Sub-regions

APCOM operates in 7 Asia Pacific sub-regions: the Pacific (including New Zealand), South Asia (including Mongolia but excluding India), Greater Mekong (GMS), South East Asia (excluding GMS), Developed Asia (Australia, Hong Kong, Japan, New Zealand, South Korea, Singapore, Taiwan), China and India; and two community sub-regions: PLHIV and Transgender. Within these sub-regions there are countries and areas that all have individual operations.

China

China’s HIV epidemic is one of low prevalence overall, but there are high and increasing rates of HIV infection among people engaging in high risk behaviours (injecting drugs using unsterilized needles and syringes, unprotected sex in the context of sex work and unprotected sex between men with multiple partners). Comprehensive HIV prevention initiatives are therefore increasingly focused on behavioural change among these populations.

Since 2005, the Chinese Government has strengthened its intervention efforts to MSM. In 2007, the National Center for AIDS/STD Control and Prevention (NCAIDS) worked with MSM civil society organizations to develop national working protocols and guidelines on HIV prevention and control among MSM and convened national technical workshops on comprehensive HIV prevention and behavioural interventions among MSM. Recently, the China Ministry of Health (MOH) estimated that men who have sex with men account for approximately 5 million to 10 million (2 to 4%) of the total number of sexually active men in China.

Due to the size of the population APCOM has designated China as an APCOM sub-region unto itself. As well, although the two southern provinces of China border the Mekong River, APCOM includes them as part of the China Sub-region.

Developed Asia

The socio-economic dynamics in this group of countries and areas are different from the rest of the region. The needs of MSM, particularly related to types of interventions, service coverage and resource allocation, are very similar within these countries and areas. Although limited data that is available, for the most part HIV prevalence remains low in the general population; however, the number of HIV infections in men who have sex with men (MSM) has risen sharply in many urban locations throughout these countries and areas as recently reported in Japan, Tokyo and Singapore.

Developed Asia includes:

  • Australia
  • Hong Kong
  • Japan
  • New Zealand
  • Singapre
  • South Korea
  • Taiwan

Greater Mekong

The Greater Mekong Sub-region (GMS) is comprised of countries bordering or surrounding the Mekong River. Since 2006, the Purple Sky Network (PSN) has coordinated a regional network of organisations involved in the work of HIV and MSM. PSN’s Secretariat is currently based at TREAT Asia, a program of the American Foundation for AIDS Research (AmfAR). Some of the highest known prevalence numbers among MSM are found in the GMS. It was announced in late 2007, for instance, that the HIV prevalence rate among MSM in Bangkok, Thailand was nearly 31%.

There are MSM HIV Working Groups in each of the six countries in this region, coordinated by PSN. Four of the countries include MSM in their national AIDS plan and two have HIV and MSM national strategic plans. The Purple Sky Network is the APCOM focal point for the GMS. While the two southern provinces of Yunnan and Guangxi in China also border the Mekong River, for APCOM purposes they are included in the China Sub-region rather than the Greater Mekong Sub-region.

The Greater Mekong includes:

  • Cambodia
  • Laos
  • Myanmar
  • Thailand
  • Vietnam

Each country has its own MSM Working Group, which is coordinated by the Purple Sky Network.

India

Issues surrounding stigma, misconceptions about male to male sex and entrenched political positions multiply the challenges to address the needs of MSM in India. India’s population surpassed the one billion mark in 2001 and recent official estimates state that between 2 and 3 million people are living with HIV today. The epidemic itself is concentrated amongst people engaging in high risk behaviours.

India has a long history of community based organizing including groups that work on addressing HIV among MSM. On the APCOM governing board India is represented by the India Network for Sexual Minorities (INFOSEM), a coalition of many community based organisations and a centre for technical support and training to its members. INFOSEM is a collective national effort of sexual minorities working to ensure equality in all spheres of life, free from discrimination.

India is a large and diverse country and is often referred to as a “subcontinent”. Although geographically part of South Asia, because of its population size and the estimated size of MSM sub-populations APCOM has designated  India as an APCOM Sub-region unto itself.

Pacific

The Pacific covers a very large geographic area of many countries, possessions and territories, containing a fairly low overall population base. According to the latest figures (UNAIDS 2007), the Pacific sub-region is nearing a crisis in regard to HIV. There are now 75,000 people living with HIV, including an estimated 14,000 new infections last year alone. The Pacific region is comprised of island countries and territories that share similar although distinctly different cultural identities. For APCOM, HIV and MSM work in the Pacific is organised under the newly formed Pacific Sexual Diversity Network (PSDN), which is supported largely by UNAIDS Pacific.

