Brochures, posters, calendars, and other informational materials
that are being distributed throughout the country as part of the
media campaign to end stigma and discrimination.

“I cannot get infected, because I don’t live in Africa,” says Mihai, a 35-year-old man living in the capital of the Republic of Moldova, Chisinau . “Also, I don’t do drugs, I don’t practice sex for money, and I’m not gay. So, I cannot get infected”, he adds.

Alexandru, 23 years old, remembers: “One of my schoolmates is HIV-positive. After the class reunion, we continued our discussion at my place. When everybody left, I tried to remember which objects he had touched; I didn’t know what to do with the dishes he had used.”

These testimonials are part of a recently launched national campaign to promote solidarity with people living with HIV in Moldova. Extracted from real life examples, they reveal deeply rooted misconceptions about AIDS in Moldova.

“In 2005, we discovered with great concern the results of a survey on the attitude toward people living with HIV” said Mrs. Gabriela Ionascu, the UNAIDS Country Coordinator in Moldova. “We had to address stigma associated with HIV in Moldova urgently”.

The survey conducted by the AIDS Foundation East-West revealed that 74% of the respondents believed that people living with HIV should not be allowed to attend medical and social facilities used by the rest of the society. 64% of people surveyed said they experienced a certain degree of fear toward HIV-positive people, 45% expressed disgust, 37% felt anger, while 41% were totally indifferent.

Cooperating with UNAIDS, the Moldovan National Coordination Council, the Ministry of Health and Social Protection, as well as the Moldovan Orthodox Church—the AIDS Foundation East-West developed a concept for a large scale national campaign. The group raised sufficient funds to produce four video clips for national television, short radio messages and outdoor advertisement billboards. With financial support from the Swedish International Development Cooperation Agency (SIDA), the campaign aims to overcome groundless fears and negative attitudes toward people directly affected by HIV and debunking some of the myths around AIDS by conveying accurate information about HIV transmission.

Under the slogan “Because they are no different from you. Just be supportive!” the campaign will run, over four months, in five regions: Chisinau, Baltsi, Edinets, Comrat, and Tiraspol. A number of social events are also planned to encourage interactions and debates.

The campaign gives voice to people living with HIV who tell their stories of injustice and rejection by other members of their communities. It also allows HIV-negative people to speak about their fears regarding HIV as well as how they managed to overcome them. Every effort is made to facilitate identification with the characters in the campaign and to go against the idea that AIDS is a far distant problem.

“This campaign is unique”, says Elena Voskresenskaya, Regional Director of the AIDS Foundation East-West, “because for the first time such an activity involves people living with HIV. This is their first attempt to tell the society about their feelings, fears, problems, and dreams, thus striving to elicit a more tolerant attitude toward HIV and AIDS”.

According to the latest official figures, approximately 3 400 people are living with HIV in 2007 in the Republic of Moldova.

AIDS Foundation East-West (AFEW)  is a Dutch nongovernmental humanitarian organization working in the field of public health to reduce the impact of HIV in Eastern Europe and Central Asia. AFEW works in all areas of prevention and treatment, and has gained valuable experience in conducting informational campaigns. AFEW is guided by international best practices which take into account and use the specific mentalities and traditions of the people in every country.

Links:

View the videos
UNAIDS Moldova website
AIDS Foundation East-West (AFEW) website

South African cricket team fielding coach
Jonty Rhodes (left) and wicketkeeper AB de
Villiers (centre) watch a young cricketer hit.
The cricket team visited the Dorothy Bailey
Health Centre in Georgetown, Guyana.
Phot credit:UNICEF/Wilson

“Every wicket counts in cricket, and it’s the same with the fight against AIDS - everybody’s contribution makes a difference.” These were the words of the UNAIDS Country Coordinator for Guyana and Suriname, Dr. Ruben del Prado, speaking during a visit by members of the South African cricket team to the Dorothy Bailey Youth Health Centre in Georgetown, Guyana.

After their close victory over Sri Lanka in the Super 8 stage of the ICC Cricket World Cup 2007, the South African team decided to take some time off and show their support for the health centre and its initiatives for young people living with HIV, the first of its kind in  Guyana.


