Information and tools to protect against HIV and gain access to therapy

Scaling-up HIV services for men who have sex with men

On June 21, 2011 in Geneva - New public health recommendations from WHO and partners aim to help policymakers and doctors scale-up access to treatment and prevention services for HIV and sexually transmitted infections among men who have sex with men and transgender people. These are the first global public health guidelines to focus on these specific population groups.

There has been a recent resurgence of HIV infection among men who have sex with men, particularly in industrialized countries.

Data are also emerging of new or newly identified HIV epidemics among men who have sex with men in Africa, Asia, the Caribbean and Latin America.

Generally, men who have sex with men are nearly 20 times more likely to be infected with HIV than general populations. HIV infection rates among transgender people range between 8–68% depending on the country or region.

Stigma, criminalization remain barriers

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.”

Information and tools to protect against HIV and gain access to therapy

The new guidelines 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 provide 21 recommendations for actions to be taken by multiple stakeholders, in close cooperation with men who have sex with men and transgender people.

For national policy-makers

To develop anti-discrimination laws and measures to protect human rights and to establish more inclusive services for men who have sex with men and transgender people based on their right to health.

For health service providers

To develop anti-discrimination laws and measures to protect human rights and to establish more inclusive services for men who have sex with men and transgender people based on their right to health.

For communities

To scale-up behavioural interventions for the prevention of HIV and STIs among men who have sex with men and transgender people.

For affected individuals

Practice consistent condom use over choosing partners based on HIV infection status (sero-sorting).
"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 Mariângela Simào, Chief, Prevention, Vulnerability and Rights, UNAIDS.

The WHO guidelines have been developed over the past year through global consultations involving public health officials, scientists, representatives from donor organizations, civil society and health service providers.