  Posted: 29 Mar 2013 09:02:37 GMT

  Inside this report, you will find a snapshot summary of the top 10 key policy developments over the past year that relate to the HIV response among gay men and other men who have sex with men (MSM) worldwide. Ranked by the Global Forum on MSM & HIV (MSMGF), the list includes both successes and setbacks in the global effort to achieve Universal Access for all. Taking stock of these developments is essential for evolving our response to the HIV epidemic among MSM, strengthening community mobilization efforts on the ground, and sharpening our global advocacy efforts. The list also includes events that were not direct policy developments in and of themselves but carry significant policy implications. This page summarizes the developments contained in the report.

• Fundraising Toolkit A Resource for HIV-Related Community-Based Projects Serving Gay, Bisexual, and Other Men who have Sex with Men (MSM) and Transgender Individuals in Low- and Middle-Income Countries

  Posted: 29 Mar 2013 09:02:31 GMT

  This guide was developed by amfAR’s MSM Initiative to provide fundraising assistance to community-based organizations (CBOs) that provide HIV-related programs and services for gay men, transgender individuals, and other men who sex with men (MSM) in low- and middle-income countries. In this guide, a number of key questions are answered: • Which donors are funding MSM and other lesbian, gay, bisexual and transgender (LGBT) community- based organizations? • Which donors are funding projects in particular geographic areas? • What kinds of grants are these donors making? • What kinds of programs and projects are being funded by these grants? • Whom do I contact and how does my organization apply for funding? The guide offers information about who is funding MSM/LGBT groups, snapshots of what those grant programs look like, how to approach funders, and what projects those grant makers have supported in the past.

• The Potential impact of free Trade agreements on Public health

  Posted: 28 Mar 2013 09:02:36 GMT

  Over the past ten years, an increasing number of countries are initiating, negotiating and agreeing new trade agreements between two countries or amongst a group of countries. These are commonly known as free trade agreements or “FTAs”. They are promoted as providing significant economic benefits to signatory countries through the removal or reduction of barriers to trade in goods and services. Many political leaders have indicated that they would prefer to remove or reduce trade barriers through the multilateral system in a way that benefits all countries belonging to the World Trade Organization. Nevertheless, given that the “Doha Round” of negotiations is taking longer than initially anticipated to be concluded, bilateral and regional FTAs are often seen as a way to move forward the trade liberalization agenda in the meantime.

• GIYPA Guidebook: supporting organisations and networks to scale up the meaningful involvement of young people living with HIV

  Posted: 28 Mar 2013 09:02:33 GMT

  GNP+ has recently finalised and published two documents which aim to enhance the greater and more meaningful involvement of young people living with HIV within the HIV response. Supported by funding from the HIV Young Leaders Fund, GNP+ conducted research among 350 young people living with HIV, and among over 175 youth led organisations and networks living with HIV, to identify the key barriers faced by YPLHIV to engaging more meaningfully in the HIV response. The findings from this research led to the development of these two tools: - the GIYPA Roadmap: Supporting Young People Living with HIV to be Meaningfully Involved in the HIV Response -and GIYPA Guidebook: Supporting Organisations and Networks to Scale Up the Meaningful Involvement of Young People Living with HIV.

• Language, identity and HIV: The responsible use of language

  Posted: 28 Mar 2013 09:02:29 GMT

  Language matters. It impacts on how we think about ourselves, as individuals within our families and within society. As advocates and activists, we constantly use language as a tool to effect change. People living with HIV have been critical in shaping this language over the last 30 years and still play a central role in ensuring that new discourse in the HIV field does not stigmatize, but rather that it catalyzes empowerment for our community members. In this annotation, we seek to shift the language used in relation to ourselves, our medical condition, our bodies, our identities and the events we face, towards something more life-enhancing, self-affirming and positive in outlook.

• Positive Health, Dignity and Prevention: A Policy Framework

  Posted: 28 Mar 2013 09:02:26 GMT

  Positive Health, Dignity and Prevention: A Policy Framework (January 2011) was developed by GNP+ and UNAIDS through consultation with networks of people living with HIV, civil society, governments, UN cosponsors and donors globally. The Policy Framework provides the broad concepts that represent the first steps towards operationalising Positive Health, Dignity and Prevention. The Policy Framework informs the development and implementation of operational guidelines that reflect linkages between a wide range of policies and programmes aimed at supporting and improving the health, dignity and prevention needs of people living with HIV.

• Best practices guidance in conducting HIV research with gay, bisexual, and other men who have sex with men (MSM) in rights-constrained environments

  Posted: 27 Mar 2013 09:02:21 GMT

  This guidance tool has been developed for both researchers and community-based organisations in rights- constrained environments. The guidance is intended to help both researchers and community organizations to:
  
  

  • better design and conduct meaningful research on HIV among MSM in challenging social, political, and human rights contexts
  • provide a check list of factors for researchers and community organizations to consider in the design, conduct, and implementation of research studies
  • offer lessons learned through case studies of research and community partnerships, recent successes, and challenges

  
  This guidance expands upon existing documents (e.g., Good Participatory Practice: Guidelines for Biomedical HIV Prevention Trials [UNAIDS/AVAC, 2011]  and the guidance document, Ethical Considerations in Biomedical HIV Prevention Trials [UNAIDS/WHO, 2007]).

• Sex Work and the Law in Asia and the Pacific

  Posted: 27 Mar 2013 09:02:17 GMT

  The report is intended to provide an evidence-base for: policy makers working in government, regional and multilateral organizations; parliamentarians; members of the judiciary; civil society organizations; donor agencies; and sex workers and their organizations engaged in advocacy to improve the legal and policy enabling environment for HIV responses. The study focuses on 48 countries of the Asia-Pacific region, with an emphasis on low and middle-income countries.

