July 12, 2011
Oakland, Calif. -- A new global survey of more than 5,000 men who have sex with men (MSM) has shown that less than half of MSM around the world have easy access to lifesaving HIV prevention and treatment services. Released on the eve of the 6th HIV Pathogenesis Conference, the survey is the first of its kind to examine levels of access and knowledge regarding HIV services -- including emerging prevention interventions like pre-exposure prophylaxis (PrEP) -- among MSM across all major world regions.
Conducted by the Global Forum on MSM & HIV (MSMGF), the study shows that less than 50% of MSM surveyed worldwide could easily access HIV testing or free condoms. Only 36% of respondents could easily access HIV treatment, and less than a third reported easy access to behavioral interventions and HIV education materials. Levels of knowledge about emerging prevention technologies were also low. Of all study participants, 39% of respondents had never heard of PrEP and 44% had never heard of topical microbicides for preventing HIV.
The study also identified key variables that influenced access to HIV prevention services among MSM. Greater access to HIV prevention services was positively correlated with receiving HIV prevention messages and having access to venues that distribute HIV prevention information. Among all variables, the strongest predictor of compromised access to HIV prevention services was the level of homophobia experienced by participants.
"The results of this study lay bare the enormous role that homophobia plays in undermining the global response to HIV," said George Ayala, Executive Officer of the MSMGF. "Even the most effective prevention, care and treatment tools are useless if discrimination prevents gay men from accessing healthcare services in the first place. More than anything, this data is a call to action."
Significant disparities in levels of access, knowledge and homophobia were observed between regions. Levels of access to HIV prevention and knowledge of emerging technologies were lowest among participants in Asia and the Middle East, followed by participants in other low- and middle-income regions, while these measures were significantly greater among participants in higher-income areas like Europe and North America. Meanwhile, participants from Africa reported the highest levels of homophobia, followed again by other low- and middle-income regions.
Considerable differences also emerged between age groups. Among all age groups, younger MSM reported the lowest access to HIV prevention services, the lowest knowledge of emerging technologies and the highest levels of homophobia.
"Across the board, the trend is alarming -- men who have sex with men are not able to access the services they need," said Pato Hebert, Senior Education Associate at the MSMGF. "But just below the surface, we find that those barriers are enormously complex, varying according to age, region, and other factors. We will need smart, locally-tailored responses to overcome these challenges."
The full report -- Access to HIV Prevention Services and Attitudes about Emerging Strategies: A Global Survey of Men Who Have Sex With Men (MSM) and their Health Care Providers -- is available here.