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HIV infection among men who have sex with men in East and South-East Asia time for action

Lim, SH and Chan, R (2011) HIV infection among men who have sex with men in East and South-East Asia time for action. Sexual Health, 8 (1). 5 - 8. ISSN 1448-5028

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Abstract

The epidemiological data reported from these countries paint a worrying picture of HIV infection and transmission among MSM. Common areas of concern include use of recreational drugs in combination with sex, use of the internet for sexual liaisons, growth of sex-on-premises venues, regional sex travel, and group sex parties. The symposium identified subpopulations of MSM who are at greater risk of HIV infections, in particular, young MSM. A recent review by van Griensven and van Wijngaarden on epidemiology and HIV prevention responses among MSM in Asia16 has called for rapid scale up of intervention programs in order to avert a public health catastrophe. The responses to the HIV epidemic among MSM in these countries vary and are determined by the capacity of community-based organisations, commitment and support from the government, as well as the legal and socio-cultural environments. A common feature is that HIV prevention programs for MSM have been difficult and under-resourced and therefore reach only a small proportion of MSM. Sex between men is criminalised in 19 out of 48 countries in the Asia Pacific region25 and is stigmatised by traditional Asian values and cultures. Many MSM are afraid to acknowledge their sexual orientation, to disclose it to their family and friends, and to access available health services such as HIV testing. In many of these countries, budgets for MSM-specific services are disproportionately low. Some countries such as China and Malaysia have been resistant to include MSM as important component of HIV/AIDS planning. In order to increase the response from government, public health, and medical sectors, it is necessary to reduce stigma and discrimination at multiple levels.26 Decriminalisation of homosexuality and a human rights approach to prevention are recommended by experts27 and the international agencies28,29 as crucial to achieve these goals. It is implicit that programs provided forMSMhave to involve community-based organisations and infected persons in planning and delivery. As exemplified by the work in Hong Kong and Japan, HIV prevention programs must be tailored to the local cultures. The programs must appeal to and address the needs of MSM clients. HIV and STI testing and counselling, increased access to lubricants and condoms, and outreach at various social venues are the basic services that non-government organisations must provide. To some degree this is the case in some developed countries in Asia. With relatively more funding, non-government organisations in Hong Kong and Singapore have been able to scale up programs, and to provide more comprehensive services that address sexual health needs and psychosocial issues among MSM. The clear commitment of government in HIV responses is also crucial. As is the case in Thailand, Hong Kong and Singapore, governments provide financial and technical assistance and coordinate MSM research and programming activities. Government financial support is crucial to ensure the survival of the non-government organisations and community-based organisations such that they would not have to rely on funding from donors or international agencies. In Singapore and Hong Kong, coalitions of clinicians, researchers, public health officials, and community-based organisations collaborate and have increased coverage of prevention services, leading to the most significant impact in reducing risk behaviours and HIV infection among MSM in the region. This partnership approach has also been recommended.12-14,16,27-29 A central body, supported by government, that coordinates MSM research and programming activities is critical to ensure a concerted and sustainable effort to reduce HIV among MSM populations in the region. Other countries must put into place similar coordination structures, increase resources and energise their community networks and organisations if they are to contain the alarming explosion of HIV transmission in their MSM communities.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Lim, SH
Chan, R
Centers: Other Centers, Institutes, Offices, or Units > Center for LGBT Health Research
Date: 3 February 2011
Date Type: Publication
Journal or Publication Title: Sexual Health
Volume: 8
Number: 1
Page Range: 5 - 8
DOI or Unique Handle: 10.1071/sh10124
Refereed: Yes
ISSN: 1448-5028
Article Type: Review
MeSH Headings: Asia--epidemiology; Asia, Southeastern--epidemiology; HIV Infections--epidemiology; HIV Infections--prevention & control; HIV Infections--transmission; Homosexuality, Male--statistics & numerical data; Humans; Male; Prevalence; Prostitution--statistics & numerical data; Sexual Partners; Unsafe Sex--statistics & numerical data
PubMed ID: 21371375
Date Deposited: 12 Jun 2013 21:37
Last Modified: 20 Dec 2018 00:55
URI: http://d-scholarship.pitt.edu/id/eprint/18910

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