In the Southern United States, there is a disproportionately high rate of HIV diagnoses amongst Black and Latino men who have sex with men. However, these groups are also less likely than their white counterparts to take PrEP, or pre-exposure prophylaxis, which can safely decrease a person’s likelihood of getting HIV through sex by about 99% when taken as prescribed.
Tagged: MSM
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Inextricable links: HIV and human rights
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The AIDS epidemic has been characterized by the stigma and discrimination of people who are all too often already on the margins of society.
This marginalization has made it more difficult for millions of people on every continent to access much-needed HIV prevention, treatment, care and support services. As we recognize International Human Rights Day on Dec. 10, we cannot lose sight of the inextricable link between HIV and human rights, which should be the cornerstone of our response to and understanding of this epidemic.
And there is, perhaps, reason for cautious optimism. Despite some policy gains and increased global attention, HIV continues to disproportionately affect “key populations” — men who have sex with men, sex workers, people who inject drugs and transgender people. UNAIDS estimates that 40 to 50 percent of new adult HIV infections worldwide occur among key populations and their partners.
Read the remainder of the blog here.
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At approximately 18 percent, the prevalence of HIV in Botswana’s general population is one of the highest in the world. As a result, national HIV prevention efforts have focused more intensively on the general population than on other populations. Little is known about key populations, such as female sex workers and men who have sex with men, whose behaviors are both stigmatized and illegal in Botswana.
In 2012, the Botswana Ministry of Health used an integrated behavioral and biological surveillance survey to estimate population sizes and prevalence of HIV and sexually transmitted infections (STIs) among female sex workers and men who have sex with men. The study was historic. For the first time, it showed the HIV and STI burden among these two key populations and raised awareness about how they might have contributed to the generalized HIV epidemic.
The survey, carried out with technical assistance from FHI 360 through the Preventive Technologies Agreement (funded by the U.S. Agency for International Development), uncovered a population of more than 4,000 female sex workers in the three districts where the survey was conducted. Among these female sex workers, HIV prevalence was 61.9 percent, and the prevalence of gonorrhea and chlamydia were both higher than 10 percent. The female sex workers had a mean of more than seven partners per week, and condom failure, which includes condom breakage and being paid or forced not to use condoms, was common.
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In an era of limited resources, HIV prevention, care and treatment efforts need to focus on the smartest investments. This means investing in programs that can have the greatest impact in halting HIV transmission and turning back the epidemic. From a public health perspective, the effective use of resources requires focusing on key populations who have the highest level of HIV infection and tackling the barriers that discourage and prevent them from accessing health systems and services. These populations are broadly defined as sex workers, men who have sex with men, transgender persons and persons who inject drugs.
As the world gathers at the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia, July 20–25, 2014, we have an excellent opportunity to share how investing in evidence-based strategies can change the trajectory of the epidemic once and for all.
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New strategies reach men who have sex with men with HIV prevention and care services in Ghana
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In Ghana, men who have sex with men often fail to access critical HIV information and services due to deep-rooted fear of social stigma. The Ghana Men’s Study, conducted in 2011,1 revealed a high level of HIV prevalence among men who have sex with men in five sites in Ghana (17.5 percent), with the highest rates in the Greater Accra and Ashanti regions: 34.4 percent and 13.6 percent respectively. This study also found that less than half of the men who have sex with men population surveyed had been reached with HIV prevention services.
Since 2010 year, the Strengthening HIV/AIDS Response Partnership with Evidenced-Based Results (SHARPER) project, funded by the U.S. Agency for International Development and implemented by FHI 360, has worked to reduce HIV transmission among men who have sex with men and other most-at-risk groups. The project operates in 30 districts with high HIV prevalence, with the goal of reaching 178,000 individuals with health behavior messages and improved access to health services by June 2014.
Before 2012, SHARPER relied on peer education alone to reach this key population. We found, however, that less than 10 percent of the men in this group referred by peer educators for HIV testing were positive. Clearly, new strategies were needed to identify those most at risk of HIV and link them with prevention and care services.
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Turning the Tide: Increasing Access to HIV Prevention and Care for Men Who Have Sex with Men in Ghana
An Interview with
Kim Green, Deputy Country Director for Ghana, FHI 360