 Using teamwork to defeat AIDS

Led by Minister of Health Dr. Leslie Ramsammy, UNICEF Guyana Representative Johannes Wedenig and Dr. del Prado, the cricket team was escorted into a crowded hall full of schoolchildren and other guests. Under banners calling people to “Unite for Children, Unite against AIDS”, two local schoolchildren, Murisa and Darren, welcomed everyone and spoke of the need to fight against the spread of the HIV.

Dr. Ramsammy told the assembly that HIV and AIDS was a global problem. “We are all in this together and AIDS can only be beaten if we work as a team,” he remarked.

Mr. Wedenig said it was heartening to see the peoples of South Africa and Guyana joining hands in a common cause. “Knowledge is power,” said Mr. Wedenig. “By empowering children with knowledge to protect themselves, we can win.”

Speaking on behalf of the South African cricketers, the team’s fielding coach, Jonty Rhodes, said that as well-known sportsmen they had the opportunity to highlight global challenges facing society. “ South Africa has a high prevalence of HIV,” he said, and the national cricket team is “committed to doing all we can to raise awareness about HIV, and fight the stigma and discrimination that surround it”.

Through an informal question and answer session with the participating young people and media, the world-famous right-handed batsman reiterated the importance of knowledge, teamwork and endurance in order to successfully fight HIV; similar to the skills needed for winning a cricket match.

Realizing dreams

Saud, a Guyanese student, ties a Band of
Commitment on the wrist of Jonty Rhodes,
the South African cricket team’s fielding
coach at the Dorothy Bailey Health Centre
in Georgetown, Guyana.
Phot credit:UNICEF/Wilson

In a solemn moment, Mr. Rhodes and a Guyanese student, Saud, tied Bands of Commitment on each other’s wrists, as all present pledged to protect themselves and each other against HIV.

South African star bowler, Shaun Pollock, spoke of his three-year-old daughter, “She has dreams just like other kids,” he said. “I need to make sure that she can realize her dreams.”

After the formal ceremony, the visitors toured Dorothy Bailey Health Centre before everyone went outside to play cricket. On a bumpy grass-and-sand wicket next to the centre, Mr. Pollock lobbed soft balls to Minister of Health Dr. Ramsammy, who played a secure, straight bat before being caught in the slips.

The event was one of many taking place across the region on the occasion of the World Cup organized by the partnership between the International Cricket Council (ICC), UNICEF, UNAIIDS and the Caribbean Broadcast Media Partnership on HIV/AIDS, to highlight the situation of children and young people living with and affected by HIV.

This story first appeared on the special ICC Cricket World Cup section of the Unite for Children Unite against AIDS web site – uniteforchildren.org

Prizes have been given out for the “Be smart protect yourself” competition with winners receiving sweatshirts signed by UNAIDS Special Representative Michael Ballack.

The competition was announced in connection with the launch of the UNAIDS Public Service Announcement (PSA) “Be smart protect yourself” featuring Michael Ballack. The footballer talks about HIV prevention and urges young people to make smart choices.

Dressed in a one of the coveted red UNAIDS sweatshirt, Ballack spent a rainy afternoon at the famous London stadium, Stanford Bridge, taping the HIV prevention video. The PSA script was prepared by UNAIDS and produced by partner Aljazeera TV. The announcement is available in both English and German and has been broadcast around the world.

Ballack’s popularity helped reach a large audience – participants from 44 countries entered the competition giving the correct data to a key question – how many people were newly infected with HIV in 2006. The correct answer is an estimate of 4.3 million people. Young people are at particular risk, accounting for 40% of new infections in 2006 among people 15 years and older.

Michael Ballack, captain of the German Football team and worldwide a role model to young people, signed up with UNAIDS in May 2006 as Special Representative and has dedicated time and effort to raise awareness on HIV issues through the mass media and the world of sport. During the 2006 FIFA World Cup Michael Ballack was featured in social marketing advertisements in the German magazine Der Spiegel and in the 60 th anniversary issue of TIME magazine. Ballack has also used new media to draw attention to the issue by posting AIDS awareness messages on his own web site  http://www.michael-ballack.com/.

Football is one of the most popular sports worldwide and sports stars such as Michael Ballack can be important role models for many young people. Sport is also a force for change as it can build self-esteem and important life skills.

On 1 December 2006, UNAIDS joined with a broad range of UN and Thai partners to organize a World AIDS Day event with a difference.

As well as hosting a packed celebration event, Thailand captured international attention with an attempt to create the world’s longest chain of condoms.