• Nutritional status of HIV-infected adults on antiretroviral therapy and the impact of nutritional supplementation in the Northern Cape Province, South Africa

  Posted: 25 Mar 2013 09:02:45 GMT

  The study was a descriptive prospective trial aimed to describe the nutritional status and impact of current nutrition intervention strategies on weight changes in adult HIV-infected patients on antiretroviral therapy. Results showed that patients from Kuruman had a greater incidence of underweight compared to other towns, with a median BMI of 17.9kg/sqmeter. Of the 87 patients assessed during the final week, 49.4% experienced weight gain and 40.2% lost weight. 18(20.7%) patients gained more than 5% of their baseline weight. 22 patients who presented with BMI < 18.5kg/sqmeter at baseline had a median weight gain of 1.13kg during the intervention period, while the group with BMI > 18.5kg/sq meter presented with no change in median weight. Nutrition supplementation provided according to provincial policy and combined with ARVs, nutritionally benefitted about half of the patients in the ARV programme in the Northern Cape

• Anthropometric and immunological success of antiretroviral therapy and prediction of virological success in West African adults

  Posted: 25 Mar 2013 09:02:42 GMT

  The 6 month assessment of the response to antiretroviral therapy (ART) is a critical step. In sub-Saharan Africa, few people have access to plasma viral-load measurement. The gain or loss in body mass index (BMI) was assessed alone or in combination with corresponding gain in CD4 cells as a tool for predicting the response to ART. In a cohort of 622 adults in Abidjan, Côte d’Ivoire, we calculated the sensitivity, specificity and predictive values of BMI and CD4 for treatment success defined as viral-load undetectability (< 300 copies/ml) as gold standard. The article concludes that in settings where viral-load measurement is not available, a high BMI gain does not reflect virological success, even when combined with a high CD4 gain. In the study population, most patients with detectable viral-load had probably adhered to the drug regimen sufficiently to reach significant gains in body mass and CD4 count but had adhered insufficiently to reach viral suppression.

• Clinical predictors cannot replace biological predictors in HIV-2 infection in a community setting in West Africa

  Posted: 25 Mar 2013 09:02:40 GMT

  The was a prospective community cohort aimed to identify clinical predictors of mortality in HIV-2 infected individuals that may be used in place of CD4 count or plasma viral load to guide treatment management in resource limited settings. Participants were followed up for 7years. In 2003, 146 HIV-2 infected individuals were examined. Over the next 7years, 44 died. BMI <18.5kg/sq metres was associated with a crude mortality hazard ratio[HR] of 1.9 (95% CI; 1.0-3.9, p=0.08). MUAC < 230mm in women and <240mm in men was also associated with an elevated mortality HR, though statistical evidence was weak. WHO clinical stage and WHO performance scale was not associated with mortality. In conclusion, baseline BMI, MUAC, WHO stage and WHO performance scale were not strong or statistically significant predictors of mortality among HIV-2-infected individuals. CD4 count and PVL are more reliable tools, when available for the management of HIV-2-infected patients in the community setting

• The neurological and neurocognitive function of HIV-infected children commenced on antiretroviral therapy

  Posted: 25 Mar 2013 09:02:21 GMT

  This prospective study aims to describe the neurological and neurocognitive deficits in HIV-infected children and the short-term effect of highly active antiretroviral therapy (HAART) on the observed deficit. 39 children were evaluated before the start of HAART and 30 were reassessed 6month later. The subjects were evaluated with a range of cognitive tests used in everyday clinical practice. At the start of HAART, no child had cranial nerve or cerebellar dysfunction, but 33.3% had evidence of motor dysfunction. By 6months, 1 child had developed cerebellar dysfunction, but there was no statistically significant change in the frequency of motor dysfunction. mean baseline performances on cognitive testing were generally subnormal. Between 33% and 81% of the children recorded subnormal intelligence quotients on various cognitive tests. Mean performances did not change significantly after 6months of HAART.

• MSMGF Technical Bulletin: Serosorting and Strategic Positioning

  Posted: 18 Mar 2013 09:06:17 GMT

  This technical bulletin focuses on two HIV risk reduction strategies known as serosorting and strategic positioning. The bulletin gives an overview of both the strategies and includes information and current research on the community perception as well as possible limitations of these two strategies as a form of HIV risk reduction.

• MSMGF Technical Bulletin: Treatment as Prevention (TasP)

  Posted: 18 Mar 2013 09:06:12 GMT

  This technical bulletin gives an overview to what treatment as prevention (TasP). Treatment as prevention (TasP) is a HIV prevention intervention where treating an HIV-positive person with antiretroviral medication is used to reduce the risk of transmission of the virus to a negative partner. The primary purpose of antiretroviral treatment (ART) is to treat HIV disease in order to improve health and extend lifespan. TasP is a secondary benefit of ART. The bulletin highlights the challenges and risks to MSM using the TasP method and details the current research for the TasP method globally.

• MSMGF Technical Bulletin: Treatment 2.0

  Posted: 18 Mar 2013 09:06:08 GMT

  This technical bulletin is a part of the MSM GF Technical Bulletin Series focusing on Treatment 2.0. What is Treatment 2.0? Designed and developed by UNAIDS and the WHO in June 2010, Treatment 2.0 is an overarching HIV/AIDS strategy that aims to markedly improve access to, and optimize the prevention benefit of, antiretroviral therapy (ART) globally. The 10-year initiative articulates the need for a coordinated plan of action across multilateral, bilateral, and country-level agencies to dramatically simplify and scale up efforts toward universal access to HIV care and treatment. This bulletin gives information on context of Treatment 2.0. The foreseeable challenges and barriers to achieving the goals of Treatment 2.0.

