TY - JOUR
T1 - The global response to HIV in men who have sex with men
AU - Beyrer, Chris
AU - Baral, Stefan D.
AU - Collins, Chris
AU - Richardson, Eugene T.
AU - Sullivan, Patrick S.
AU - Sanchez, Jorge
AU - Trapence, Gift
AU - Katabira, Elly
AU - Kazatchkine, Michel
AU - Ryan, Owen
AU - Wirtz, Andrea L.
AU - Mayer, Kenneth H.
N1 - Funding Information:
CB has received grants from Centre for AIDS Research, Johns Hopkins University, and US National Institutes of Health (NIH) and National Institute of Allergy and Infectious Diseases (NIAID; P30AI094189). KHM has received grants from Harvard University Center for AIDS Research. The views or opinions expressed in this paper are those of the authors and not of UNAIDS.
Funding Information:
Public and private sector donors continue to play a crucial role in supporting MSM programmes in low-income and middle-income countries. Notable government donors include Denmark, France, Germany, Ireland, Norway, Sweden, the UK, and the USA. Of concern, several of these countries with progressive approaches to key populations, including Denmark, Norway, and Sweden, have recently reduced their investment in global AIDS. Active foundation donors include the Bill & Melinda Gates Foundation, Elton John AIDS Foundation, the MAC AIDS Fund, ViiV, AIDS Fonds, and The Foundation for AIDS Research (amfAR). The Robert Carr Civil Society Networks Fund has emerged as an important funder of worldwide and regional networks working to advance the response in inadequately addressed populations, including gay men and other MSM. 8 Since 2013, the fund has invested more than $18 million in civil society organisations and the networks that facilitate their coordination.
Publisher Copyright:
© 2016 Elsevier Ltd
PY - 2016/7/9
Y1 - 2016/7/9
N2 - Gay, bisexual, and other men who have sex with men (MSM) continue to have disproportionately high burdens of HIV infection in countries of low, middle, and high income in 2016. 4 years after publication of a Lancet Series on MSM and HIV, progress on reducing HIV incidence, expanding sustained access to treatment, and realising human rights gains for MSM remains markedly uneven and fraught with challenges. Incidence densities in MSM are unacceptably high in countries as diverse as China, Kenya, Thailand, the UK, and the USA, with substantial disparities observed in specific communities of MSM including young and minority populations. Although some settings have achieved sufficient coverage of treatment, pre-exposure prophylaxis (PrEP), and human rights protections for sexual and gender minorities to change the trajectory of the HIV epidemic in MSM, these are exceptions. The roll-out of PrEP has been notably slow and coverage nowhere near what will be required for full use of this new preventive approach. Despite progress on issues such as marriage equality and decriminalisation of same-sex behaviour in some countries, there has been a marked increase in anti-gay legislation in many countries, including Nigeria, Russia, and The Gambia. The global epidemic of HIV in MSM is ongoing, and global efforts to address it remain insufficient. This must change if we are ever to truly achieve an AIDS-free generation.
AB - Gay, bisexual, and other men who have sex with men (MSM) continue to have disproportionately high burdens of HIV infection in countries of low, middle, and high income in 2016. 4 years after publication of a Lancet Series on MSM and HIV, progress on reducing HIV incidence, expanding sustained access to treatment, and realising human rights gains for MSM remains markedly uneven and fraught with challenges. Incidence densities in MSM are unacceptably high in countries as diverse as China, Kenya, Thailand, the UK, and the USA, with substantial disparities observed in specific communities of MSM including young and minority populations. Although some settings have achieved sufficient coverage of treatment, pre-exposure prophylaxis (PrEP), and human rights protections for sexual and gender minorities to change the trajectory of the HIV epidemic in MSM, these are exceptions. The roll-out of PrEP has been notably slow and coverage nowhere near what will be required for full use of this new preventive approach. Despite progress on issues such as marriage equality and decriminalisation of same-sex behaviour in some countries, there has been a marked increase in anti-gay legislation in many countries, including Nigeria, Russia, and The Gambia. The global epidemic of HIV in MSM is ongoing, and global efforts to address it remain insufficient. This must change if we are ever to truly achieve an AIDS-free generation.
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U2 - 10.1016/S0140-6736(16)30781-4
DO - 10.1016/S0140-6736(16)30781-4
M3 - Review article
C2 - 27411880
AN - SCOPUS:84982793878
SN - 0140-6736
VL - 388
SP - 198
EP - 206
JO - The Lancet
JF - The Lancet
IS - 10040
ER -