And at the end of March, confirmation arrived—at 2,715 metres long, the condom chain sets a new Guinness World Record™.

The tying of the world’s longest chain of condoms was one of the events of the “Condom Chain of Life Festival”, a unique celebration of World AIDS Day, held at Lumpini Park in Bangkok. The festival was organized by the United Nations Educational, Scientific and Cultural Organization (UNESCO) Bangkok in collaboration with the Thai Red Cross, PLAN Thailand, UNAIDS and local NGOs as part of efforts to promote the acceptance of condoms, emphasize the need for safe sex, and encourage strengthening of national policies for comprehensive treatment, care and support for people living with and affected by HIV.

UNAIDS Special Representative Senator Mechai Viravaidya, well known for his groundbreaking HIV prevention efforts in Thailand, led the tying of the chain.

Here, UNAIDS Country Coordinator for Thailand, Patrick Brenny, tells (click on link below to listen to the interview) www.unaids.org about how the World Record attempt came about and its importance to the Thai AIDS response.

Mr. Jorge Sampaio, UN Special Envoy to
Stop TB helping to give out TB treatment
at the Martin Preuss Centre in Malawi.
Photo credit:S.Muguro

Tuberculosis was declared a national public health emergency in Malawi this week. More than 77% of TB patients in Malawi are also HIV positive and TB is the leading cause of death among people living with HIV.

The UN Special Envoy to Stop TB, Mr. Jorge Sampaio and WHO Regional Director for Africa, Dr. Luís Gomes Sambo, attended a ceremony hosted by the Honourable Mrs. Marjorie Ngaunje, Minister of Health, to launch the new five-year plan to

L to R: Dr. Gomes Sambo, WHO
Regional Director for Africa;Hon.
Marjorie Ngaunje, M.P.,Malawi
Minister of Health; Mr.Sampaio,
UN Special Envoy to Stop TB;
Dr. Moeti, WHO Representive,
Malawi

tackle the tuberculosis emergency. The plan seeks to increase access to TB diagnostic and treatment services, improve collaboration between the TB and HIV services and strengthen community involvement.

In Ghana UNAIDS, UNICEF and WHO joined civil society representatives, traditional leaders and politicians to launch a National Stop TB Partnership on World TB Day.

Civil society partners march through the streets to
raise awareness of TB and HIV on World TB Day in
Ghana. Photo credit: T.Erkkola

Collaboration between the TB and HIV programmes has already been fruitful in Ghana but needs to be increased to reduce the high death toll from HIV/TB co-infection.

UNAIDS HIV/TB Adviser, Dr Alasdair Reid, said: “Increasingly we are realising that we cannot address AIDS without addressing TB and vice versa. The best way to do this is through HIV and TB programme collaboration”

Supporting the active engagement of people living with HIV in the AIDS response is one of UNAIDS’ most important goals. Building on its work in this area, UNAIDS has developed a policy brief with recommendations for governments, civil society and international donors on how to increase and improve the involvement of people living with HIV in global, regional and country AIDS responses.

Nkensani Mavasa from South Africa addressing the United Nations
General Assembly on HIV and AIDS in New York. Credit: UNAIDS/J.Rae

GIPA or the ‘Greater Involvement of People Living with HIV/AIDS’ is a principle that aims to realize the rights and responsibilities of people living with HIV, including their right to participation in decision-making processes that affect their lives. GIPA aims to enhance the quality and effectiveness of the AIDS response and is critical to progress and sustainability.

The idea that personal experiences should shape the AIDS response was first voiced by people living with HIV in Denver in 1983. The GIPA Principle was formalized at the 1994 Paris AIDS Summit when 42 countries agreed to “support a greater involvement of people living with HIV/AIDS at all levels and to stimulate the creation of supportive political, legal and social environments”.

GIPA seeks to ensure that people living with HIV are equal partners and breaks down simplistic and false assumptions that those living without HIV are “service providers” and as those living with HIV are “service receivers”.

The new UNAIDS policy brief gives an overview of the context for the policy brief, underlines why this principle is key to the long-term sustainability and development of the AIDS response, highlights some of the challenges to achieving GIPA and outlines a number of actions governments and other bodies need to implement to ensure the principle is put into practice.

