A new report published by the World Health Organization (WHO) supports known concerns that criminalization of men who have sex with men and stigmatization of trans identity is hampering HIV prevention efforts.
The report, entitled “Prevention and treatment of HIV and other sexually transmitted infections among men who have sex with men and transgender people,” gives a guidelines focus on the prevention and treatment of HIV and other sexually transmitted infections (STIs) and includes evidence based recommendations, implementation issues and key research gaps. The report is particularly concerned with low-and middle-income countries, but WHO is keen to stress this guidance is also applicable communities in high-income countries as well.
The report is a response to a recent resurgence of HIV infection among men who have sex with men (MSM), a trend most startling in industrialized countries. Men who have sex with men are, WHO estimates, 20 times more likely to contract HIV than the general population, while the infection rate among transgender citizens can range from 8-68% depending on the country or region. Data also suggests newly identified HIV epidemics among MSM in Africa, Asia, the Caribbean and Latin America.
Part of the reason for that, the study finds, is because of persecution and stigmatization of LGBT identity.
One reason for this is the stigma experienced by many men who have sex with men and transgender people. In many countries, criminalization of same sex relationships drives such relationships underground, making people afraid to seek HIV prevention and treatment services. WHO and its partners advise more inclusive approaches and suggest some practical ways to improve their access to HIV prevention, diagnosis, treatment and care services.
“We cannot imagine fully reversing the global spread of HIV without addressing the specific HIV needs of these key populations,” said Dr Gottfried Hirnschall, WHO’s Director of HIV/AIDS Department. “We are issuing these guidelines to help countries and communities scale-up the services needed to reduce new infections and save lives.”
“Men who have sex with men and transgender people everywhere face huge difficulties in accessing HIV services,” said George Ayala, Executive Director of the Global Forum MSM & HIV (MSMGF), a key partner in producing the recommendations. “The guidelines both present evidence for effective prevention interventions for these populations and provide recommendations to help ensure that pervasive barriers like stigma and criminalization no longer stand in the way of life-saving services.”
“Urgent action is needed to ensure that the basic human rights of people most at risk of HIV infection are respected and that they have the information and tools to protect themselves against HIV and gain access to antiretroviral therapy if needed,” said Mariangela Simao, Chief, Prevention, Vulnerability and Rights, UNAIDS.
The “Prevention and treatment of HIV and other sexually transmitted infections (STIs) among men who have sex with men and transgender people: Recommendations for a public health approach” guidelines provide 21 key recommendations for combating HIV and STI infection for these at risk groups. You can read those in full in the report, but a general overview is as follows.
The guidelines recommend:
– national policy makers develop inclusive human rights laws and health services by enacting nondiscrimination rules and publicizing inclusive, nonthreatening environments for MSM and trans people;
– health service providers develop inclusive nondiscrimination policies tailored to encourage MSM and transgender people to avail themselves of services without threat of stigmatization or harassment;
– communities should scale-up HIV and STI prevention efforts specifically targeting MSM and transgender people in ways that emphasize nondiscrimination; and
– for affected individuals it is important that they (be allowed to) practice consistent condom use as opposed to choosing partners based on HIV infection status.
It is the first time guidelines specifically for men who have sex with men and trans people have been issued. The guidelines were developed as a result of year-long consultation with global public health officials, scientists, and, among others, health service providers.
To read the report in full, please click here.
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