At a community meeting in Atlanta, Georgia on March 20th, Kevin Fenton, director of Centers for Disease Control & Prevention’s (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention said, “Our own stigma, our own homophobia, cascades down in our funding and allocations…” Dr. Fenton was recognizing a reality in the United States that has become increasingly apparent to health policymakers throughout the world: that despite high prevalence rates of HIV among gay men and other MSM, funding for HIV prevention, treatment and care consistently neglects these populations, often due to stigma and discrimination.
Our own research at amfAR, the Foundation for AIDS Research, in partnership with the Center for Public Health and Human Rights at Johns Hopkins University has drawn similar conclusions. In our report, “Achieving an AIDS-Free Generation for Gay Men and Other MSM”, we found that MSM are neglected and marginalized by national HIV responses throughout the world, even in countries where MSM are a significant proportion of all HIV infections. For example, in Guyana where MSM account for a large majority of infections, funding to this population was as little as .05% of overall HIV funding from the Global Fund (a major donor in that country).
However there is an even larger reality that is more pernicious than budget cuts. In many settings, MSM are completely neglected by epidemiological surveillance, the data that informs funding flows. In countries like Ethiopia and Mozambique, which have received billions of dollars in aid for their HIV response, epidemiological surveillance of HIV deliberately excludes MSM and other key populations leading to a dearth of programming; this despite several reports that have shown significant epidemics among gay men throughout Africa. Our data reflect a simple truth: if MSM aren’t counted, they aren’t funded.