“No single agency can provide for the full spectrum of needs of people living with HIV: partnerships between actors are therefore needed,” says Kate Thomson, UNAIDS GIPA focal point. “To enable the active engagement of people living with HIV, UNAIDS urges all actors to ensure that people living with HIV have the space and the practical support for their greater and more meaningful Involvement.”

Governments, international agencies and civil society are urged to implement and monitor minimum targets for the participation of people living with HIV, including women, young people and marginalized populations, in decision-making bodies.

The policy brief also underlines that selection processes should be inclusive, transparent and democratic and that people living with HIV should be involved in developing funding priorities and in the choice, design, implementation, monitoring and evaluation of HIV programmes from their inception. “The engagement of people living with HIV is all the more urgent as countries scale up their national AIDS responses to achieve the goal of universal access to prevention, treatment, care and support services,” states the brief.

Wide ranging benefits

Measuring involvement of people living with HIV in policy is not an easy or exact science; yet, experiences have shown that when communities are proactively involved in ensuring their own well-being, success is more likely. People living with HIV have directly experienced the factors that make individuals and communities vulnerable to HIV infection. As a result, their involvement in programme development and implementation and policy-making will improve the relevance, acceptability and effectiveness of programmes.

An HIV positive woman addressing students at the University of Beijing,
People's Republic of China, during a session organized by a local NGO
to raise AIDS awareness. Credit: UNAIDS/K.Hesse

“Positive people bring the unique perspective of their experience to the range of organizations and agencies working in AIDS, “ says Dr Keven Moody, International Coordinator for the Global Network of People Living with HIV and AIDS, GNP+.

As the policy brief underlines, the benefits of GIPA are wide ranging. At the individual level, involvement can improve self-esteem and boost morale, decrease isolation and depression, and improve health through access to better information about care and prevention. Within organizations, the participation of people living with HIV can change perceptions, as well as provide valuable experiences and knowledge. At the community and social levels, public involvement of people living with HIV can break down fear and prejudice by showing the faces of people living with HIV and demonstrating that they are productive members of, and contributors to, society.

“The participation and contribution of people living with HIV is one of the best examples of global progress in public health. We have come from a place where people openly living with HIV were stoned to death, to a place where we have been invited to stand among the leaders of the world to shape international policies,” said Gracia Violeta Ross, the National Chiar of the Bolivian Network of People Living with HIV/AIDS. “There is still a long way to walk but we have made historical changes and gains of which we can be proud,” she said.

From principle to action: Leading by example

The policy brief draws on examples of policy makers, county and community actions that are transforming GIPA from principle to action. In Tanzania, nearly 80% of Tanzanian parliamentarians are dues-paying members of the Tanzanian Parliamentarians’ AIDS Coalition (TAPAC). Putting the principle into practice, TAPAC engages people living with HIV as advisers and organizes regular roundtable meetings with them to discuss issues. TAPAC members meet people living with HIV in their constituencies and publicly speak up in favour of GIPA. “You cannot plan for [people living with HIV]; you have to plan with them! Political leaders have to stand up for the rights of people living with HIV by enacting laws, budgeting for programmes and also by speaking up in ways that will normalize HIV,” said the Honourable Lediana Mafuru Mng’ong’o, Member of Parliament, Tanzania, Chair of the Coalition of the African Parliamentarians against HIV/AIDS and the Tanzanian Parliamentarians’ AIDS Coalition, who’s ‘voice’ is featured in the UNAIDS policy brief.

“If we want to win the battle against HIV, the full participation of people living with HIV in the AIDS response is necessary. At the same time, people living with HIV need to stand united, they need to strengthen their organizations and they need to speak with one voice in order to influence policy makers and to realize GIPA,” he added.

Russian civil society networks, including people living with HIV, during a
workshop on community-based advocacy and networking to scale up HIV
prevention. Credit: UNAIDS/S. Drakborg

Similarly i n Kazakhstan-also featured in the policy brief— there is a growing movement to engage people living with HIV in the response. Today, the country’s national and local level strategic planning and monitoring and evaluation processes actively engage people living with HIV.

But a s Dr Yerasilova Isidora, Director General, the Republican AIDS Centre (National AIDS Programme) outlines in the policy brief, the involvement of people living with HIV is not always straightforward, or welcomed. In Kazakstan the majority of people living with HIV are injecting drug users and sex workers and involving them in the response is often met with mistrust and opposition. Nevertheless, policy makers have taken a stand and pushed forward the agenda.

