“Such poor levels of access at the global level are unacceptable,” said Dr. George Ayala, executive director MSMGF, in a media release issued this week.
“The differences in access by country income are especially important to note as the Global Fund moves into a new funding model where countries are grouped into bands by income level. Even in upper middle income countries, MSM still have extremely low access to services. Without targeted funding to MSM and other key populations, the new funding model may continue to deteriorate levels of access for the groups most affected by HIV,” Ayala continued.
Country income, homophobia and stigma continue to stand in the way of treatment and prevention, the report states. “Homophobia, provider stigma, and negative consequences for being out as MSM were significantly associated with reduced access to services.”
Ayala believes that the best way to address these barriers is to build community-based organizations.
“Successfully addressing HIV among MSM will require a real effort to address structural barriers, and the findings from this study suggest that investing in MSM-led community-based organizations may be the best way to do that,” said Ayala.
While global access to care is limited, researchers at Emory University working on the six-year EnhanceLink project this week stressed the importance of access to care for those who have been in jail or recently were released from jail.
The program was instituted in 20 jails throughout the United States and voluntarily tested more than 210,000 inmates for HIV between 2007 and 2011. As a result, nearly 10,000 HIV-positive persons were offered services like education and treatment once leaving the facility.
“Of all the life events that knock people out of HIV care, going to jail is one of the biggest disrupters. And we know that HIV prevalence among jail detainees is higher than the general population, which creates a great public health need to connect these infected detainees to services during jail and after release,” said Anne Spaulding, MD, MPH, assistant professor of epidemiology at Emory’s Rollins School of Public Health.
Emory’s researchers found that those who had accepted care after release were more likely to carry a lower viral load.
“When you treat HIV you want to suppress the virus and get the virus level in the blood so low that it can’t be transmitted to another person. This not only treats and benefits the patient but it is also prevents new cases,” Spaulding said.
Top photo: Percent of MSM reporting that condoms, lubricant, HIV testing, and HIV treatment are easily accessible, organized by country income level using World Bank country income classifications. (PRNewsFoto/The Global Forum on MSM & HIV)