May 19, Washington – Today the office of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) released a technical guidance note to assist PEPFAR administrators in developing health interventions that respond to the unique needs of men who have sex with men (MSM). The guide finds that MSM are on average 19 times more likely to have HIV than the general population in low and middle-income countries, and that dedicated MSM programming is essential to reach this severely at-risk population. Download the guidance here.
The Council is pleased that the guidance reviews best practices in identifying and serving MSM communities. The guidance also calls for PEPFAR support to develop legal environments that allow MSM to access HIV prevention, care and treatment in an affirming and nondiscriminatory manner that respects their human rights. To accomplish this, the guidance explains that PEPFAR resources may be used “to establish laws, regulations and policies that support HIV prevention efforts for MSM.” In simple terms, the guidance recognizes that laws criminalizing homosexual relations and relationships undermine our country’s large international investments, and that PEPFAR resources should also be used to support legal reform. It calls on PEPFAR implementers to offer nondiscriminatory programs and for government leaders to make legislative changes, recognizing that “country leadership . . . is needed to develop and implement, at all levels, any necessary supportive legislation, policies, and regulations.”
The guidance also emphasizes that “PEPFAR prevention, care and treatment programs should be conducted in a manner that is consistent with Department of State’s efforts to advance a comprehensive human rights agenda that includes the elimination of violence and discrimination based on sexual orientation and gender identity.” This may be enhanced, the guidance notes, by co-locating MSM prevention services in community settings that also provide broader social services or legal support to MSM communities.
PEPFAR is our nation’s historic effort to respond to the global HIV/AIDS epidemic. As the largest international investment ever made by any country to combat a single disease, in 2008 Congress authorized U.S. officials to spend $48 billion over the next 5 years to combat global HIV/AIDS, tuberculosis, and malaria. The law also called for PEPFAR administrators to provide “assistance for appropriate HIV/AIDS education programs and training targeted to prevent the transmission of HIV among men who have sex with men (MSM).”
Earlier this year the Council for Global Equality joined other global health leaders in calling on the U.S. Global AIDS Coordinator to issue this PEPFAR guidance. (Read the letter here.) The Council is pleased that the guidance is now available, and we look forward to working with PEPFAR to implement it by directing sufficient financial and technical resources to MSM programming, including appropriate legal reform initiatives in PEPFAR countries.
Download the guidance here.