“We have managed to identify several partners [among groups and networks of people living with HIV] and have supported them by developing their personal and institutional capacities to become proactive and to make their voices heard,” she explains in the brief. Slowly but surely, Kazakstan is seeing results: In Temirtau, the city facing the largest HIV epidemic in Central Asia, more people living with HIV are openly talking about their status, which is improving public understanding and reducing stigma.

“Positive people have a great deal to contribute towards the challenges posed by AIDS, if they are given the opportunity to spell out their needs on an equal platform with government and non-government organizations.”

At the 6 th annual session of Burkina Faso’s National AIDS Commission, President Blaise Compaoré underlined his personal commitment to fighting AIDS as he chaired the one-day session and called for a scaling-up of the AIDS response towards universal access to HIV prevention, treatment, care and support in the country.

The annual session brought together actors involved in the country’s AIDS response to discuss ways forward in coordination of the response, to outline achievements in 2006 and to agree on action to strengthen AIDS action in Burkina Faso.

The President of Burkina Faso, who also serves as President of the National AIDS Commission, welcomed participants and highlighted Burkina Faso’s commitment to tackling AIDS issues and the necessity to make the country’s response an inclusive one, involving partners from all sectors of society. He outlined the significant results that had been achieved, particularly in Burkina Faso’s HIV prevention strategy, and thanked both public and private sectors for their hard work in the area of prevention.

UNAIDS Director of Country and Regional Support, Michel Sidibe, attended the session and heralded the President’s concrete commitment to AIDS. “The participation of President Compaoré is an example of truly exceptional leadership on AIDS—chairing for 10 hours of the meeting, engaging and motivating all sectors of the response and driving action forward,” he said.

“Burkina Faso is on the right road. The challenge now is to coordinate these efforts to make the response as effective as possible and to make the goal of universal access to HIV prevention, treatment care and support a reality. We at UNAIDS will do all we can to support Burkina Faso in doing this,” he added.

The session was well represented with around 200 people from different sectors of the AIDS response in Burkina Faso including ministers, parliamentary representatives, religious groups, youth groups, women’s organisations, associations of people living with HIV, technical and financial partners, private sector representatives and regional governors. In addition, representatives from National AIDS Commissions from the neighbouring countries of Benin, Mali, Niger, Senegal and Togo were present at the session as well as the UNAIDS Regional Support Team for West and Central Africa.

During the meeting participants reported on and analysed data from 2006 and made specific recommendations in the areas of planning, coordination and technical support; transfer of resources and monitoring and evaluation of the epidemic for 2007 and beyond.

In a communiqué finale issued at the close of the meeting, the National AIDS Commission underlined the recommendations for the country to reinforce coordination and partnerships within the response and to give greater focus and develop specific strategies on the issue of gender and AIDS, fighting stigma and discrimination and improving paediatric treatment and care.

“Burkina Faso has made great progress in the response to AIDS over recent years and the results are encouraging, we have seen a levelling off––and in some urban sites a decline––in HIV prevalence,” said UNAIDS Country Coordinator for Burkina Faso, Mamadou Sakho Lamine. “However, Burkina Faso still has a serious generalised epidemic, increasingly women are becoming infected and there is evidence that new infections are also on the rise among young people. There is still much to be done,” he added.

At the close of the session, President Compaoré called on participants to ‘double their efforts in the fight against AIDS’ and congratulated them on constructive suggestions and recommendations which will help strengthen the AIDS response in Burkina Faso.

UNAIDS Executive Director Dr Peter Piot with the Director General of the World Health Organisation Dr Margaret Chan at the launch of the Global Tuberculosis Control Report in Geneva.

WHO Director General Dr Margaret Chan welcomed the new findings in the report and emphasised that TB needed to be tackled as part of the larger challenge of increasing access to primary health care services.

UNAIDS Executive Director Dr Peter Piot stressed the importance of scaling-up collaboration between the TB and HIV communities if the goal of universal access to quality TB and HIV prevention, diagnostic, treatment and care services is to be achieved.

Director of the WHO Stop TB Department Dr Mario Raviglione warned of the serious threat XDR-TB posed to the global response to AIDS and highlighted the need for greater funding to support research into new diagnostics, treatments and vaccines.

