It is hard to believe that it has been 30 years since the beginning of the HIV/AIDS epidemic, an epidemic that was initially very much concentrated on gay men. A lack of political will and poor response from the health care sector meant that the community began to organise and mobilise for their own rights. The right to access treatment and espouse prevention, rather than do nothing and simply watch their friends and partners die. Now, ironically, 30 years later the very same communities are still not getting the attention and the resources that the epidemiological data clearly indicate are vital to curb the epidemic and save lives.
A high and rising HIV prevalence among populations of men who have sex with men (MSM) and transgender people has now been documented throughout much of Asia and the Pacific region. By 2015, it is projected that up to 40 percent of Asia’s epidemic will be constituted by transmissions attributed to male-to-male sex, sharply rising from an estimated 13 percent in 2008.1 Sex between men already accounts for approximately a third of HIV transmission in Asia and the Pacific, although this is very likely to be under-reported.2
MSM are up to 19 times more likely to be living with HIV than the general population.3 However, the proportion of MSM reached by HIV prevention, treatment, care and support interventions remains low. In fact, funding levels are usually far from adequate in meeting the challenge depicted by the epidemiological data and serving the needs of MSM and transgender people.
Despite irrefutable evidence establishing male-to-male sex as one of the main driving forces of HIV transmission in the Asia and Pacific region, few strategic interventions have addressed male-to-male and transgender sexualities and related HIV vulnerabilities. To address this, a regional consultation was called for in 2006 titled, ‘Risk and Responsibilities’. It brought together 380 community leaders, researchers and policy makers from 22 countries across Asia and the Pacific to urgently discuss the need for greater coordination, advocacy and investment in the region, and to swiftly convert talk into action.
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