Sunday, July 22, 2007

Sending out a MSM SMS

Kenya may be one of the African countries to get funding for the prevention of the spread of HIV among Men who have Sex with Men (MSM), through a new initiative that seeks to build awareness about this issue in the face of the HIV epidemic.

Speaking about the 4th International Aids Society (IAS) conference in Sydney, Australia, Sam Avrett, a consultant to the Foundation for Aids Research (amFAR) said the MSM funds would initially target seriously affected regions of the world.

"Our funds are still small compared to the need but by the end of the year we are hoping to make initial grants to seriously affected regions of the world such as south Asia, the Caribbean and Africa," said Avrett. He did not disclose the amounts the country would benefit.

Kenya is the most affected country in Africa. According to sero-prevalence studies among small groups of MSM in Nairobi and Mombasa, done by the International AIDS Vaccine Initiative (IAVI), the Population Council, and others last year, Kenya has documented up to a 40 percent HIV prevalence rate among men who have sex with men, the highest reported rate in Africa followed by Senegal at 22 percent prevalence.

Other countries have documented MSM HIV prevalence rates at 28 percent for Bangkok, Thailand, 27 percent in the Ukraine, 21 percent for Uruguay and 16 and 17 percent for Andhra Pradesh and Mahashtra in India respectively.

Foundation for AIDS Research officials said the world's inability to prevent widespread HIV infection among MSM is one of the greatest public health failures in the fight against AIDS-denial, discrimination, and criminalisation lie at the root of this failure.

The high prevalence rates in Kenya and other developing countries are blamed on lack of appropriate health messages and support which makes many men who have sex with men unknowingly engage in behavior that increases their risk of infection.

In Kenya up to half the men who engage in MSM do not use condoms and most of them have no access to HIV prevention, treatment and care services as well as information and they are largely ignored by the government because it is illegal.

Even those who seek Voluntary Counseling and Testing services (VCT) are not advised because the curriculum used to train counselors does not include specialised advice for sex between men. Another missed opportunity for prevention.

With no data available yet as to how many men are engaged in MSM in Kenya, the practice increases the risk of transmission among the populations because some of the men are bisexual, transgendered or heterosexual.

The UNAIDS report on Global Aids epidemic 2006 says globally less than one in 20 men who have sex with men have access to the HIV prevention, treatment and care services they need.

Sex between men is significant in the HIV epidemic because it can involve anal sex, which when unprotected carries a very high risk. At least 5-10 percent of HIV infections worldwide are estimated to occur through sex between men, though this figure varies considerably between countries and regions, says the report.

But Avrett says most governments have also failed to acknowledge that sex between men happens and that unprotected sex contributes to transmission of HIV thus denying their programmes funding.

Kenya like other developing countries is a place where most HIV transmission is through heterosexual relationships and mother-to-child-transmission of HIV/Aids (MTCT) during child birth and breastfeeding.

Sex between men carries a lot of stigma and discrimination and men are not likely to take up HIV prevention, care, support and treatment services. MSM is the most prominent mode of HIV transmission in nearly all Latin American countries, USA, Canada and some Western Europe countries.

The MSM initiative to be launched by the amFAR in Sydney will be with the grassroots organizations providing small, target grants to provide prevention, treatment, care and support services to MSM.

Grassroots organizations have been at the forefront since the beginning of the epidemic, delivering services to vulnerable populations and demanding for greater actions from governments so they will be targeted. In Kenya GayKenya and Galebitra are some of the groups that have been working with MSM.

Grants will also be used to foster increased collaboration among organizations by supporting efforts to share information, and address new challenges, said Avrett to journalists under the National Press Foundation in Sydney, Australia.

"These grants will have an immediate and significant impact on poorer communities with limited resources for MSM. They could also have a multiplier effect helping to attract funding from additional donors," he said.

With sufficient funding and support these organizations are expected to transform community attitudes, drive policy change and mobilize the necessary funding to reverse the alarming spread of HVI among MSM around the world.

Even when countries are beginning to recognize the HIV/AIDS needs of vulnerable groups like sex workers and injectable drug users, MSM are still largely ignored which is fueling the crisis.

Esther Nakkazi
Special Correspondent
The EastAfrican newspaper
1st Floor Short Tower
Crested Towers, Hannington Road
P.O.Box 6100 Kampala, Uganda
Mob: 256-77-2491950


Rainbow said...

