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3 Dec 2007

new asia pacific statistics reveal an alarming incidence of HIV in MSM

HIV infection rates in some Asian cities in the MSM community are estimated to be anywhere from 5 percent to as high as 32 percent, according to a recent survey. The following report was issued by the Asia Pacific Coalition on Male Sexual Health.

Today, on World AIDS Day 2007, hundreds, perhaps thousands, of men who have sex with men (MSM) will become infected with HIV in cities across the Asia Pacific, becoming the latest statistics in an almost unrecognised but ever-growing crisis that many governments in the region are only just beginning to grapple with. As these efforts take shape, the Asia Pacific Coalition on Male Sexual Health (APCOM) - a regional coalition of civil society groups, government representatives and the United Nations system - is offering its partnership to develop and support new strategies aimed at tackling this regional challenge.

Top and above: In conjunction with World AIDS Day, the Taiwan Tongzhi Hotline Association, AIDS care (Taichung) and Love and Hope Association (Kaoshiung) in association with Taipei's Department of Health have made some 7,000 safe sex kits available. Each kit comprise a wrist/ankle pouch, 2 packs of lube and 3 condoms. The kits can be ordered by party organisers and gay venues for distribution to its patrons at no charge.

Paradoxically, it may be more challenging for APCOM to draw attention to the MSM HIV issue. The recent adjustment downwards of global HIV and AIDS figures has been construed in some quarters as an indication that the AIDS crisis has been "exaggerated" all along. However, APCOM and the stakeholders it represents are urging the Asia Pacific region, and indeed the world, not to confuse the true picture.

Most MSM who contract HIV today in city after city in the Asia Pacific region will never know they harbour the virus until they become ill with advanced symptoms. Without that knowledge, they probably will not change the very behaviours that put them, as well as their partners and loved ones, at risk. A recent survey in a major Asian capital suggested as many as 32 percent of MSM there are HIV positive. In other cities across the region, HIV infection rates for MSM range from estimates anywhere from 5 percent to 15 percent or 20 percent and higher.

"Despite MSM having higher infection rates than the general adult population, the financial investment for HIV prevention, care and support services for this marginalised group across the Asia Pacific is abysmally low in national HIV and AIDS programme planning, usually between zero and four percent," says Shivananda Khan, APCOM Chairperson and CEO of Naz Foundation International.

"Less than one in ten MSM in the region have access to any sort of HIV services, woefully short of the eight in ten that UNAIDS describes as optimal coverage necessary for high-risk groups. Is it any surprise then that we really don't have a clear picture of the true extent of the HIV crisis affecting men who have sex with men?"

Edmund Settle, HIV/AIDS Programme Manager for UNDP China, concurs: "You've got these really alarming statistics of ten, 20, 30 percent HIV infection rates among MSM in some major cities, but when you ask whether this picture holds true across other urban centres, or even in suburban or rural areas, the answer's not at all simple. It ranges from `Yes, it's somewhat likely' to `Well, we're not really certain.' Still, we do know more today than just a couple of years ago."

That growing clarity comes from a recent review of available data, soon to be released by UNAIDS, that describes the epidemiology of HIV and sexually transmitted infections (STI), and behaviours of MSM in the Asia Pacific region that put them at considerable risk of HIV and STI. As the paper states: "Severe and established HIV epidemics are found among MSM in some countries while imminent or beginning HIV epidemics were observed in others." The review also recommends ways to change policy and programming that would confront this challenge and help improve the situation.

"This collection of data in the upcoming review allows us to highlight more accurately than before the extent of the HIV scenario vis-�-vis MSM in our region," according to Geoff Manthey, Regional Advisor on MSM for Asia Pacific UNAIDS Regional Support Team (RST-AP). "It also comes at a most opportune time, with the recent creation of the Asia Pacific Coalition on Male Sexual Health. We hope that the work of APCOM, and its strength in bringing together representatives from governments, the UN system, donors and NGOs side by side with affected communities will finally make the difference in creating a truly regional strategy to address the MSM HIV crisis -- and yes, even though it's an overused word or sounds like a clich�, this is a crisis, make no mistake about that."

In 2006, a year before APCOM's creation, JVR Prasada Rao, director of UNAIDS RST-AP, had warned that "data in Asia show that without interventions, male to male sex will become one of the main sources of new HIV infections in the region."

