On World AIDS Day 2007, hundreds, perhaps thousands, of men who have sex with men (MSM) will become infected with HIV in cities across the Asia Pacific, becoming the latest statistics in an almost unrecognized but ever-growing crisis that many governments in the region are only just beginning to grapple with.
As these efforts take shape, the Asia Pacific Coalition on Male Sexual Health (APCOM) is offering its partnership to develop and support new strategies aimed at tackling this regional challenge.
Paradoxically, it may be more challenging for APCOM to draw attention to the MSM HIV issue. The recent adjustment downwards of global HIV and AIDS figures has been construed in some quarters as an indication that the AIDS crisis has been ''exaggerated'' all along. However, APCOM and the stakeholders it represents are urging the Asia Pacific region, and indeed the world, not to confuse the true picture.
Most MSM who contract HIV in city after city in the Asia Pacific region will never know they harbour the virus until they become ill with advanced symptoms. Without that knowledge, they probably will not change the very behaviours 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 there are HIV positive. In other cities across the region, HIV infection rates for MSM range from estimates anywhere from 5% to 15% or 20% and higher.
''Despite MSM having higher infection rates than the general adult population, the financial investment for HIV prevention, care and support services for this marginalized group across the Asia Pacific is abysmally low in national HIV and AIDS programme planning, usually between zero and four percent,'' says Shivananda Khan, APCOM Chairperson and CEO of Naz Foundation International. ''Less than one in ten MSM in the region have access to any sort of HIV services, woefully short of the eight in ten that UNAIDS describes as optimal coverage necessary for high-risk groups. Is it any surprise then that we really don't have a clear picture of the true extent of the HIV crisis affecting 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 HIV infection rates among MSM in some major cities, but when you ask whether this picture holds true across other urban centres, or even in suburban or rural areas, the answer's not at all simple. It ranges from 'Yes, it's somewhat likely' to 'Well, we're not really certain.' Still, we do know more today than just a couple of years ago.''
That growing clarity comes from a recent review of available data, soon to be released by UNAIDS, that describes the epidemiology of HIV and sexually transmitted infections (STI), and behaviours of MSM in the Asia Pacific region that put them at considerable risk of HIV and STI. As the paper states: ''Severe and established HIV epidemics are found among MSM in some countries while imminent or beginning HIV epidemics were observed in others.'' The review also recommends ways to change policy and programming that would confront this challenge and help improve the situation.
''This collection of data in the upcoming review allows us to highlight more accurately than before the extent of the HIV scenario vis-a-vis MSM in our region,'' according to Geoff Manthey, Regional Advisor on MSM for Asia Pacific UNAIDS Regional Support Team (RST-AP). "It also comes at a most opportune time, with the recent creation of the Asia Pacific Coalition on Male Sexual Health. We hope that the work of APCOM, and its strength in bringing together representatives from governments, the UN system, donors and NGOs side by side with affected communities will finally make the difference in creating a truly regional strategy to address the MSM HIV crisis -- and yes, even though it's an overused word or sounds like a clich¨¦, this is a crisis, make no mistake about that.''