On 17 July, in Vienna, the Global Forum
on MSM & HIV (MSMGF) held Be Heard!
This, the fourth pre-conference on MSM, was first created in response to shared
concerns that sexual minority issues were all but invisible at International
AIDS Conferences. From a small inaugural meeting before the 2004 Bangkok
conference, the event is now the world’s largest gathering focused on the
health and human rights of MSM, with over 100 speakers and 650 participants
attending from more than 100 countries.
It’s now time to begin asking
critical questions about what this year’s event achieved, what it could or
should accomplish in the future, and what its existence says about the IAC and
its role in the health and human rights of MSM.
The programme kicked off with
speeches from a number of key global health leaders on the current state of the
epidemic among MSM worldwide. Speakers included Global Fund Executive Director
Michel Kazatchkine, UNAIDS Executive Director Michel Sidibé, and AIDS-Free
World Co-Director Stephen Lewis.
Many speakers underscored a core
set of themes - criminalisation, stigma, human rights, and access to treatment
and prevention.
“We call on legislators to
change outdated penal codes that contain prohibitions against same-sex
activity. Getting rid of these laws is urgent,” said Michel Kazatchkine in his
plenary address.
Michel Sidibé concurred. “The
human rights of men who have sex with men and other sexual minorities must be
fully protected and respected if universal access to HIV services is to be
achieved,” he said. “All people should have equal access to HIV prevention,
treatment and care services in their countries regardless of sexual
orientation.”
Chris Beyrer of the Johns
Hopkins Center for Public Health and Human Rights unveiled the results of a Johns
Hopkins/World Bank survey, Global
Epidemics of HIV among MSM in 2010. HIV prevalence rates among gay and
other MSM have risen as high as 21.4% in Malawi, 13.8% in Peru, and 23% in
Thailand, he said. In one of the most significant announcements of the day, he
explained the survey revealed that higher levels of HIV-related services for
MSM populations would result in lower rates of HIV among the general population
- not just in MSM.
Topics in twenty-six small
group sessions, the heart and soul of the pre-conference, ranged from recent
developments in biomedical prevention, internet interventions, and effective
strategies for fundraising to sessions focusing on HIV work in specific regions
or with specific MSM subpopulations. The content was planned around results of
a multilingual survey asking what MSM, particularly those in low- and
middle-income countries, wanted to achieve.
A thought-provoking workshop
entitled Nothing about MSM and HIV
without MSM Living with HIV! addressed a key theme, discussing the
importance of involving MSM living with HIV in devising and running prevention,
support and treatment programmes for MSM. It included discussion on whether
having HIV automatically conferred expertise or leadership entitlement, and
explored issues such as the right of people - who may have half a lifetime of
symptom-free living ahead of them - to choose not to publicly
identify as HIV-positive.
Advocacy and working with
government bodies was also a theme. MSMGF staff led participants through the
use of a newly developed Advocacy Toolkit that offers guidance on matters such
as prioritising local advocacy issues and designing a campaign for working in
hostile contexts.
Dr Mariângela Simão, Director
of Brazil’s National AIDS Programme, joined Hong Kong AIDS Concern Executive
Director Loretta Wong and others to discuss NGO and health department
collaboration in improving access to programmes for sexual minorities.
A session on internet
interventions provided international examples of online communities seeding
in-person peer support. Yves Yomb from Alternatives-Cameroun explained how -
where homosexuality is penalised, funding is limited and harassment and
blackmail are common - peer educators befriend and inform men using sexual
networking sites. In eastern Europe, Tudor Kovacs of PSI Romania
described how he conducted an internet search of MSM contact sites for Romanian
MSM who disclosed HIV-positive status, who came to form the core of a support
and social group.
In Asia, Nada Chaiyajit and
Christopher Walsh of MPlus in Chiang
Mai, Thailand,
described how they use short, downloadable, animated videos to inform and
contact subpopulations such as immigrant male sex workers. Working on a much
larger scale, Stuart Koe of the large Singapore-based MSM website www.fridae.com,
described launching the world’s second-largest MSM sex survey and an HIV test
reminder service.
Soon after the event
concluded, conversations began springing up in meeting rooms, online discussion
forums and magazine articles about where the event succeeded and what could
have been done better. But first, what is the event trying to achieve?
The
human rights of men who have sex with men and other sexual minorities
must be
fully protected and respected if universal access to HIV services is to
be
achieved. Michel Sidibé, Executive Director of UNAIDS
Some ask whether an MSM pre-conference
is necessary. Maybe it was needed before – but hasn’t there been progress in
MSM representation at the IAC?
The MSMGF Secretariat did an analysis of the MSM
content at this year’s main conference. The results were shocking. Only 2% of
all conference sessions, excluding posters, specifically and exclusively
concerned MSM. Plenty more mentioned us - but, as we’ve found, lip service is
not enough. This population, in low- and middle-income countries, is on average
19 times more likely to be infected with HIV than the general population.