Survey reveals gaps in HIV programming for MSM

Via PlusNews.

A new global survey of more than 5,000 men who have sex with men (MSM) reveals a marginalized group of people with little access to basic HIV prevention tools such as condoms and few means to learn about HIV.

Conducted by the Global Forum on MSM & HIV between 24 June and 17 August 2010, the survey sought to highlight key gaps in global efforts to provide MSM with evidence-informed HIV prevention services. More than 1,000 of the study participants - drawn from all over the world - were health workers; 22 percent reported being HIV-positive.

The authors recommend expanding access to HIV prevention services for MSM across the globe, more focus on promoting awareness of emerging HIV prevention interventions and more robust and sustained stigma-reduction efforts. Some of the major findings of the survey include:

Access to health services - Fifty-three percent of participants said they could easily access testing for sexually transmitted infections, while 51 percent said they had easy access to HIV counseling; 47 percent found STI treatment easily accessible.

Just 36 percent of MSM surveyed reported having easy access to HIV treatment, while 27 percent said it was available but difficult to access, was not available or had never heard of HIV treatment.

Access to HIV prevention - Free condoms were easily accessible only to 44 percent of participants, while just 29 percent could obtain lubricant.

Just 30 percent of participants reported easy access to each of the basic HIV prevention services, including behavioural HIV/AIDS interventions, HIV education materials, mental health services, free or low-cost medical care, media campaigns focused on reducing HIV, and laws/policies to ensure access to HIV prevention.

Just 25 percent said they had access to sex education.

Stigma - Africa reported the highest levels of stigma and external homophobia, followed by the Middle East, Asia-Pacific, Central/South America and the Caribbean, which all reported similar levels of stigma. Australia and New Zealand reported the lowest levels of stigma and external homophobia.

MSM from Africa and the Asia-Pacific region reported the highest levels of internalized homophobia.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

WHO Urges India to Address Medical Needs of Gay Men, Transgenders

Via The Hindu.

India must make an “extra effort” in addressing the medical needs of men who have sex with men (MSM) and transgender people affected by HIV and sexually-transmitted infections, a top WHO official said on Tuesday.

“Though India has addressed the HIV problem among MSM and transgender people, it has to make an extra effort in scaling up treatment and prevention services for HIV and sexually transmitted infections,” Dr. Gottfried Hirnschall, Director of HIV Department in World Health Organisation, told PTI.

In India, around 1.5 million transgender people and around 30.5 million MSM are vulnerable to the HIV and sexually-transmitted infections.

“In Asia, the odds of MSM being infected with HIV are 18.7 times higher than in the general population and the HIV prevalence ranges from 0 per cent to 40 per cent,” he said.

The WHO on Tuesday issued, for the first time, new public health recommendations to sensitise governments and health pressure groups in the developing world about the need to provide adequate medical treatment and prevention services to MSM and transgender people affected by HIV and sexually transmitted infections.

The guidelines call on governments to develop anti-discrimination laws and measures and provide more inclusive services for MSM and transgender people.

Health pressure groups must provide HIV testing and counselling followed by treatment for patients with CD4 count 350 or below.

Dr. Hirnschall said “criminalisation, and legal policy barriers play a key role in the vulnerability of MSM and transgender people to HIV.”

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

KENYA: Rural MSM Too Afraid to Access HIV Health Services

Via PlusNews.

Discriminatory laws and a largely homophobic society mean that men who have sex with men (MSM) in Kenya generally find it difficult to access HIV-related information and health services, but rural MSM have an especially hard time.

When Kibet Kipsowen*, 30, a cattle keeper in Kenya’s Rift Valley Province, and his partner have sex, they use the oil-based jelly he applies when milking his cows; he’s never heard of a water-based lubricant, let alone used one. “Milking jelly is the only lubricant I have known for the last four years,” he told IRIN/PlusNews at his home in the village of Lanjuera.

Health practitioners discourage the use of oil-based lubricants for anal sex, as the oil degrades condoms, increasing the likelihood that they will break. Studies have found that most African MSM use oil-based lubricants, heightening their risk of contracting HIV.

According to a 2008 Modes of Transmission study conducted by UNAIDS and the government, MSM and prisoners account for 15.2 percent of new HIV infections in Kenya annually.

Kipsowen and his partner have been an item for a few years now, but dare not let anyone in their village know they are a couple. “Even people who have ‘normal’ sex do not speak about it - I can never reveal my sexuality or else I would risk being an outcast, or even be killed,” he said.

The only other person in the village who knows about his sexuality is Soita Wellapondi, a local nurse and social worker, and that’s only because Kipsowen visited her when he developed a sexually transmitted infection.

“At that time I had a lot of wounds in my anus; I felt so much pain that I thought I would die, yet I could not even confide to my own mother, brother or sister, and I could not visit a health centre,” he said.

He knew that by confiding in Wellapondi he risked his secret being revealed to the community, but he felt she was his only chance of accessing health care. “I bought him some antibiotics and pain killers; it was absolutely impossible to convince him to visit a health centre, even one far away where he is not known,” said Wellapondi.

Local health workers have very little experience and no training in dealing with MSM. A clinical officer at the Mogotio health centre near Lanjuera says he has only ever had one MSM client.

Even people who have 'normal' sex do not speak about it - I can never reveal my sexuality or else I would risk being an outcast or even be killed“He came here for treatment of injuries resulting from anal sex, and was advised to come for further treatment but he never came back,” said the clinical officer, who declined to be named.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Vietnam: Gay rights group tackles insensitive medical care

Doctors believed, for example, that becoming a homosexual was a fashion statement. They teased gay patients, and criticised anal sex despite training on gay issues, the survey revealed.

via VietNamNet

Nguyen Thanh Trung (not his real name), a gay man who lives in Ha Noi, was very upset by the way doctors discriminated against him when he was undergoing an anal health test in one of the city's many health clinics.

"The doctor told me to my face that having sex with men is not a natural act and asked me why I did it," Trung recalled.

"I was so upset that I left the clinic and will never return," he said.


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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Kenya: Testing the Integration of HIV and public healthcare

Via PlusNews

HIV could lose its "special status" in Kenya's health system if a new pilot programme integrating HIV care and public healthcare proves successful.

Traditionally, public hospitals in Kenya have a "comprehensive care clinic" (CCC) dedicated to people living with HIV; under the new system, these would no longer exist.

For more than six months, the Ministry of Health and its partners have been piloting the move in Western Province; senior government officials say it will not reduce the focus on HIV, but will ease pressure on an already overburdened and understaffed health system.

"Integrating HIV treatment with other outpatient services doesn't mean it has become less important; it only means maximizing on space and reducing the burden on healthcare personnel and to help increase focus on other equally important diseases like malaria," said Ibrahim Mohamed, head of the National AIDS and Sexually transmitted infections Control Programme, NASCOP.

Joshua Omoro likes the new system, stating, "I have come today to pick my [antiretroviral] medicine but nobody can know; people are just guessing what I might be suffering from just like I am also just guessing for other people," he said. "It puts you at ease... before when you went to a specific room, people just knew you had HIV."

"It is not only reducing stigma but is also easing the staff shortages that had been experienced earlier when too much focus was placed on HIV/AIDS," said Beatrice Misoga, HIV/AIDS integration officer for US government-supported AIDS, Population and Health Integrated Assistance II (APHIA II) in Western Kenya.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]