• Prevention and Treatment of HIV and Other Sexually Transmitted Infections for Sex Workers in Low- and Middle- Income Countries

  Posted: 12 Mar 2013 09:02:09 GMT

  These global guidelines, produced by WHO, UNAIDS and UNFPA, aim to provide technical recommendations on effective interventions for the prevention and treatment of HIV and other STIs among sex workers and their clients. The guidelines are designed for use by national public health officials and managers of HIV and STI programmes, civil society and health workers. Regions and countries are encouraged to adapt these guidelines to support acceptable services for sex workers taking into account the epidemiological and social context.

• AVAC Report 2012 - Achieving the End: One Year and Counting

  Posted: 12 Mar 2013 09:02:03 GMT

  This advocacy report claims that the fight against HIV has reached a tipping point. Five priority points must be addressed to carry this through: 1) End confusion about “combination prevention” 2) Narrow the gaps in the treatment cascade 3) Prepare for new non-surgical male circumcision devices 4) Define and launch a core package of PrEP demonstration projects 5) Safeguard HIV prevention research funding. The report, which is abundantly illustrated with graphs and tables, concludes with a call for amplified global and national leadership.

• Regional legal reference resource: protective laws related to HIV, men who have sex with men and transgender people in South Asia

  Posted: 12 Mar 2013 09:01:56 GMT

  This document was produced by the South Asian Roundtable on Legal and Policy Barriers to HIV held in Kathmandu in November 2011. It documents key protective laws focused on HIV, MSM and transgender people in five South Asian countries. The main objectives of this Reference Resource are to build the capacity of legal professionals to analyse protective laws (focusing on PLHIV, MSM and transgender people) and to develop a resource to support legislative drafting, law reform and advocacy initiatives.

• Transforming health: international rights-based advocacy for trans health

  Posted: 05 Mar 2013 14:00:19 GMT

  Trans people worldwide experience substantial health disparities and barriers to appropriate health care services. This report presents a number of case studies submitted by organisations from several countries, offering examples of efforts to improve the quality and affordability of healthcare presented to trans people.
  
  The paper notes that trans people are significantly more likely than the general population to be targeted for violence and harassment, to contract HIV, and to be at risk for mental health concerns. Barriers to healthcare include discriminatory treatment by health care providers, a lack of providers who are trained to offer appropriate health care to trans people, and refusal by health systems to cover services for trans people.
  
  The document introduces a set of themes that describe major areas of focus for trans health work:
  

  • providing health care services not related to transition, including sexual and reproductive health services
  • providing health care services related to transition, including hormone therapy, mental health services, and reconstructive surgeries
  • training health care providers to respect and respond appropriately to the health needs and concerns of trans people
  • conducting public education aimed at raising awareness of trans experiences and discrimination against trans people
  • advocating for policy change aimed at reforming the structures that impact trans people’s lives.

  The following actions are recommended:
  

  • governments have to protect transgender people from discrimination and create trans-friendly identity document policies
  • they have to invest in evidence-based and rights-based programs to achieve health equity for trans communities
  • human rights advocates have to integrate trans issues into human rights agendas by including trans community concerns and recognising gender diversity
  • trans communities have to form alliances to amplify trans voices, establishing activities promoting trans human rights in the language of health
  • funders have to support innovations in trans health advocacy and health care services.

  

• Internalized HIV/AIDS-related Stigma in a Sample of HIV-positive People in Bangladesh

  Posted: 27 Feb 2013 09:01:22 GMT

  Internalized stigma among people living with HIV/AIDS (PLHA) is prevalent in Bangladesh. A better understanding of the effects of stigma on PLHA is required to reduce this and to minimize its harmful effects. This study employed a quantitative approach by conducting a survey with an aim to know the prevalence of internalized stigma and to identify the factors associated with internalized stigma among a sample of 238 PLHA (male=152 and female=86) in Bangladesh. The findings suggest that there is a significant difference between groups with the low- and the high-internalized HIV/AIDS stigma in terms of both age and gender. The prevalence of internalized stigma varied according to the poverty status of PLHA. An exploratory factor analysis (EFA) found 10 of 15 items loaded highly on the three factors labelled self-acceptance, self-exclusion, and social withdrawal. About 68% of the PLHA felt ashamed, and 54% felt guilty because of their HIV status.

• MSM Country Snapshot Series: MONGOLIA

  Posted: 24 Feb 2013 09:00:35 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in Mongolia. Mongolia hosts one of the region’s smallest HIV epidemics. It remained hidden until around 2007 when serological surveillance was performed after indications of rising incidence. From then until 2012, 75 HIV diagnoses were added to the HIV registry, bringing the total cumulative number
of infections between 1992 and the end of 2011 to 100. Among these cases, 66 percent were reported cases among MSM. Given that between 1992 and 2007, data on sexual orientation were not collected, the 66 percent is probably an underestimation.

  Similar to in neighbouring countries, MSM in Mongolia remain largely hidden because of widespread and institutionalised prejudice. Societal and family pressures lead many Mongolian MSM to marry and live secret ‘double lives’ with both male and female sexual partners. One survey meant to gauge levels of discrimination against MSM in Ulaanbaatar and Darkhan-Uul found that 53 percent of respondents thought of MSM as healthy people whose sexual behaviour is abnormal, meanwhile 14 percent thought MSM are mentally ill. Arbitrary detentions and physical abuse by law enforcement authorities have also been recorded.