He added, "We are facing a public health crisis, but you would never know it from the region's almost invisible response so far" - a fact supported by a UNAIDS report published this past August, Men who have sex with men - the missing piece in national responses to AIDS in Asia and the Pacific.

The China Center for Disease Control and Prevention (CCDC) recently stated that HIV prevention for MSM was the latest hurdle for the government's drive to curb a fast-rising AIDS epidemic. In fact, China - the world's most populous nation - was the first country in the region to issue a specific national framework on MSM and HIV, which calls for urgent efforts to engage civil society in a concerted effort to reach out to men who have sex with men. China recently reported that male to male sexual transmission now accounts for 12.5 percent of new HIV cases in 2007, up from 2.5 percent in 2005.

Reflecting the growing regional awareness for enhanced surveillance that incorporates epidemiology as well as socio-cultural awareness, the Center for HIV/AIDS/STI (CHAS) in Laos PDR has conducted the first survey of HIV among MSM in Laos and will soon be releasing the results. As governments and health partners across the Asia Pacific wake up to the realisation that national HIV prevention strategies must include a significant MSM component, APCOM and its partners stand ready to support and strengthen such approaches.

"All of these surveys, these papers, these data and statistics represent hope that our region is making a breakthrough," says Dede Oetomo, who sits on APCOM's interim governing board and is a noted long-time gay activist in Indonesia, a country with limited but successful and well-documented results in HIV and STI prevention among MSM.

"However, the good work that's emerged in recent times also serves as a warning that the hard work now really begins. With the multi-sectoral strength that APCOM provides, we are poised to finally reach out to MSM groups in a way that hasn't been possible before. It's an important, exciting time - full of challenges, yet full of promise. Let's go forward now and get the work done."

The APCOM website, scheduled to be online in early 2008, will be located at www.msmasia.org.

Reader's Comments

1. 2007-12-03 21:36  
instead of saying "in a major Asian capital," why dont they tell us the stats for specific cities?
2. 2007-12-03 23:31  
Because a detailed statistical report on each city could give some people a sense of "Oh! Our scores are not too bad. We're safe!" mentality and thus continue with unsafe sex practices, or worse, start practicing unsafe sex.
3. 2007-12-04 01:30  
Apparently that 'major Asian capital' is most probably with little doubt to be 'Bangkok'.

Any idiot gay will know that...just be monogamous to ensure we dont run such risks...
4. 2007-12-04 05:13  
yes sure here were I am no hear noting about for example in Malaysia deep in country
5. 2007-12-04 09:30  
hi AsianQ,

i mostly agree... but using that logic, it might also compel guys living in high-risk cities to be more careful. i dont think that a vague announcement that there's significant risk in an unnamed somewhere is the best way to influence safe sexual behavior.

perhaps when they launch their website it will include the study's full stats. i hope so.
6. 2007-12-04 10:19  
The stat is bias. It usually represents a very high risk group.
7. 2007-12-04 10:26  
For the most up to date peer-reviewed statistics on HIV / AIDS, go to http://www.unaids.org/en (the Joint UN Programme on HIV / AIDS). This contains links to the WHO databases on HIV / AIDS prevalence rates across the world. Results from surveys that have not been fully validated, that use words such as "suggested" and leave out specifics, such as the name of the city in question, should be treated with caution. Having said that, the situation in the MSM community in Asia and other parts of the world is still alarming, and 32% is not inconsistent with previous surveys. HIV infection rates in MSM vary significantly across Asia, from China 1.5% (Shanghai) / 4.6% (Beijing) to places like Bangkok (28%).

The latest and most accurate statistics are captured in the 2007 AIDS Epidemic Update. You can download the PDF at http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf.

HIV / AIDS is not just an MSM problem, but a much bigger problem, particularly in places like Africa, where infection rates are much higher, particularly in children, mothers, sex workers and drug users. Certainly focusing on messages of safe sex, regular testing and awareness are important for MSM, but we should also think about access to medicines to HIV+ patients. There are some relatively effective therapies for HIV / AIDS - they are not perfect and they have some nasty side effects, but they can give HIV+ patients an almost normal life, with an average life expectancy of 30-40 years post-diagnosis. The problem is the drugs are expensive, and not many people have access to the best medicines. We should all be asking ourselves what we can do to help. Most HIV / AIDS charities support provision of HIV / AIDS drugs to patients in these poorer communities.

