The World Health Organization (WHO) has issued the first public health guidelines intended to curb the spread of HIV and other STI's among men who have sex with men (MSM) and transgender people. As WHO explains, the new document has been in the works since 2008:
Despite the strong impact of the HIV epidemic on MSM and transgender people, to date, no technical recommendations have been made to guide health systems’ response to the epidemic among them. In September 2008, the World Health Organization (WHO) held a global consultation on “Prevention and treatment of HIV and other sexually transmitted infections (STI) for men who have sex with men and transgender populations”, in Geneva, Switzerland.29 Recommendations from that global consultation, as well as from WHO regional consultations,30, 31, 32 called for the need to develop guidance for delivering an evidence-based, pack- age of interventions for implementation by the health sector to prevent and treat HIV and other STIs among MSM and transgender people.
"This guidance will provide a broad framework," the report says, "for action to ensure an enabling environment and a set of evidence-based recommendations."
The scope of these guidelines focuses on the prevention and treatment of HIV and other STIs among MSM and transgender people. They include evidence-based recommendations, the summary and grading of evidence, implementation issues and key research gaps. Although the focus of this guidance is on low- and middle-income countries, WHO recommends that this guidance be available for MSM and transgender people in high-income countries as well.
UNAIDS reports that new data have helped bolster the case for the new guidance:
There has been a recent resurgence of HIV infection among men who have sex with men, particularly in industrialized countries. Data are also emerging of new or newly identified HIV epidemics among men who have sex with men in Africa, Asia, the Caribbean and Latin America. Generally, men who have sex with men are nearly 20 times more likely to be infected with HIV than general populations. HIV infection rates among transgender people range between 8 to 68% depending on the country or region.
One reason for this is the stigma experienced by many men who have sex with men and transgender people. In many countries, criminalization of same sex relationships drives such relationships underground, making people afraid to seek HIV prevention and treatment services. WHO and its partners advise more inclusive approaches and suggest some practical ways to improve their access to HIV prevention, diagnosis, treatment and care services.
Among the 21 recommendations, WHO suggests the following actions:
- For national policy-makers: To develop anti-discrimination laws and measures to protect human rights, and to establish more inclusive services for men who have sex with men and transgender people based on their right to health
- For health service providers: To offer HIV testing and counselling followed by treatment for patients with CD4 count 350 or below as recommended in the WHO 2010 HIV treatment guidelines
- For communities: To scale up behavioural interventions for the prevention of HIV and STIs among men who have sex with men and transgender people
- For affected individuals: Practice consistent condom use over choosing partners based on HIV infection status (sero-sorting)
All these actions touch on deeper stories and certainly would (or will) have complex results if implemented, but the fourth action listed here - consistent condom use instead of "sero-sorting" - struck me as especially interesting, and definitely worth looking into as a possible story angle. Is "sero-sorting" more common among MSM? If so, why? Take a look at the full report and let us know what catches your eye.
Also worth exploring are the results of a new survey from the Kaiser Family Foundation about American attitudes on HIV/AIDS. Here are just three of the findings. How do the results compare to public opinion about HIV/AIDS in your country?
Black Americans say they are more concerned about HIV/AIDS than white Americans.
More than half of Americans support more funding for HIV/AIDS.
Three-quarters of Americans could not name an individual who stands out as a national leader in the fight against HIV/AIDS.
Finally, for a relatively comprehensive of HIV/AIDS scientific research, check out the latest edition of HIV This Week. A few highlights to get you started:
Mobile phones and HIV
• Are we harnessing the promise of mobile phones rapidly enough?
• Short message service (SMS) reminders for re-testing among men who have sex with men in Australia
• Kenya demonstrates how the Chinese Shang Ring device for adult male circumcision can cut surgical time
Positive health, dignity, and prevention
• Why ABC for people living with HIV is not enough in Jinja, Uganda