  A 2012 study discovered that stigma and discrimination against LGBT populations and MSM is common in Mongolia and creates significant barriers to health service access, employment, and social acceptance. The same study reported that 77.4 percent of MSM in Ulaanbaatar had experienced at least one of the following incidents in the last three years: forced sex or rape (14.7 percent); verbal harassment (54.8 percent); and physical harassment or beating (10.4 percent). Other key issues included: loss of employment upon discovery of sexual orientation or HIV status; being tested for HIV without consent; and blackmail by law enforcement.

  The snapshot provides more information about priorities for Mongolia reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• MSM Country Snapshot Series: BANGLADESH

  Posted: 24 Feb 2013 09:00:30 GMT

  Bangladesh is considered a low-prevalence country with 2,533 cumulative reported cases since 1989 and approximately 7,500 people living with HIV.  Routine surveillance has consistently reported HIV prevalence of less than 1.0 percent among the general population and among MSM and male and female sex workers. The country’s epidemic is understood to be concentrated and disproportionately affects male people who use drugs, of whom 1.0 percent are believed to be living with HIV. Between 2008 and 2011, 19 cases of HIV among MSM were reported.

  Given HIV patterns in South Asia and because of recent behavioural survey data of MSM in Dhaka, Bangladesh considers MSM one of the focal points in their HIV prevention efforts. In 2009 and again in 2010, the National STD/AIDS Programme and the International Centre for Diarrhoeal Disease Research (ICDDR) conducted a size estimation exercise of key affected populations that included MSM. Such efforts are beginning to shed light on what is otherwise a poorly understood demographic.

  Little is known about the nature of male-male sexuality
in Bangladesh. Previous exploratory research has consistently found that approximately 2 percent of males engage in same-sex sexual behaviour. Research has found a
 high prevalence of penetrative sex as well as related risk behaviours among MSM. Despite popular disapproval
of sexual relationships between men, intimate relationships between men are common and sexual boundaries are crossed with relative ease. The socio-cultural contexts 
in which such interactions occur determine how MSM perceive and manage sexual risk and thus impact the uptake of HIV services.
  
  The snapshot provides more information about priorities for Bangladesh reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.
  

  

• MSM Country Snapshot Series: BHUTAN

  Posted: 24 Feb 2013 09:00:26 GMT

  Bhutan’s HIV epidemic is small relative to its neighbours, with 270 cumulative reported cases since the first case
was detected in 1993. Presently, an estimated 988 people (or below 0.1 percent of the adult population) are living with HIV in Bhutan, making it a low-prevalence country. A recent behavioural assessment in two major towns found evidence of high-risk behaviour among key affected populations, including MSM.

  The National STI and HIV AIDS Prevention and Control Programme (NACP) was established in 1988, five years before HIV was first detected in the country. Bhutan’s HIV response continues to be led by the 2004 Royal Decree on HIV Prevention, delivered by the Fourth King, His Majesty Jigme Singye Wangchuck, and subsequent proclamations of support. In 2005, the Fifth King, His Majesty Jigme Khesar Namgyel Wangchuck, advocated for abstinence and urged Bhutan’s youth to use their strength of character to reject undesirable activities.

  Homosexuality is a taboo subject in Bhutan, though younger generations are thought to be more accepting. Little is known about the nature of same-sex sexual activity in Bhutan. Anecdotes exist of sex between men occurring in army barracks, prison cells, and monk dormitories. Online chat rooms, cruising websites, and restaurants and bars are cited as key places where MSM meet in Bhutan.

  The snapshot provides more information about priorities for Bhutan reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• MSM Country Snapshot Series: INDIA

  Posted: 24 Feb 2013 09:00:18 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in India.
  India accounts for approximately half of Asia’s HIV epidemic with approximately 2.4 million people living with HIV. In 2009, an estimated 87.4 percent of all infections were related to heterosexual sex and 1.7 percent was related to sex between men. India’s national HIV epidemic is concentrated, though a functional distinction is made between ‘core’ and ‘bridge’ populations. Both receive focused support in India’s National AIDS Control Programme but the intensity of the intervention varies between the two and across geographic areas. The 50 percent decline in incidence attributed to intensified programmatic attention in six high- prevalence states serves as possible evidence of the value of this approach.

  In 2007, the third National AIDS Control Programme (NACP – III) articulated the need for enhanced programmatic attention to MSM and was the first to outline a strategy for HIV prevention interventions targeted at hijra and male sex workers. It is thought that funding for targeted prevention interventions for MSM, male sex workers, and hijra is insufficient to meet basic needs for condoms and water-based lubricant.

  Much of HIV services in India are managed by community- based organisations. A 2008 organisation mapping exercise found that 65 percent of all organisations and networks working with MSM in India are community-based. A handful of LGBT-oriented organisations and networks also play a key role in the formulation of national policy and guidelines related to HIV. They include: the Indian Network for Sexual Minorities (INFOSEM), and MANAS Bangla in West Bengal state.

  Whereas MSM are viewed as a ‘core’ population under NACP – III, there is emerging evidence of MSM as a ‘bridge’ population. The proportion of MSM that report recent sex with women varies greatly across states and reaches
as high as 66 percent. Yet female partners of MSM are excluded from information, education, and communication programmes, a cornerstone of India’s HIV prevention strategy. India’s National AIDS Control Programme has demonstrated remarkable leadership in responding to
the HIV prevention needs of MSM. Future policy advancements may depend on the extent of overlap between MSM and other risk groups and the ability for policy leaders to quickly recognise the need for greater spending on targeted programmes for MSM.

  The snapshot provides more information about priorities for India reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• MSM Country Snapshot Series: NEPAL

  Posted: 23 Feb 2013 09:04:45 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in Nepal.
  Nepal’s National Centre for AIDS and STD Control has officially recognised MSM as an important driver of the country’s HIV epidemic since at least 2003.