Sex Workers are vulnerable for HIV/AIDS in Bangladesh

Mohammad Khairul Alam
Executive Director
“Rainbow Nari O Shishu Kallyan Foundation”
24/3 M. C. Roy Lane
Dhaka-1211, Bangladesh
Tel: 88028628908,

The over all HIV/AIDS epidemics situation is low in Bangladesh. But it is increasing very high in some heterogeneous group who are actually vulnerable of HIV/AIDS. HIV/AIDS spread out very quickly in all over the population. There are many ways in Bangladesh to HIV/AIDS increasing issue.

The cause of poverty, gender discrimination, low prevalence of health facility, lack of reproductively knowledge, illiteracy and high risky behavior may be called epidemic in future of Bangladesh. The atmosphere, which is needed to spread HIV as epidemic of HIV/AIDS, those are present in Bangladesh.

It seems that there are three issues that are appearing to play a crucial position in HIV transmission in Bangladesh: female sex work substance use, Intravenous drug use, professional blood donor and mobility. Female sex workers and their clients have been a major factor in the heterosexual transmission of HIV. Separate but unstable epidemics have been seen in some IDU populations in Dhaka city. And mobile populations, particularly at national borders are at higher risk of HIV acquisition due to the fact of being away from home, community and the anonymity and loneliness of traveling. The following three segments focus on the monitoring of the HIV epidemic in these vulnerable populations.

Commercial/Professional sex workers operate in all over the country. But it is important to know how large the sex-worker population may be to adequately interpret surveillance results. It is hypothetical that in some region, rapid increases in the absolute numbers of sex workers have resulted from significant political, social or economic changes. The nature of sex work and the profile of sex workers vary enormously within and between countries. There are most female sex workers, and those that work full-time, part-time or seasonally. Sex workers may operate in variety of settings such as brothels, riverbanks, bars, parks, under contraction buildings, street corners, hotels, etc. Sex work does not consider in Bangladesh, expect 14 reported brothels. Some HIV/AIDS or social workers suspected that brothel sex worker in Bangladesh is limited, near about 35,000 to 45,000, but other category sex workers is no countable, it is suspected more then 1,00,000. Dhaka city, for example, has approximately 5,000-15,000 female sex workers--an estimate (Source: Rainbow Nari O Shishu Kallyan Foundation). In most Cities, however, validated estimates of the numbers of sex workers are almost non-existent.

All estimates require regular updating and validation but these two approaches are worthy of repetition in other settings. Neither method can work without the trust and involvement of commercial sex workers themselves.

Frequency of exposure to HIV infection through sexual intercourse is the key factor for transmission of HIV among sex workers. For example, there are many countries; a significant proportion of sex workers is infected with HIV. The rates might vary from less than 1 percent to 40 percent or higher in some settings.

Even where HIV infection has not yet increase extensively, STD infection is often very high among sex workers. For example, in one brothel area in Bangladesh, 95 percent of 466 sex workers tested positive to antibodies for genital herpes virus and 60 percent for syphilis, although HIV was not detected among any of them. With the sequence of the epidemic, HIV tends to increase where other STDs are present.

There are many aspects to the nexus of drug use and HIV infection, In most of Bangladesh, people who choose to use drugs (Smoking-drug, morphia, heroin, hashish, Medicare-drug some kinds of sleeping pill, cold syrup, injections etc) that are not all socially sanctioned are treated as entirely outside society, enemies even of the social structure. The factor of Injection/ intravenous Drug Users (IDUs), which is directly can influence of HIV/AIDS, STDs/STI. For the majority of injecting drug users (IDUs), it means that lip-service is paid to the principles supposedly learned through the course of the epidemic: in relation to IDUs and the risks of HIV transmission, issues such as human rights, peer education, community participation, and legal and social change are unachievable fictions.

Besides, better estimation of populations at risk (i.e., those currently injecting drugs, or sex partners of IDUs and populations coming to be at risk), and a better understanding of the dynamics of drug utilization and social association of drug use are all necessary for targeting interventions efficiently.

Populations in Bangladesh are moving across land and sea borders in increasing numbers. International trade supports this growth in population mobility, international border between India and Bangladesh, more than 500 trucks come daily. Also occurring in Bangladesh are high levels of maritime trade, and seamen on fishing vessels travel widely in the region, enabling the transmission of HIV to populations in areas where the virus was previously unfamiliar.

Crossing land or sea borders often requires overnight stays, leaving the individual with idle time and opportunities to visit drinking and gambling establishments and brothels. HIV surveillance data for female sex workers, male STD clinic patients and young males at two sea ports – Cittagong & Mongla --show a clustering of high prevalence sites.

Source: Rainbow Nari O Shishu Kallyan Foundation

Anonymous said...

It is a good initiative, HIV is a problem that concerns the entire planet, many people dont care to be protected or dont care to take exams to see if they have it or not.

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