Discourse –> Progress for MSM HIV Prevention

On July 18th, I attended a session at #AIDS2010 which focused on the impact on families and children when services to most-at-risk populations are inadequate and/or when uptake is low due to reluctance of those in need to go for services. “Families of Men who have Sex with Men in the Developing World” covered research from India. While the prevalence rate in the general population in India is less than 1%, in the MSM population, HIV prevalence is 21%.

MSM in developing countries are 19.3% more likely be HIV positive than the MSM in the developed world due to a lack of services for this population. Many (if not most) MSM are also in heterosexual relationships and are therefore putting their female partners at risk. Of those men who had one partner, presumably their wives, 12% were positive. Of those who had multiple sexual partners, 4.7 percent were positive. While not yet confirmed by the research, one could assume that those with multiple partners may be better informed about risk and are more willing to use condoms. The implications are obvious; we know from recent studies in Uganda and other countries in which we work that marriage is one of the greatest risk factors for women, and we know that the recent proposed anti-gay legislation (which has been taken off the table for now), only drives MSM further away from services which can protect them, their partners, and their children. While I am not implying that MSM are the main drivers of new cases among married woman, we know that African countries encounter this phenomenon.

In Uganda and Malawi, people have been forced to think about the implications of the policies and the discourse, and we have a long way to go. But just having the discourse—in any form—is progress.

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