  Infections among the general population and injecting drug users have declined in recent years. Meanwhile, infections among MSM and female sex workers appear stable. Nepal’s HIV programme is recognised as a ‘P1’ or first priority in the country’s Interim National Development Plan. The Government of Nepal prioritises P1 programmes over all other non-P1 programmes when determining budget allocations. However, there are popular concerns regarding the sustainability of Nepal’s HIV financing mechanisms.

  Coverage among key affected populations has improved over the years as a result of focused interventions and increased community-based organisation involvement. Community-level interventions, some of which involve MSM, are central to Nepal’s National HIV/AIDS Strategy, 2011–2016.

  MSM are stigmatised and socially marginalised in Nepal. The Blue Diamond Society (BDS), a prominent advocacy group for the rights of LGBTI Nepalis, reports of a prevalent ‘double stigma,’ or stigma related to sexual orientation and HIV infection. Faced with continued discrimination and threats of violent attacks, ‘metis,’ or persons of the third gender in Nepal, sometimes take to hospices.

  Several policy and legal advancements have been made with regard to MSM and other key affected populations. Sunil Babu Pant, Director of BDS and member of the Contituent Assembly and Parliament of Nepal, led a campaign that demanded an end to all kinds of discrimination and violence against LGBTI populations. In 2007, the Supreme Court of Nepal ruled in favour of recognising the third gender in national identification cards, a same sex marriage law, and ending or amending discriminatory laws against LGBTI populations. The ruling allegedly led to a reduction in violence against LGBTI populations and greater acceptance among segments of society, media, and government.

  Nepal’s political instability continues to be a major barrier to an effective national response. It threatens sustained leadership in the national HIV response and risks a reversal of progress on meeting Millennium Development Goals.

  The snapshot provides more information about priorities for Nepal reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• MSM Country Snapshot Series: PAKISTAN

  Posted: 23 Feb 2013 09:04:37 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in Pakistan. Pakistan’s HIV epidemic is driven by key affected populations. In 1999, Pakistan, in partnership with UNAIDS, determined that it would prevent a generalised epidemic by targeting key vulnerable groups. Subsequent surveillance activities revealed disproportionate HIV risk among injecting drug users and hijra and male sex workers, who exhibit HIV prevalence of 37.8, 7.2 and 3.1 percent, respectively. Targeted HIV prevention interventions among these three groups continue to be the cornerstone of Pakistan’s HIV response. Hijra and male sex workers are commonly considered MSM by Pakistani AIDS authorities and so determining whether data correspond to MSM who self-identify as male and are not sex workers is at times difficult.

  Sex other than that between husband and wife is strictly forbidden by Islamic law. Consequently, overt expressions of homosexuality carry the risks of social stigmatisation, class discrimination, ostracism from family and friends, and extreme physical punishment under current sodomy laws. Yet sex between men appears to exist among segments of society beyond those included in definitions of hijra and male sex workers. More overt examples of male-to-male sexual behavior include the practice of keeping boys for sexual gratification observed among rich elderly men in Khyber Pakhtunkhwa Province.

  It will be important in the implementation of the forthcoming national strategic plan for efforts intended for MSM to cater to the specific needs of various subgroups. Significant overlap exists between MSM and other key affected populations such as migrants, truck drivers, and drug users. There exists an opportunity to improve the effectiveness of prevention efforts through better integration and nuance.

  The snapshot provides more information about priorities for Pakistan reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• MSM Country Snapshot Series: SRI LANKA

  Posted: 23 Feb 2013 09:04:32 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in Sri Lanka. Sri Lanka’s HIV epidemic is considered low-level, with 1,544 cumulative reported cases and an estimated 3,000 people living with HIV. Infections related to sex between men account for approximately one-eighth of total reported cases. Other key affected populations include injecting drug users and female sex workers. HIV risk among men who have sex with men (MSM) is low relative to other countries in the region but is increasing, both in HIV prevalence and as a proportion of total infections. There is little evidence to suggest that Sri Lanka’s epidemic will become generalised in the future.

  Since the first detected case in 1987, Sri Lanka has demonstrated a progressive commitment to a comprehensive response. Socio-economic and cultural factors are taken into account when designing programmes. To date, the National STD and AIDS Control Programme (NSACP) has been unsuccessful in scaling prevention programmes targeted to MSM and is yet to develop community sensitive clinical services. The NSACP’s attention to MSM is characterized by a non-continuous series of awareness programmes primarily in Colombo, Kandy, and Anuradhapura and occasional support to groups working for the human and political rights of LGBT communities in Sri Lanka. Despite strong civil society interest in operating targeted HIV prevention interventions, limited and inconsistent funding has limited the expansion of such activities. In addition, the limited capacity of MSM community groups in administration and financial management contributes to funding issues.

  Sri Lanka’s laws are unsupportive of MSM and present significant challenges to effective HIV prevention programmes. A sodomy law that punishes sex between men with long-term imprisonment is used to extract bribes and threaten individuals and LGBT organizations. Negative societal attitudes towards homosexuality discourage access to critical health services targeted at MSM. In response to growing concerns of homophobic violence, the NSACP issued a ‘special policy statement’ to voice support for the protection of the rights of MSM and sex workers.

