HIV prevention that works

HIV prevention that works

When MSM are targeted by HIV prevention campaigns, it can be extremely effective. One study of 33 behavioural interventions aimed at MSM around the world showed that these efforts reduced the number of men having unprotected anal sex by one quarter, and increased condom use by 61%.¹³

One of the most important prevention responses is to make high-quality condoms, along with water-based lubricants, available and accessible to MSM (if suitably strong condoms are not used then they may break, and if oil-based lubricants are used they can damage condoms). In some countries gay bars and other known meeting places for MSM, such as bathhouses, provide and promote condoms and lubricants. Successful prevention work has also been carried out by outreach workers and peer educators, who meet with MSM personally and provide them with condoms, lubricants, and information.

Prevention work with men who have sex with men in India

As is the case with sex workers (another marginalised group who are heavily affected by HIV), many of the most successful programmes aimed at MSM empower this group and actively involve them.

"Empowering MSM and other marginalized groups to protect themselves from HIV is one of the world's most urgent health priorities." - Peter Piot, UNAIDS ¹⁴

Even in countries where homosexuality is not widely recognised, and where HIV services for gay men are severely lacking, groups of MSM have made a substantial difference in some areas. In India for instance, the use of peers to distribute condoms among MSM has resulted in a significant increase in condom use in the city of Mumbai, where a study found that more than two-thirds of condoms used by MSM were those handed out by peer educators.¹⁵

In some countries it has been understood that fighting prejudice and changing public attitudes towards MSM are important prevention measures. In Mexico, the government has appointed Jorge Saavedra, an openly gay, HIV-positive man, as head of its national AIDS council. He has been the driving force behind a large nationwide media campaign to reduce homophobia.¹⁶

Another successful approach has been to introduce ‘safe spaces’ where MSM can meet, talk openly and receive sexual health services, including testing facilities and treatment. MSM have specific STI-related needs but often feel uncomfortable going to conventional public sector health services with their problems.¹⁷

The internet can be another effective means of reaching out to MSM, as increasing numbers of MSM are meeting online – not just in developed nations, but also in countries such as the Philippines¹⁸ and Peru¹⁹. Some websites used by MSM place health advisors in chatrooms, display animated characters to educate people about HIV, and encourage users to be open about their HIV-status.²⁰