Dr Kevin de Cock, Director of WHO's HIV/AIDS programme welcomed the report's findings and underlined Dr Piot's message of strenghtening cohesion between groups working on TB and groups working on HIV.. 

All photo credit: D.Bregnard

TB ANYWHERE IS TB EVERYWHERE is the theme of this year’s World TB Day. UNAIDS, WHO and the Stop TB Partnership have come together this World TB Day to highlight their commitment to working together in scaling-up TB and HIV programmes and call for increased action on the two diseases.

Statements on World TB Day

HIV/TB features in World TB Day events

Events linked to World TB Day in Ghana and Malawi highlight the importance of greater collaboration between the HIV and TB communities in order to reduce the burden of these leading causes of death.

Read the full story

Global tuberculosis control
report

Launch of the 2007 Global Tuberculosis Control Report

At the launch of the WHO Global Tuberculosis Control Report, UNAIDS Executive Director highlighted the need for TB and HIV communities to scale up collaboration if the goal of universal access is to be achieved. The report, released by WHO, indicates that the worldwide TB epidemic has levelled off for the first time since it was declared a public health emergency in 1993. But despite these signs that the epidemic may be slowing, there are still major impediments to rapid progress against TB - prominent among them being the lack of investment, uneven access to diagnosis and treatment within countries, the emergence of XDR-TB, the inextricable links between HIV and TB and the ageing population.

Global Tuberculosis Control Report
Photo Gallery - Press launch of report 

Photo credit:StopTB/T.Falise

TB ANYWHERE IS TB EVERYWHERE

Tuberculosis is both preventable and curable, so why today is TB still a global emergency? On World TB Day this year experts around the world will be debating this issue and looking into the reasons behind the chronic lack of investment in TB programmes and research.Also on the agenda this year will be the discovery of a strain of TB that is resistant to almost all drugs (extensively drug resistant TB – XDR TB); the deadly synergy between HIV and TB; and the ageing global population––all of which are jeopardizing the ability of TB control programmes around the world to cope.

Read the full story

Photo credit: WHO

Joining forces to tackle TB and HIV 

TB is one of the biggest killers of people living with HIV and at least one third of the 39.5 million people estimated to be living with HIV around the world are likely to be infected with the TB bacteria. As a result of chronically poor investment in global TB control a new strain of TB is emerging that has become resistant to most of the available anti-tuberculosis drugs. Known as extensively drug resistant TB (XDR TB) this strain has serious implications for people living with HIV as it is almost untreatable in many of the countries where it is occurring leading to very high death rates. WHO and UNAIDS, together with other actors working on TB and HIV issues are stepping up action to stop the spread of TB and this deadly new strain. 

Read the full story

Jorge Sampaio, UN Secretary General's
Special Envoy to Stop TB

UNAIDS interviews UN Special Envoy to Stop TB

UNAIDS asks the UN Secretary General’s Special Envoy to Stop TB and former President of Portugal, Dr Jorge Sampaio about his involvement in the fight against TB, its links with HIV and what he sees are the top priorities for HIV/TB collaboration in the future.  

Read the full story

It’s an unfortunate reality that all too often, the people most at risk and most in need of HIV prevention, treatment and care programmes are those least likely to have access to these services. According to latest estimates, only one in ten people ‘most at risk’ has access to prevention services. In many cases, for injecting drug users, sex workers and men who have sex with men, AIDS poses a double burden—on the one hand, there are a very limited number of programmes specifically designed to reach them, and on the other hand, they are often faced with discrimination, stigma and in some cases even criminal prosecution by the societies they live in.

But evidence and experience shows that focusing AIDS programmes and services specifically on people who are most at risk leads to encouraging progress within the response and can help reduce stigma and discrimination.

This month’s review of the UNAIDS Best Practice collection looks at the issue of men who have sex with men (MSM) in the Asia and the Pacific region and the focused programmes implemented in six countries that are showing progress.

In Asia, men who have sex with men are disproportionately affected by HIV. It is estimated that HIV prevalence is as high as 14% in Phnom Penh, Cambodia; 16% in Andrha Pradesh, India; and 28% in Bangkok, Thailand.

Men who have unprotected sex with men may also have unprotected sex with women and thus serve as an epidemiological bridge for the virus to the broader population. For example, a survey of over 800 men in China who have sex with men found that 59% reported having had unprotected vaginal sex with women in the previous year.

