As country delegations to the United Nations gather this week to strengthen their commitment to ending the global HIV epidemic by issuing a new political declaration on AIDS, the Global Forum on MSM & HIV (MSMGF) calls for a re-thinking of global AIDS strategy that elevates evidence-based policies, key populations, and human rights as core pillars of the response.

"Now 30 years into the epidemic, we know that the most effective strategies have been the ones based on evidence, with research informing their targets and delivery," said Dr. George Ayala, Executive Officer of the MSMGF. "In many cases, that evidence has called for attention to key populations like gay men, sex workers, people who inject drugs and transgender people. With more than 33 million people living with HIV and over two million newly infected every year, we can no longer afford to ignore effective evidence-based approaches in the name of cultural norms, religious values or penal codes that violate basic human rights."

Two groundbreaking reports released this week reinforce the fact that tailored responses for key populations are essential to ending the global epidemic. The World Bank published a report today that shows investing in interventions for men who have sex with men (MSM) improves overall epidemic control in all country contexts included in the study. Meanwhile, the Lancet published a new model for financing the AIDS response, arguing that population-based approaches targeting groups at risk represent the most effective and cost-efficient way to bring the epidemic to a halt.

"These reports, taken together, make a clear and extremely well-documented case that the fate of the global epidemic depends in large part on the way we handle HIV among key populations," said Krista Lauer, Policy Associate at the MSMGF. "We must respond appropriately to the needs of key populations if we are to have any hope of reaching our target of zero new infections by 2015."

Key populations represent large portions of regional epidemics, making interventions for these groups an indispensable component of any comprehensive national response. MSM comprise an estimated 25% of people living with HIV in Latin America and the Caribbean, while injection drug use is responsible for over 80% of infections in Eastern Europe and Central Asia. Sex work has been linked to 32% of new HIV infections in Ghana, 14% of new infections in Kenya and 10% of new infections in Uganda. And although it is difficult to find similar data on transgender epidemics, HIV infection rates have been recorded as high as 25%, 35% and 42% among transgender people in El Salvador, Indonesia and India respectively.

"In addressing epidemics among key populations, the evidence argues strongly in favor of an approach founded in human rights," said Ms. Lauer. "Members of key populations around the world are subject to stigma, discrimination and human rights abuses that undermine their ability to access essential services. Little progress can be made without addressing these barriers."

HIV strategies based on human rights have been adopted by the World Health Organization, UNAIDS and a number of other UN bodies. Both of the UN General Assembly's previous consensus declarations on AIDS endorsed human rights as a key feature of successful HIV responses.

"In concrete terms, a human rights approach for key populations means recognizing that there are no excuses for the denial of internationally recognized human rights," said Dr. Ayala. "It means harm reduction, efforts to decrease stigma, and the elimination of policies that exclude or discriminate against MSM, sex workers, people who inject drugs and transgender people. These are not lofty ideals this is what it will take to end the epidemic, period."

MSMGF leadership and staff have been working with key partners at the High Level Meeting in New York to advocate for an approach based on these principles. A final outcome document is expected before the close of the meeting on Friday.

Source: The Global Forum on MSM & HIV