Accelerating infection rates can only be reversed by government-led interventions, increased funding, scaled-up coverage and steps to end stigmatisation

BALI – Soaring HIV infection rates among men who have sex with men (MSM) and transgender (TG) communities throughout Asia Pacific pose a looming health crisis that cannot be reversed until governments in the region close ranks and allocate the funding and resources necessary to scale up prevention interventions and end the stigmatization and criminalization of these at-risk target groups.

The latest epidemiological data, released today at a forum held by the Asia Pacific Coalition on Male Sexual Health (APCOM) in Bali, shows that epidemics in the region are accelerating, with estimated HIV prevalence rates in Bangkok above 30 percent, and hovering just below 30 percent in Yangon, Myanmar. One alarming trend is the high rate of infection among the youngest segments of the MSM and TG communities. A newly completed study in Thailand that followed 1,000 HIV-negative MSM for 3 years found that eventually 20 percent became HV infected with HIV. Among those between 18 and 22, the infection rate was a staggering 30 percent.

Frits van Griensven, Chief, Behavioral Research, US CDC, said, “HIV has established itself in all Southeast Asian cities, with Bangkok and Yangon the most alarming. In Myanmar we are seeing the same pattern as in Bangkok, starting with the very young.  New data shows that among the TG community in Jakarta the prevalence rate is 34 percent, which is extremely high – the highest in all of Asia. We have learned that when the prevalence rate is low in the beginning you still have time, but if you don’t have the resources, prevalence will grow and it will be very difficult to bring it down.”

Dr. Swarup Sarkar of the Global Fund said at the conference that despite the statistical evidence, investments in HIV programming for MSM remain dramatically limited.

“Almost everywhere in Asia and the Pacific, the MSM epidemic is going up, even if the overall HIV infection rate in some countries is declining,” Sarkar remarked. “Unless we address it immediately, it will produce a huge number of infections and will require huge amounts of resources. Over the last five years a cumulative $4 billion was spent by countries in the region, but MSM investment is less than $100 million.”

The failure of national governments to allocate resources to their MSM and TG communities constitutes nothing less than “a crime against humanity,” according to APCOM Chairperson Shivananda Khan, OBE. “MSM are beaten, criminalised, harassed, denied services and imprisoned. No wonder HIV is increasing so rapidly. It is not only about condoms. We cannot get medicine. We are not accepted as human beings. It is this discrimination that leads to high rates of HIV.  Nearly 200 MSM and TG are infected every day across the Asia Pacific region – this number is shocking and shameful. The only way we can win this battle is if we work together and stand shoulder to shoulder to address the crisis so this genocide stops. We have the technology and the evidence to stop it, and enough is enough. What we are dealing with is a crisis in human lives.”

The all-day forum preceded the 9th International Congress on AIDS in Asia and the Pacific and offered an interactive platform for exchanging information. APCOM, a regional coalition of community-based organisations that includes the government sector and the United Nations system focusing on HIV and MSM, focused today’s forum squarely on this at-risk target.

Jeff O‘Malley, Global Director, UNDP, HIV/AIDS Group, remarked at the forum, “Diversity gives the community strength. So does adversity – the fights against sodomy laws, against the day-to-day discrimination and invisibility. These causes are important in and of themselves, but just as important, they forge new communities and a new generation of leaders. The development of new partnerships and leaders is essential to reducing the rate of HIV infection and continuing the struggle against HIV.”

Now in its second year, APCOM is a regional coalition of MSM and HIV community-based organizations, the government sector, donors, technical experts and the UN system. Its main purpose is to advocate for political support and increased investment in and coverage of HIV services in Asia Pacific. APCOM promotes principles of good practice and lessons learnt by bringing together representatives from diverse groups in an effort to share experience, knowledge and expertise.