“It is a commonly held misperception that male-male sex happens only among men who self identify as ‘gay’. Most men who have sex with men living outside the West are not identifiable as such, they live and work in their communities unremarked and are often heads of families with children,” the Best Practice outlines

“HIV transmission prevention programmes addressing men who have sex with men are therefore vitally important. However, this population is often seriously neglected because of official denial by governments, the relative invisibility of men who have sex with men, stigmatization of male-to-male sex, ignorance or lack of adequate information,” it says.

The MSM programmes, implemented in Bangladesh, India, Indonesia, the Philippines, China and New Zealand, were chosen to be part of the UNAIDS Best Practice collection due to their success in providing comprehensive interventions that engage all actors involved in the AIDS response.

Although different in their make-up, the programmes have common elements and activities that have proved to be effective in reaching and supporting men who have sex with men on AIDS issues in Asia.

Advocacy activities with governments, health services and mainstream communities are common to all programmes. In Bangladesh, successful advocacy from the Banhu Social Welfare Society, including networking and participation in governmental meetings, has ensured the inclusion of issues relating to men who have sex with men in the five-year National AIDS Strategic Plan. In Indonesia, the Aksi Stop AIDS and Family Health International programme have worked hard to engage the authorities in the AIDS response. The Indonesian Ministry of Health is now recognising the seriousness of the situation and communities of men who have sex with men have been invited to participate in consultations on AIDS-related issues.

The Best Practice publication highlights a number of interesting outreach activities that some of the programmes are implementing. For example, in Hong Kong, the ‘AIDS concern’ organization set up a programme focusing on customers of saunas. Materials promoting safer sex such as leaflets, comic books and information brochures were produced and distributed across 13 saunas and outreach workers met with owners and staff to foster relationships and assess the situation. Increasingly, condoms, and lubricant were also distributed. “Good relations between the outreach workers and the sauna owners continue and there have been increased opportunities for contact with clients as a result of testing services. As a result clients are less apprehensive,” the publication states.

The programmes highlighted in the publication underline that activities implemented by people living with HIV have been proven to be more effective and help to further break down AIDS-related stigma and discrimination.

Know your epidemic

As the Best Practice outlines, in many countries, prevention efforts are hindered by laws that criminalize male-male sex, making work with men who have sex with men difficult and hindering their contribution to the response to the epidemic. Where social, cultural and religious attitudes make the issue politically sensitive, politicians are generally reluctant to support policies and programmes that might result in public criticism from community leaders and groups .

HIV prevention programmes for men who have sex with men like those featured in the Best Practice are vitally important to stop HIV transmission. However, lack of research about men who have sex with men including their behaviours and attitudes, and criminalization and stigmatization of and legal discrimination against these men, are also significant barriers to implementing effective programmes. Research was an integral part to the success of the AIDS Concern sauna outreach activities in Hong Kong – as part of the activity a research project was undertaken to determine the prevalence of high risk behaviours among sauna clients, levels of access to free condoms and lubricant, and the nature of information materials that would be best suited to sauna clients.

Through the examples of the six MSM programmes, the publication underlines that HIV programming for men who have sex with men needs to be carefully tailored to local cultures and conditions. Rather than relying on approaches based on patterns of male-male sexual behaviour observed in Western Europe and North America, local sexual minorities should be identified and engaged in developing programmes. In New Zealand, the New Zealand AIDS Foundation promotes the use of a community’s cultural resources to make AIDS information materials relevant and attractive. Designs, images, colours, language and models are used which are instantly recognizable as belonging to either the Maori or Pacific Islander communities.

As the Best Practice underlines, UNAIDS supports a range of responses aimed at reducing the vulnerability of men who have sex with men to HIV and its impacts including the promotion of high-quality condoms and water-based lubricants, ensuring their continuing availability; safer-sex campaigns and skills training; peer education among men who have sex with men and female partners; and strengthening organizations of self-identified gay men, enabling them to promote and rapidly increase HIV prevention and care programmes for men who have sex with men.

“Twenty five years into this epidemic, the reality is that only one in ten men who have sex with men have access to HIV prevention services. This is a massive failure, and setting it right has to be among the highest priorities for the increasingly strong global AIDS response as we aim to achieve universal access to HIV prevention, treatment, care and support for all groups, including men who have sex with men and transgender people,” said Purnima Mane, UNAIDS Director of Policy, Evidence and Partnerships.