Representatives of organisations working on HIV prevention, treatment, care and support among men who have sex with men (MSM) and transgenders from Indonesia, Malaysia, Philippines, Timor Leste and Singapore, as well as government representatives, UN, donor agencies and associated experts decided to establish a subregional network to coordinate and expand their efforts in the region during a meeting held in Denpasar, Bali, Indonesia, Aug 4‐6.

The meeting brought together over 60 participants from these five countries, and was hosted by the Indonesian NGO GAYa NUSANTARA. The meeting was supported by UNESCO, UNDP, USAID and HIVOS. The new network will initially mainly focus on improving country‐level coordination, and also focus on joint advocacy for more resources and coverage of interventions to prevent HIV and expand treatment, care and support for MSM and transgenders.

The meeting was opened by Dr Nafsia Mboi, Chair of the National AIDS Commission of Indonesia. She is affectionately known as Ibu Naf ("Mother Naf") and she had flown in especially for this occasion, taking a break from her busy schedule as Chair of the International Congress on AIDS in Asia and the Pacific (ICAAP) held Aug 9 - 13.

Ibu Naf reminded the participants that "this meeting has special importance because of who you are and who you represent ‐ the millions of men across Insular Southeast Asia* who historically have been unseen, unheard, under‐served and inadequately represented, people of key importance in connection with the HIV epidemic. Today, and in the next few days, you will move forward to build solidarity among yourselves to increase your access to information and resources, as well as effectiveness and ability to act for the direct benefit of MSM, transgenders and your partners across Insular Southeast Asia."

[*The Insular Southeast Asia region is one of eight APCOM-designated Asia Pacific sub-regions that comprises Brunei, East Timor, Indonesia, Malaysia, the Philippines. For more details about the eight sub-regions, visit www.msmasia.org.]

Dede Oetomo, manager of GAYa NUSANTARA and organizer of the meeting, said that "we are only beginning to understand the diversity of male‐to‐male sex in and across the borders of Island Southeast Asian countries. It is also changing rapidly with the spread of the new media". He and others urged research institutions to conduct more research on the dynamics of HIV transmission among men who have sex with men. 

"It has taken us 17 years to get to the point that we are organizing ourselves in a partnership to confront HIV", said Shivananda Khan, Chairperson of the Asia Pacific Coalition on Male Sexual Health (APCOM), of which the new network will become part. "Now let us make sure it will take us less than 17 years to reach our objectives of saving the lives of our brothers, who are getting infected with HIV in growing numbers across the region."

Frits van Griensven of the US Centers for Disease Control had some encouraging words for the participants. "Whereas there is a serious problem already in terms of HIV prevalence among MSM and transgenders in this subregion, the situation is not as bleak as in Thailand and some surrounding countries. There is still time to act. But you have to act quickly!"

One of the challenges discussed at the meeting was the situation of MSM and transgenders in Singapore and Malaysia. Due to the status of these countries as 'developed' or (relatively) 'rich' there is no donor funding available for HIV prevention among those most at risk, especially MSM. "This is a challenge for us", said Stuart Koe, director of Fridae.com, a gay website. 

HIV rates among MSM are raising, also in Hong Kong, Taiwan and Japan. "The authorities of these countries do not invest in HIV prevention for MSM, or at least not enough", Koe said. "This is not different from countries like Cambodia and Vietnam ‐ with the difference that those countries receive significant foreign funding for HIV prevention among MSM."

The meeting concluded that whereas HIV prevention efforts for MSM and transgenders are needed and should be scaled up everywhere, these efforts should not forget the urgent needs for enhanced HIV prevention in so‐called 'rich' countries and territories which do not currently provide sufficient attention to their MSM and transgender citizens.

- HIV among MSM ignites volatile cultural and economic issues (11 Aug 2009)

The risk behaviours among MSM and TG in Asia Pacific combined with the unique social, cultural and economic pressures that influence them create cross-cutting issues that must be taken into account by those seeking to support, educate and advocate for these often neglected communities.

 “The vast majority of MSM is Southeast Asia are married or will be married, whether they want to be or not,” said Shale Ahmed of the Bandhu Social Welfare Society, Dhaka, Bangladesh. “”In China, more than 70 percent of the MSM are in partnership with a woman. Throughout the region, MSM face pressures of fatherhood, lineage, and religion, and many of them unknowingly infect their sex partners in other groups, such as female sex workers and their own wives.”

In addition, a large number of MSM in the region who are sex workers face a double stigma, exacerbated by low access to condoms, drug and alcohol abuse, low levels of education, a high level of mobility and dealing with harassment and violence.

- Gender variance and male-male sexualities across the global south (9 Aug 2009)

- Call for HIV funding at AIDS congress (9 Aug 2009)

- Men who have sex with men face high levels of violence and discrimination across Asia (8 Aug 2009)

Men who have sex with men (MSM) are confronting high levels of violence and discrimination, including rape and forced sex, across multiple countries in Asia which has implications for preventing the spread of HIV.

A brief online survey of MSM experiences commissioned by the International HIV/AIDS Alliance shows respondents had experienced violence from within their communities and at least a third (32%) had experienced arrest, rape, blackmail and violence from police or authorities because they knew they had sex with other men.

“We are seeing MSM subject to high levels of violence. Of particular concern is the level of rape and forced sex that has occurred among this group of men. This is not an issue often considered for MSM. It has implications for HIV prevention programmes and the risks it poses for transmission into the wider community,” said Elden Chamberlain, Asian Regional Representative of the International HIV/AIDS Alliance.

Read the full press release, which includes additional information on Alliance activities at ICAAP.

See the key findings of the survey.

- Satelitte: Cross cutting issues for MSM and HIV (4 Aug 2009)

- Pre-Congress Satellite: The 200 Forum (2 Aug 2009)

- MSM Country Snapshots released (1 Aug 2009)

MSM Country Snapshots for 15 countries have been developed as a collaborative product of UNAIDS Regional Support Team Asia-Pacific, the AIDS Datahub and APCOM. Each 1-page snapshot pulls together the latest epidemiological, behavioural response data available from the Datahub, with information from the Commission on AIDS in Asia Report, and included in some key sessions relating to MSM at ICAAP. A 1-page Regional Picutre snapshot is also attached to each MSM Country Snapshot.