Advocacy case study: prioritizing men who have sex with men (MSM) and other sexual minorities in the President’s Emergency Plan for AIDS Relief (PEPFAR)
K.J. Lauer1, G. Ayala1, P. Curtis2
1The Global Forum on MSM & HIV (MSMGF), Oakland, United States, 2AIDS Project Los Angeles, Los Angeles, United States
Issues: In low- and middle-income countries, men who have sex with men (MSM) are 19 times more likely to be infected with HIV than the general population. As one of the largest providers of HIV-related funding and services around the world, the President’s Emergency Plan for AIDS Relief (PEPFAR) has a key role to play in ensuring that MSM and other most-at-risk populations are a priority in the global response. The 2008 reauthorization process of the law enacting PEPFAR and the 2009 effort to write a new five-year strategy for the program provided two key opportunities to make MSM an explicit priority population in PEPFAR.
Description: Advocacy efforts by The Global Forum on MSM and HIV (MSMGF) and AIDS Project Los Angeles beginning in the fall of 2007 targeting members of U.S. Congress helped lead to the inclusion of language on HIV prevention specifically for MSM in the 2008 law reauthorizing PEPFAR. Building on these efforts, APLA and the MSMGF undertook a range of initiatives toward the prioritization of MSM in the PEPFAR five-year strategy, including: organizing congressional hearings on MSM and the global HIV epidemic; face-to-face meetings with key policy makers; convening a D.C.-based policy Working Group on HIV, MSM and Other Sexual Minorities and spearheading the Working Group’s efforts to submit recommendations on the five-year strategy. The PEPFAR five-year strategy published in December 2009 explicitly prioritizes MSM.
Lessons learned: Critical factors that led to prioritizing MSM in PEPFAR legislation and policy included strong champions in U.S. Congress, cooperation with key allies in the advocacy community, growing data on HIV among MSM in the global south; and expert testimony from advocates on the ground.
Next steps: Efforts to ensure that high level policy language on MSM in PEFPAR’s five-year strategy translates into effective implementation on the ground of HIV programs for MSM.