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Paradoxically, it may be more challenging for APCOM to draw attention tothe MSM HIV issue. The recent adjustment downwards of global HIV and AIDSfigures has been construed in some quarters as an indication that the AIDScrisis has been ''exaggerated'' all along. However, APCOM and thestakeholders it represents are urging the Asia Pacific region, and indeed theworld, not to confuse the true picture.
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Most MSM who contract HIV in city after city in the Asia Pacific regionwill never know they harbour the virus until they become ill with advancedsymptoms. Without that knowledge, they probably will not change the verybehaviours that put them, as well as their partners and loved ones, at risk.A recent survey in a major Asian capital suggested as many as 32% of MSM thereare HIV positive. In other cities across the region, HIV infection rates forMSM range from estimates anywhere from 5% to 15% or 20% and higher.
''Despite MSM having higher infection rates than the general adultpopulation, the financial investment for HIV prevention, care and supportservices for this marginalized group across the Asia Pacific is abysmally lowin national HIV and AIDS programme planning, usually between zero and fourpercent,'' says Shivananda Khan, APCOM Chairperson and CEO of Naz FoundationInternational. ''Less than one in ten MSM in the region have access to anysort of HIV services, woefully short of the eight in ten that UNAIDS describesas optimal coverage necessary for high-risk groups. Is it any surprise thenthat we really don't have a clear picture of the true extent of the HIV crisisaffecting men who have sex with men?''
Edmund Settle, HIV/AIDS Programme Manager for UNDP China, concurs.''You've got these really alarming statistics of ten, 20, 30 percent HIVinfection rates among MSM in some major cities, but when you ask whether thispicture holds true across other urban centres, or even in suburban or ruralareas, the answer's not at all simple. It ranges from 'Yes, it's somewhatlikely' to 'Well, we're not really certain.' Still, we do know more today thanjust a couple of years ago.''
That growing clarity comes from a recent review of available data, soon tobe released by UNAIDS, that describes the epidemiology of HIV and sexuallytransmitted infections (STI), and behaviours of MSM in the Asia Pacific regionthat put them at considerable risk of HIV and STI. As the paper states:''Severe and established HIV epidemics are found among MSM in some countrieswhile imminent or beginning HIV epidemics were observed in others.'' Thereview also recommends ways to change policy and programming that wouldconfront this challenge and help improve the situation.
''This collection of data in the upcoming review allows us to highlightmore accurately than before the extent of the HIV scenario vis-a-vis MSM inour region,'' according to Geoff Manthey, Regional Advisor on MSM for AsiaPacific UNAIDS Regional Support Team (RST-AP). "It also comes at a mostopportune time, with the recent creation of the Asia Pacific Coalition on MaleSexual Health. We hope that the work of APCOM, and its strength in bringingtogether representatives from governments, the UN system, donors and NGOs sideby side with affected communities will finally make the difference in creatinga truly regional strategy to address the MSM HIV crisi