Finally, just to put things into perspective, we should also be spending some effort on trying to get people to stop smoking, particularly in places like Singapore. The mortality due to smoking-related diseases is higher than HIV / AIDS. 50% of people who smoke regularly will die from a smoking-related disease, most likely lung cancer or COPD. Almost all those diagnosed with lung cancer will die within 3-5 years, even with the most effective drugs. Some will die within 6 months. Smoking is the single most preventable cause of premature death. About 5 million people die worldwide from smoking every year (3.5 million in developing countries) compared to around 3 million for HIV / AIDS. Across all developed countries, 1.6 million people will die from smoking compared to less than 0.1 million from HIV / AIDS. For more information on the scale of the problem, read http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030442&ct=1.

For what it's worth, my advice:
1) Stop smoking
2) Practise safe-sex (should be obvious)
3) Go for regular check-ups (HIV, gonorrhea, syphilis, chlamydia, hepatitis) if you have multiple partners
4) Donate to worldwide HIV / AIDS charities (or you could also go to the HOPE concert on 13 December)
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12. 2007-12-04 12:26  
sk10600 , we are the high risk group and we must look at ourselves and ask why are we the high risk group.

The problem with us is that we are not capable of controling ourselves. Are we simply that naive to educate ourselves ? Or are a certain portion in our gay community an obstacle to prevention ?. You know who I am talking about.

Let me tell you a story of someone I know, whom contracted HIV in 2004 in Singapore through orgy parties, became revengefull, and continued to infect God knows how many through sex parties around the region and that is almost everywekend. And I believe that this is not just an isolated case.

Sadly, the gay community do not want to talk about HIV or things like that openly. Majority of the gay population is just interested in sleaze. Any mention of HIV or AIDs, all will quiet down or change the subject.

We need to do something to save our community !!
13. 2007-12-04 12:45  
I have just returned to Ausralia form Japan and was appauled that the saunas in Tokyo and Osaka do not provide condoms and lube free to their clients. Do they seek to have as many as possible contract HIV n- they will soon lessen their business if they continue this way as their clients die one by one.
14. 2007-12-04 12:51  
Well it isn't just Bangkok. Singapore's rates are quickly rising and as a poster stated below there are some very irresponsible parties in our community here. Come on! How many times do you see someone on Trevvy, or Gay.com with raw in their nick name or profile. And if you ask these folks about it they get quite defensive, or say they don't care. DON'T CARE! Amazing.
15. 2007-12-04 17:21  
Malaysian spas don't provide condoms because their presence implies illicit activities.
A condom in the pocket is evidence of criminal behaviour in the authorities' minds.
16. 2007-12-04 21:37  
Are the stats trustable?

Pray hard that eventually the epidemic has a total cure. By God's grace.
17. 2007-12-05 13:50  
afternoon, agree with gymhotbod ... something needs to be done ... also think the only ... and single largest ... idiot on this forum is mica ...
18. 2007-12-05 16:41  
Though i wish i can say I have zero energy on this, but the rising rate is quite alarming. All I can say is that... be RESPONSIBLE! That's it! Don't let your casual lifestyle be the one that will affect other people's lives. The world isn't about you and you alone, it also affects close ones around you! So juz drop the selfish attitude and be SAFE always!! =D
19. 2007-12-06 07:51  
I did an online search and came up with this page:
Didn't get the 32% but got an older 28%.


Men who have sex with men (MSM)
MSM are currently a major risk group in Thailand, accounting for about one-fifth of all HIV infections. In Bangkok (Thailand's capital and largest city), HIV prevalence among MSM rose from 17% to 28% between 2003 and 2005. HIV prevalence among MSM younger than 21 years of age tripled in the same period.

It was not until February 2006 that Thailand's first campaign to prevent HIV among MSM was initiated. The seven-month campaign, known as 'Sex Alert', is jointly run by US non-governmental organisation (NGO) Family Health Planning, the Minstry of Health and local NGOs. It intends to provide MSM with information on safer sex through magazine and radio adverts, text messages, posters and the Internet. Flyers, condoms and lubricant will also be distributed.

