MSM and HIV/AIDS in 2008: Global and Regional Review of 2008 UNGASS Country Progress Reports

In the 2001 Declaration of Commitment, adopted unanimously at the UN General Assembly Special Session on HIV/AIDS (UNGASS), member states agreed by 2003 to "establish national prevention targets ... to reduce HIV incidence for those identifiable groups ... which currently have high or increasing rates of HIV infection." In the follow-up Political Declaration of 2006, members agreed to "Commit ourselves to ... scale up significantly towards the goal of universal access to comprehensive prevention programmes, treatment, care and support by 2010." They further agreed to a goal of "setting up and maintaining sound and rigorous monitoring and evaluation frameworks within their HIV/AIDS strategies."

The most recent step down the road to universal access came in January 2008 when 147 countries submitted reports to UNAIDS analyzing the concrete progress they have made toward implementing HIV/AIDS programs. Progress was charted by reporting on 23 key questions, or UNGASS indicators, five of which pertain specifically to MSM. These five UNGASS indicators seek to answer the following questions:

• What percentage of MSM are living with HIV?
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• What percentage of MSM have taken an HIV test in the last year?

• What percentage of MSM know how to prevent HIV?

• What percentage of MSM used a condom the last time they had sex?

• What percentage of MSM are being reached by HIV prevention programs?

In order to isolate these five indicators and analyze them in detail for this report, amfAR and its research associates downloaded the 2008 UNGASS country reports from the UNAIDS website and reviewed 128 of them, including those from Latin America, the Caribbean, Eastern Europe, the Middle East, Asia, and Africa. The data from this review was compiled into the maps and spreadsheets that appear in this report, and full details from this compilation can be found in Annexes 1, 2, and 4.

A detailed review of the UNGASS MSM indicators is presented in the following pages, beginning with a global overview that summarizes and graphs the reported progress on MSM and HIV. The remainder of this section presents regional breakdowns of the five UNGASS indicators, focusing on middle- and low-income countries.

In addition to reviewing the 2008 UNGASS country progress reports, amfAR research associates spoke directly with leaders around the world who work with MSM populations -- people who see the epidemic and its impact up close every day. Eighteen detailed interviews were conducted with leaders at the local, regional, and international level from major NGOs, governments, and civil society organizations. Information gathered from these interviews augments the picture of MSM and HIV found in the UNGASS country reports and appears in the form of the case studies that can be found in the regional sections of this presentation.