|AIDS and Men Who Have Sex with Men (Best Practice - Points of View) (UNAIDS, 1998, 8 p.)|
· Sex between men occurs in most societies. Its existence, and its importance for AIDS prevention, though, are frequently denied.
· Many men who have sex with men (MSM) do not see themselves as homosexual. Many are also married or have sex with women. In some regions, there is a high level of bisexual behaviour among MSM. In Mexico City, for instance, a survey of men who engaged in same-sex activities found that 56% also had sex with women.
· Anal sex, which is often practised in sex between men, carries a high risk of transmission of HIV, when the virus is present and when condoms are not used.
· Sex between men is the main route of transmission of HIV in some parts of the world. In some other places it is a secondary route of transmission. Nearly everywhere, it is a significant and interconnected part of the epidemic and needs to be taken seriously into consideration.
· Some 5 10% of all HIV infections worldwide are due to sexual contact between men, but the figures vary considerably from one place to another. In North America, parts of Latin America, most of Europe, Australia and New Zealand, the rates are often as high as 70%.
· The key steps that need to be taken to deal effectively with HIV transmission in male-to-male sex are:
· for political leaders and all other key players to accept that sex between men exists, and is relevant to AIDS prevention, care and support work
· for national AIDS programmes to include the issue of male-to-male sexual transmission of HIV in their planning and implementation
· for donor agencies to commit themselves to giving serious consideration to funding AIDS prevention, care and support among MSM
· for both governments and nongovernmental organizations (NGOs) to promote safer sex and the provision of condoms, conducting programmes involving: outreach work; peer education projects; and mass media and small media campaigns, as appropriate
· for national AIDS programmes and other partners to encourage the creation of gay organizations and strengthen existing networks of men who have sex with men
· for national AIDS programmes and other partners to reproduce or expand HIV prevention approaches that have proved successful among MSM, locally and abroad
· for political leaders and influential people in society to support HIV programmes directed at MSM
· for national AIDS programmes and donor agencies to ensure that effective HIV interventions among MSM are maintained. In the past, good projects have sometimes been stopped, or had funding decreased, when it was thought that they had been successful, or that the risk to MSM had declined.