  The snapshot provides more information about priorities for Sri Lanka reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• MSM Country Snapshot Series: CAMBODIA

  Posted: 23 Feb 2013 09:04:25 GMT

  The United Nations Joint Programme on HIV/AIDS (UNAIDS), the United Nations Development Programme (UNDP) and the Asia Pacific Coalition on Male Sexual Health (APCOM) have released a new publication series intending to document and circulate good practices, share progress, stimulate discussion, and inform priority interventions and advocacy efforts to address the rising HIV epidemic among men who have sex with men (MSM) in Asia. The MSM Country Snapshots were initiated in recognition of the difficulty of accessing up-to-date country-level information on MSM and HIV. Most importantly, they allow for convenient access to key findings for anyone with limited access to academic journals or knowledge of sources for biological and behavioral surveillance data. The documents synthesize key findings at time of publication that span four areas of strategic information: epidemiological, behavioral, programmatic and legal.

• MSM Country Snapshot Series: INDONESIA

  Posted: 16 Feb 2013 09:01:30 GMT

  The United Nations Joint Programme on HIV/AIDS (UNAIDS), the United Nations Development Programme (UNDP) and the Asia Pacific Coalition on Male Sexual Health (APCOM) have released a new publication series intending to document and circulate good practices, share progress, stimulate discussion, and inform priority interventions and advocacy efforts to address the rising HIV epidemic among men who have sex with men (MSM) in Asia. The MSM Country Snapshots were initiated in recognition of the difficulty of accessing up-to-date country-level information on MSM and HIV. Most importantly, they allow for convenient access to key findings for anyone with limited access to academic journals or knowledge of sources for biological and behavioral surveillance data. The documents synthesize key findings at time of publication that span four areas of strategic information: epidemiological, behavioral, programmatic and legal.

• MSM Country Snapshot Series: MALAYSIA

  Posted: 16 Feb 2013 09:01:23 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in Malaysia. The composition of Malaysia’s HIV epidemic is changing rapidly. Whereas it was previously understood to be more heavily concentrated among people who use drugs (PWUD), sexual transmission appears to be on the rise. Women and MSM in particular are facing an increasing share of new infections. Given the emphasis that PWUD have received in research and prevention programmes in Malaysia over the last several years, some postulate that decreased transmission among PWUD enhances the vividness of risk among other populations.

  Islam inevitably influences how homosexuality is viewed
by the general public and may influence sexual risk taking behaviours in ways that are not entirely understood. Ostracisation from family and friends, class discrimination, and social stigmatisation are all common experiences for MSM in Islamic countries. Risk might also rise from the belief that adherence to religious teachings should suffice
as protection from HIV; or in some cases, a view of HIV transmission as an inescapable fate. These hypotheses were confirmed by recent focus groups and are in line with data that indicate higher HIV risk among Malays as compared to their Chinese peers.

  Together with key findings drawn from a series of epidemiological and behavioural studies released in the last few years, there is a compelling case for increased programmatic attention to MSM. Malaysia found that civil society groups such as the Pink Triangle (PT) Foundation are well positioned to scale up prevention programmes in key areas but suffer from scarce funding, legal conflicts, and general stigma. Malaysia simultaneously faces a situation where MSM within reach of venue-based outreach efforts are disproportionately educated and well off. Further work will need to be done to develop a more accurate understanding of HIV risk among Malays and lower socioeconomic classes. In the interim, Malaysia faces an opportunity to inspire the political will that could play a pivotal role in the future of the epidemic. Cooperation between government and a burgeoning LGBT civil society may indeed be the most promising path forward.

  The snapshot provides more information about priorities for Malaysia reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.
  

  

• MSM Country Snapshot Series: MYANMAR

  Posted: 15 Feb 2013 09:01:28 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in Myanmar. Myanmar’s HIV epidemic is highly concentrated among people who inject drugs, sex workers, men who have
sex with men, and the sexual clients of these populations. People who inject drugs exhibited the highest HIV prevalence (21.9 percent) in the most recent serosurveillance, meanwhile MSM exhibited the second highest (7.8 percent). There is growing concern of a large-scale HIV epidemic among MSM amidst mounting evidence of it previously being underestimated.

  One of the primary reasons for delayed progress in the national response to HIV risk among MSM is a highly restrictive legal environment. Sex between men in Myanmar is punishable by a prison sentence of up to 10 years. Although such laws are rarely enforced, they complicate the delivery of effective HIV prevention services to the extent that they prevent community-based organisations (CBOs) from being registered with the state and discourage programme beneficiaries from accessing basic HIV services.

  Despite an unfavourable legal environment, Myanmar has identified MSM as a key target population since the previous National Strategic Plan (NSP) on HIV and AIDS (2006- 2010). It further elaborates that key target populations will be of ‘the utmost priority and will rely on high-intensity, sustained, and focused effective interventions.’

  The challenge of responding to HIV risk among MSM is compounded by a limited ability to measure progress towards stated objectives. For instance, data on condom and lubricant distribution, sexually transmitted infection (STI) service provision, and reliable resource expenditure data are for the most part unavailable.

  Several community-based organisations, some of which are not officially recognised by the state, are involved in health outreach although little is known of their operations. Other key actors in the response include international NGOs, most notably Population Services International (PSI) who reached over 37,000 MSM in 2011 with HIV prevention services.

  Myanmar’s most recent NSP (2011-2015), like the previous one, lays out a comprehensive set of targets to be met by actors across several sectors. It simultaneously acknowledges the difficulty of fully implementing the plan with current levels of commitment and overseas assistance. What is certain is that there is crucial progress to be made, especially with regards to the restrictive legal environment, with careful use of planned resources.

  The snapshot provides more informationa about priorities for Myanmar reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• MSM Country Snapshot Series: PHILIPPINES

  Posted: 15 Feb 2013 09:01:25 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in the Philippines. The Philippines has among the lowest rates of HIV transmission in the region, with an estimated total of just over 10,514 infections between 1984 and August 2012. Its HIV epidemic is increasingly concentrated among men who have sex with men (MSM) and other key affected populations, with tremendous variation across sub-populations and location. Some attribute the relatively slow spread of HIV in the Philippines to its complex geography and isolation from the larger regional epidemic.