Before Sex Alert, MSM had generally been neglected by prevention campaigns and had not featured in national AIDS strategies. Sex Alert marks a welcome change, but it is essential that more prevention campaigns target this group to stem rising infection rates.

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24. 2007-12-06 09:24  
The MSM HIV issue is just the tip of the iceberg. There are simply too many of us not tested regularly or worst still, not at all. And many finds that talking about HIV is a great turn-off at any situational conversation. I even come across people whom do not want to be seen at the AFA test centre as they are worried that friends will think that they have contracted HIV.

In my life, I have never come across so many people that I know inflicted with the virus, and it is at an alarming rate. To make matters worst, many of the people that I know, which should also represent the people that you know, have the notion that :

1. The younger lot are fresh from the farm and should be safe.
2. Don't want to know as ignorance is bliss.
3. Don't want to live so long as being old is miserable for gays.
4. He is too gorgeous to have HIV.
5. Since nobody cares, infect more till the message gets through.

Now, many still argue that from all reports, the main % of infection comes from the heterosexuaL. THIS IS VERY MISLEADING as it represent the overall poplulation. If we do have the statistic presented in another way, say 10% of the gay population and 0.000001% of the heterosexual population, what does it shows ?

In reality, nobody can present the true statistic in that way as nobody really knows what is the true gay population in any country. Besides, presenting the truth will further make others have the notion that it is a gay plague.

It's really scary out there. We need to help those infected and prevent further infections. We must start helping ourselves before it is too late.
25. 2007-12-06 20:17  
I too agree with gymhotbod on both counts.

It could only be much more effective if the Singapore health authorities do their basic part in supporting the basic movement. Many would not be able to afford basic treatment for this dreaded disease or care to hope for one anymore when even their own country discriminate against their existence. Countries from China, Taiwan to Thailand offer FREE and subsidized testings/medications for their affected citizens, but NOT Singapore, the only so called "1st world" (BIG yawnzzz) not to. No wonder even Singaporeans say their own country has no soul for the longest time.

And ken34my, you are spot on. But it has always been public knowledge who the largest single most insignificant IDIOT is here on Fridae's forum. Unfortunately, like cockroaches, they keep coming back. Just gotta ignore and stamp them out slowly.

"Post #13 ken34my says (Posted : 05 December 2007 13:50) :

afternoon, agree with gymhotbod ... something needs to be done ... also think the only ... and single largest ... idiot on this forum is mica ... "
26. 2007-12-08 18:37  

jammyboy, (cantonese: pung ngo seong toi ah?) ... just hated mica's insensitive remark ... what "idiot gay" ... who you calling idiot mica ? ... you a nobel guy or what ? ... HIV and AIDS are pretty serious issues ... if your are too smart to ever get infected ... maybe this particular topic is not for you ...

although i know you are pro-gay issues jammyboy, sometimes you are too emotional (or passionate) ... but in a forum, people are to express themselves ... there are bound to be different views ... you cant monopolize a forum and have your views as absolutely right and other's the opposite ...

think of it this way, if it wasnt for people like mica, maybe ... you would be bored to your wits ... ?

good nite ... kenken
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28. 2007-12-09 02:19  
kenny boi, I dun ever have any issues with anyone in this forum cos discourses are expected except with that kampong cockroach, who persistently offends with her extremist and pro-Islamic views and attacks on anything western, especially Christianity. Anyone who caught her rants historically will know the trend.

Learned people offer balanced views and participate in major issues in earnest. But those who pretends, deceives and relentlessly repeat bias here, that's not entertainment, that's offensive. I do buy your point. That's why I hold a ready can of insecticide, extra strong, whenever I read the views here. Just spray. Simple. Thanks for the up & up.

(Cantonese: Du Chei)
PS: I have no idea wat u were trying to say in Cantonese? :)

29. 2007-12-16 17:10  

hey jammyboy ... no problem ... happy holidays ... on a lighter note ... malaysia's MSP has launched a new prepaid package ... aptly titled HAPPY! ... www.happy.com.my ... who are they targeting i wonder ... ? also, heard of world community grid? or fight AIDS at home ? ... www.worldcommunitygrid.org ... merry christmas and a happy 2008 to all!


p.s. (cantonese from TVB serials) ... so here goes ... pung means lift or raise ... or hoist, ngo means me, seong means up, toi means table! ... roughly translate to "put me in the spotlight" ... ;)

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