(CNS): A recent UNAIDS report shows that decline in new HIV infections among adults has stalled. In 2014, key populations, including gay men and other men who have sex with men (MSM), sex workers and their clients, transgender people, people who inject drugs, and prisoners, accounted for 35% of new HIV infections globally. It is estimated that MSM are 24 times more likely to become infected with HIV and transgender people are 49 times more likely to be living with HIV than adults in the general population.
At XXI International AIDS Conference (AIDS 2016), in a pre-conference meet, some of the major issues got the spotlight: Are countries doing accurate size estimates for MSM and transgender populations? Is the money coming to these countries from global donors reaching the programmes for MSM and transgender or sitting in banks? And what is the connect between criminalizing same-sex behaviour, and size estimates of MSM population and service coverage among them?
Midnight Poonkasetwattana, Executive Director of Asia Pacific Coalition on Male Sexual Health (APCOM), said to CNS (Citizen News Service, citizen-news.org), "Asia Pacific region is lacking in terms of investment for HIV prevention (especially among MSM and transgender) and also political will. If we want to achieve fast track to meet UNAIDS '90-90-90' targets by 2020, time is now for urgent and increased investment in innovative and regional, national and local approaches for programmes of key populations to break down the structural barriers that affects and makes them vulnerable to HIV, especially for young gay men and MSM and transgender people in Asia Pacific."
It is essential for key populations to have access to the full range of HIV-prevention options in order to protect themselves and their sexual partners from HIV. This underscores the urgent need for the UNAIDS "90-90-90" targets to be met to realize the full potential of antiretroviral therapy (ART). The 90-90-90 targets are 90% of people knowing their HIV status, 90% of people who know their status accessing antiretroviral treatment and 90% of people on treatment having suppressed viral loads.
Are we counting properly?
Midnight Poonkasetwattana of APCOM questioned the silence on size estimates of MSM populations in Asia-Pacific countries. "Countries like China, Malaysia, Indonesia, Myanmar, Thailand and Viet Nam estimates MSM population to be over 5% when prevalence in cities like Bangkok, Hanoi and Jakarta is hiking to 15-20% or even more! Why is that access to condoms still remains very low in our region and 90% of MSM in Asia Pacific do not have access to HIV prevention services that they need because of discriminatory roles. 18 out of 58 countries in our region still criminalize same-sex behaviour. Since July 2012 when PrEP was approved by US-FDA and in 2014 WHO recommendations came in for PrEP as an effective HIV prevention tool for MSM, why are we not doing very well in rolling PrEP in Asia Pacific?
"Spending on HIV prevention in Asia Pacific remains very low, especially for key populations. Funding for HIV prevention among MSM population in Asia Pacific is less than 7% of overall HIV budget. This is unacceptable for a region that is home to over 60% of world's population and yet the funding does not match the estimated epidemic among MSM and transgender people! Critical components like advocacy, community mobilization and prevention are still getting largely funded by international donors and not domestically," added Midnight.
Criminalizing same-sex behaviour leads to lower size estimates, inflated service coverage