  There is growing concern of an emerging epidemic among Filipino MSM. Sexual transmission between males has been the predominant mode of transmission since 2007. Serologic surveillance over the last few years indicates that HIV incidence among females is reaching a plateau but appears to be growing rapidly among males. Approximately six out of ten people living with HIV contracted the virus through sexual transmission between men. In 2011, about eight out of ten new infections were among MSM. HIV diagnoses have increased three-fold between 2003 and 2008, a fact that, in the context of other mounting evidence, suggests a forthcoming expansion of the HIV epidemic.

  The central advisory, planning, and policy-making body of the government is known as the Philippine National AIDS Council (PNAC). It was established in 1992 to act as a multi-sectoral advisory body to the President on policy related to HIV. However, it remained crippled by a small budget until the Philippines Government enacted the Philippine AIDS Prevention and Control Act of 1998. Among the things it called for were a comprehensive nationwide HIV and AIDS educational and information campaign; greater recognition of the human rights of persons affected by HIV; and heightened involvement of local governments to provide community-based HIV services.

  The National HIV and AIDS Strategic Plan for MSM and TG Populations 2012-2016, which is anchored on the 5th AIDS Medium Term Plan for 2011 to 2016, represents the most ambitious effort yet to combat HIV in the Philippines. It calls for policies and programmes informed by serologic surveillance data, a broader range of actors, and the integration of stigma reduction measures across the spectrum
of HIV and AIDS services. There is indeed a precedent for a late-stage resurgence of HIV transmission in countries with historically low and stable HIV prevalence. But there is also little doubt that the epidemic’s future toll will depend in large part on how quickly and comprehensively the Philippines responds to rising HIV risk among men who have sex with men.

  The snapshot provides more information about priorities for the Philippines reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• MSM Country Snapshot Series: THAILAND

  Posted: 15 Feb 2013 09:01:22 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in Thailand. Despite Thailand’s numerous innovations in the global AIDS response, men who have sex with men (MSM) have been virtually absent in national strategic plans until 2007. Once MSM entered routine national surveillance, evidence for a rapidly growing HIV epidemic among MSM became available. HIV prevalence among MSM in Bangkok was estimated to be 17.3 percent in 2003, 28.3 percent in 2005, 30.7 in 2007, and 24.7 in 2009.

  Early in the response, MSM received HIV prevention services to the extent that male sex workers were targeted in the 100 percent Condom Use Programme. In 2003, 
the ‘Law and Order Campaign’ introduced punitive and legalistic policies that punished gay venue management
for providing condoms and lubricant. The campaign is regarded as a significant setback to Thailand’s HIV response. Common HIV prevention tools rapidly disappeared from gay venues during this period. While the situation is much improved, barriers to offering effective prevention services still exist.

  The rapid spread of HIV among MSM during 2003-2007 was gradually matched by an increase in attention from national and international stakeholders, including in Thailand’s National HIV Plan beginning in 2007. The ambitious new plan got to a slow start after the country’s HIV prevention budget was cut by approximately two-thirds in 2006. 
A revised budget for 2007-2011 allocated 8.1 percent
of HIV prevention resources to HIV prevention services for MSM. Although only 0.8 percent of HIV prevention resources were spent on MSM programmes in 2009, this value increased to 5.4 percent in 2010 and 8.2 percent in 2011.

  The snapshot provides more information about priorities for Thailand reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• MSM Country Snapshot Series: VIET NAM

  Posted: 15 Feb 2013 09:01:18 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in Viet Nam. Men who have sex with men (MSM) in Viet Nam are at disproportionately high risk of HIV transmission. Research suggests that this is due in large part to multiple sexual partners, low condom use and low perceptions of risk. Not all MSM are at equal risk, however. HIV prevalence among MSM was found to be significantly higher in cities than in rural areas.

  In 2006, a revised law on HIV passed by the Viet Nam National Assembly listed ‘homosexual people’ among the high-risk groups prioritised for HIV prevention programming. This represented the first time that MSM were recognised by the government of Viet Nam. However, funding for HIV services targeting MSM comes almost exclusively from donor programmes. As donors reduce their support to Viet Nam in the coming years, it will be critical for domestically funded programmes to target MSM as a population at high risk of HIV.

  Men who have sex with men generally keep their sexual behaviours hidden in Viet Nam due to widespread stigma and discrimination. In 2002,Viet Nam’s state-run media declared homosexuality a ‘social evil’ equally as harmful as drug use and prostitution. Among the consequences of stigma and discrimination towards MSM are continuing programmatic neglect, relative difficulty reaching MSM, and false or low perceptions of HIV risk.

  Communities of MSM in Viet Nam have been active in the response since as early as 2005, participating formally and informally in national and regional networks, including a national MSM and HIV working group founded in 2006. While there have been important indications of recognition and commitment to MSM in the HIV response, a coherent strategy for targeting MSM, including routine HIV surveillance among MSM, reporting of homosexual sex as a risk factor for transmission in case reporting, and ensuring meaningful participation in HIV response planning, remains to be seen.

  This snapshot provides more information about priorities for Viet Nam reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• MSM Country Snapshot Series: China

  Posted: 14 Feb 2013 09:01:03 GMT

  This snapshot provides information on the current situation for HIV and LGBT rights and advocacy in China.
  There is mounting evidence for a rapidly growing HIV epidemic among men who have sex with men in China. Over one-third of new infections across the country
are among MSM, with HIV prevalence estimates in some south-western cities approaching 17 percent. A large-scale survey in 2008-09 that spanned 61 cities found an average prevalence in medium and large cities of about 5 percent.

