US PEPFAR Guidelines on HIV Prevention Challenge Homophobia

Published: May 26, 2011

The US President’s Emergency Plan for AIDS Relief (PEPFAR) issued new funding policy guidelines on Saturday that call for measures to be put in place to address human rights, legal barriers and homophobia in HIV response. PEPFAR is a major contributor of funds to the fight against HIV in 15 countries in sub-Saharan Africa (Kenya receives $510 million). In an interview with the Nairobi Star, David Kuria from the Gay and Lesbian Coalition of Kenya (GALCK) said, "Ignoring effective programming for these populations is an exercise in futility if the desired goal is a HIV free society."

According to David Kuria, the spokesperson of the Gay and Lesbian Community in Kenya, over 33% of all new infections in the country are attributable to these sub-populations.

In recent times, he adds, further evidence has emerged that corroborates what the GLCK had been insisting for a long time – that effective HIV programming for these populations has additional positive impact on the general population.

The GLCK spokesperson says that MSM who seek ARVs are constantly arrested, detained and as a consequence have their treatment interrupted.

This was closely followed by threats from the religious leaders who threatened the HIV clinic in Mtwapa, because the clerics wanted gay men excluded from its services.

This not only decreases the efficacy of their treatment but also raises HIV drug resistant strains in the Kenyan society – again because of the interface between the MSM and the general population, these drug resistant strains spread not just among the MSM but also the entire population. In other words it is not possible to talk of adherence to HIV treatment, when MSM can routinely be arrested and removed from treatment because of the existing legal environment. 

“Ignoring effective programming for these populations is an exercise in futility if the desired goal is a HIV free society. Moreover effective programming for these sub-populations increases the efficiency in the use of resources, because, a dollar spent on these population has flow-over effect to the general population,” he said.

The PEPFAR report "Technical Guidance on Combination HIV Prevention" (pfd) addresses prevention programs for men who have sex with men and has been added African Activist’s resource area under HIV/AIDS. According to the report:

Recent studies show that HIV/AIDS is having a severe and disproportionate impact on MSM in low- and middle-income countries in all regions of the world, including PEPFAR countries with concentrated epidemics and generalized epidemics. A systematic review of data from 38 low- and middle-income countries found that MSM were, on average, 19 times more likely to have HIV than the general population…The negative effects of homophobia, stigma, and discrimination are obstacles to implementing effective programs for MSM and also put MSM at increased risk for HIV infection and limit the availability of appropriate HIV prevention, care and treatment services for this population. Structural factors such as laws and policies that deny MSM equal protection under the law and put them at risk for arrest and prosecution limit the availability and quality of appropriate HIV prevention services and medical care, including screening and treatment of sexually transmitted infections, access to condoms, alcohol and drug treatment, and HIV care and treatment for MSM.

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