In the year 2000, as part of the UN Millennium Development Goals, all the world’s countries committed to halt and begin to reverse the spread of HIV by 2015. Although the international community has significantly increased support to global HIV/AIDS initiatives in that time frame, resources continue to fall short of meeting projected needs.
The Kaiser Family Foundation estimates that total global spending on HIV rose from US$300 million in 1996 to $13.7 billion in 2008. However, the need for resources is much greater: UNAIDS estimates that $25.1 billion will be needed to effectively respond to the HIV/AIDS epidemic in the year 2010. This shortfall limits the ability of countries most affected by the AIDS crisis to scale up effective prevention and treatment programs. Most people at risk for HIV continue to lack access to prevention, care and treatment.
Concentrated epidemics of HIV among high-risk and often marginalized groups are cause for concern. In low and middle-income countries, men who have sex with men (MSM) are on average 19 times more likely to be infected with HIV than the general population. HIV prevalence rates among MSM have been reported at 25% in Ghana, 30% in Jamaica, and 25% in Thailand. In Sub-Saharan Africa, HIV prevalence rates among MSM have been recorded at 21.4% in Malawi, 19.7% in Botswana, and 12.4% in Namibia.