The Pacific includes:

  • Cook Island
  • Fiji
  • Kirbati
  • Marshall Islands
  • Micronesia
  • Naru
  • New Zealand
  • Niue
  • Palau
  • Papua New Guinea
  • Samoa
  • Solomon Islands
  • Tokelau
  • Tonga
  • Tuvalu
  • Vanuatu

PLHIV Community

People living with HIV (PLHIV) provide invaluable contributions to community organising, programme development, implementation and evaluation, including in the area of HIV prevention.

As stated in the APCOM Guiding Principles: “There must be greater involvement of MSM including HIV positive MSM and HIV positive transgender people, in programme planning and policy development arenas. … We believe that HIV and AIDS programme and policy responses are strengthened by ensuring inclusion, parity and representation.”

APCOM has designated a governing board position for a person living with HIV as a representative for all PLHIV in the Asia Pacific region, particularly for the unique needs of MSM. This position is chosen by the MSM Working Group of the Asia Pacific Network of People Living with HIV and AIDS (APN +). The MSM Working Group was formed in 2007 in recognition of the importance of involving MSM PLHIV in leadership and advocacy around HIV issues.

PLHIV Community includes organisations that are working on the issues of HIV infections among MSM.

South Asia

Male to male sexual activity is illegal in all countries of South Asia. Access to health services - and in particular to sexual health and HIV services - is limited and unfriendly or hostile attitudes towards MSM are common. Whilst legal reform work is underway in a few areas, societal recognition and full enjoyment of human rights of MSM are still far from being achieved. As has been the case in other parts of the region, the response to HIV has helped to foster more open discussions on sexuality and gender issues, including those of MSM, and has contributed to increased visibility and capacity of MSM organisations, where they exist. For APCOM purposes, South Asia does not to include India, which is designated as its own APCOM sub-region.

South Asia includes:

  • Afghanistan
  • Bangladesh
  • Bhutan
  • Maldives
  • Mongolia
  • Nepal
  • Pakistan
  • Sri Lanka

Southeast Asia

The countries in the APCOM Southeast Asia sub-region share geographic proximity and many share similar cultural and religious influences. There is also great religious diversity in Southeast Asia, such as two countries with some of the largest Muslim populations in the world (Indonesia and Malaysia) and two countries that are over 80% Christian (the Philippines and Timor Leste). There are rapid increases in HIV prevalence amongst people engaging in high risk behaviours as well, including MSM. Indonesia, for instance, now has the fastest growing HIV epidemic in Southeast Asia.

Singapore, although it is geographically part of Southeast Asia, is considered for APCOM purposes as part of the Developed Asia Sub-region. As well, the Southeast Asia countries that border or surround the Mekong River are included in the APCOM Greater Mekong Sub-region.

Southeast Asia includes

  • Brunei
  • East Timor
  • Indonesia
  • Malaysia
  • The Philippines

Transgender Community

In Asia and the Pacific, the most visible men who have sex with men are often those who are transgender (male-to-female). Generally, a transgender person is someone who identifies with or expresses a gender identity that is different from the person's sex at birth. Members of the transgender community are known by many names in Asia and the Pacific including hijra and kothi in Bangladesh and India, waria, banci or bencong in Indonesia, parlorista bakla in the Philippines, maknyah in Malaysia, mathis in Nepal, kathoey in Thailand and fa’afafine, which is one of 14 different identities in the Pacific.

The transgender persons attending the Consultation on Male Sexual Health and HIV in Asia and the Pacific, Risks and Responsibilities in 2006, from which APCOM derives its mandate, held their own separate caucus and resolved that they shall endeavour to create separate transgender networks, coalitions and community based organisations, and to seek separate funding to support such organising and activities for HIV prevention. Agreement for this community organising was endorsed by the delegates at Risks and Responsibilities.

Therefore, one of APCOM’s objectives is to nurture and support transgender groups and organisations and include transgender people in all activities as equal partners. This includes APCOM helping transgender groups to form their own networks and coalitions in order to best address TG issues and concerns, particularly related to HIV. To help achieve this objective, APCOM has assigned two governing board seats for transgender community representatives. In close coordination with APCOM, the Transgender community representatives are working towards the formation of a region-wide network of transgender community organisations, starting with the mapping of transgender groups, networks and organisations involved in HIV work.

Transgender Community includes organisations dealing with the issues for HIV and Transgender people.