  Men who have sex with men have been largely absent from national AIDS strategies until recent years. Sentinel surveillance began to include MSM in 2002 and a specific strategy to implement a comprehensive response to HIV among MSM began being implemented in 2009.

  Positive experiences in Chengdu, a city with one of the largest HIV epidemics among MSM as well as some of
the best-organised MSM community-based organisations, are serving as a model for other large cities in China. The outcome of its role in the ‘Men who have sex with men and transgender populations Multi-City Initiative’ demonstrates the potential and importance of collaborative partnerships and networks of MSM in China’s HIV response.

  Among the more immediate concerns facing China in the response to HIV among MSM is the need to understand the relative effectiveness of HIV prevention interventions by ensuring that strong evaluation mechanisms are in place.

  However, MSM are recognised as a priority population in China’s national strategic plan and crucial work is underway to scale-up the response in key cities.

  The snapshot provides more information about priorities for China reaching the three zeros, the most recent epidemiological data, behavioural information and programmatic information.

  

• HIV, health and rights: Sustaining community action. Strategy 2013 – 2020

  Posted: 07 Feb 2013 09:01:25 GMT

  This new global strategy articulates the determination and strengths of the International HIV/Aids Alliance. It has been developed through wide consultation with Linking Organisations and other partners, and has been approved by an international board of trustees. The strategy provides high-level direction and sets 17 ambitious but measurable goals for the whole Alliance. The targets have been set up until 2015, at which point progress will be reviewed and the goals revised up until 2020 accordingly.

• MSMGF Technical Bulletin: Systemic (Oral) Pre-Exposure Prophylaxis (PrEP)

  Posted: 18 Dec 2012 17:41:55 GMT

  This technical bulletin focuses on HIV prevention and treatment strategies for gay men and other men who have sex with men (MSM) Focusing on systemic pre-exposure prophylaxis (PrEP). Systemic pre-exposure prophylaxis (PrEP), otherwise known as oral PrEP, is a prevention method whereby an HIV-negative person ingests antiretroviral medications (ARVs) regularly in order to reduce the risk of contracting HIV. This bulletin includes recommendations regarding systemic PrEP with MSM and provides information on considerations and limitations of systemic PrEP as an HIV prevention strategy for MSM.

• MSMGF Technical Bulletin: Topical (Microbicide) Pre-Exposure Prophylaxis (PrEP)

  Posted: 18 Dec 2012 17:41:52 GMT

  This technical bulletin focuses on Topical PrEP is the use of a microbicide—a gel, lubricant, douche, or enema infused with antiretrovirals (ARVs)—applied to the vagina and/or rectum in order to prevent sexual transmission of HIV. This bulletin includes information on recent research and overall knowledge of PrEP amongst MSM. This bulletin also provides information on considerations and limitations of systemic PrEP as an HIV prevention strategy for MSM.

• Lessons Learned and Future Programming- Three Years of the Red Cross Global Alliance on HIV in the Americas 2008 - 2011

  Posted: 06 Dec 2012 09:00:59 GMT

  The GA HIV has had a profound effect on the way in which the National Societies of the Red Cross Red Crescent in Latin America and the Caribbean approach their work in HIV/AIDS. The concepts of integrated planning and working with partners on a consolidated response to the epidemic in their countries have strengthened the National Societies’ role as an important contributor to their respective national AIDS’ responses. Programmatically, the GA HIV has provided an appropriate model for working with the most marginalized populations at higher risk of HIV in the region. The relatively flexible funding provided multilaterally though the Federation Secretariat has enabled each National Society to tailor its programmatic approaches to local needs and to complement other funding sources. The GA HIV has also contributed to learning for the entire organization.

• UNAIDS Report on the global AIDS epidemic 2012

  Posted: 01 Dec 2012 09:01:24 GMT

  Drawing on information provided by countries, this report summarises the current situation in the effort to reach the 2015 targets set forth in the 2011 Political Declaration. In addition to providing a snapshot of the current situation for each target, it identifies key trends. Using a scorecard approach on key indicators, the report allows individual countries to compare their own achievements with those of others. Regional breakdowns enable comparison of progress between different parts of the world. This report highlights instances where recommended policies and programmes have yet to be implemented.

• Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub-Saharan Africa: a systematic review

  Posted: 01 Dec 2012 09:01:13 GMT

  Recent years have seen an increasing recognition of the need to improve access and retention in care for people living with HIV/AIDS. This review aims to quantify patients along the continuum of care in sub-Saharan Africa and review possible interventions. The article finds that losses occur throughout the care pathway, especially prior to ART initiation, and for some patients this is a transient event, as they may re-engage in care at a later time. However, data regarding interventions to address this issue are scarce. Research is urgently needed to identify effective solutions so that a far greater proportion of infected individuals can benefit from long-term ART.

• The securitization of the HIV/AIDS epidemic as a norm: a contribution to the constructivist scholarship on the emergence and diffusion of international norms

  Posted: 01 Dec 2012 09:00:54 GMT

  This article discusses the emergence of an innovative conceptualisation of security in the 1990s that proclaims the global HIV/AIDS epidemic is a threat to international peace and stability. The study provides a framework for understanding the securitisation of the HIV/AIDS epidemic as an international norm defined and promoted mainly by multilateral bodies, powerful states in the North and transnational HIV/AIDS advocacy networks. The HIV/AIDS securitisation norm (HASN) is an attempt of the analysis presented to synthesise under a single analytical concept the myriad of ideas and international prescriptions about HIV/AIDS interventions. The article identifies the actors who developed the main strategic prescriptions of the HASN and the transnational mechanisms that promoted the diffusion of its concepts throughout the state system.

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