Publications

In low- and middle-income countries, substantial resources for the AIDS response come from the largest bilateral, multilateral, and private philanthropic donors and from a country’s contribution to addressing its own epidemic. There is no reliable indication of what overall proportion of these resources ultimately reaches men who have sex with men (MSM) and transgender people. Our objective was to examine major donor investments targeted at these two groups in 2009, but we also recorded relevant information from other years (2008, 2010, and 2011) when available.

This preliminary report is based on the Nepal Multiple monitor progress made over the past decade on children's Indicator Cluster Survey (NMICS), conducted in 2010 by and women's issues. It will also help to identify the regional the Central Bureau of Statistics (CBS) with technical and geographical disparities that exist within the country financial support from UNICEF. The survey is intended, in and will establish a baseline for some newly developed large part, to fill the data gap that has existed in the Mid-Western and Far-Western regions of Nepal in addition to indicators, the progress status of which can be monitored preparing for the national-level MICS in 2013.

There is now overwhelming evidence that the epidemic among MSM (Men who have Sex with Men) is well established and increasing. While some actions are now being put in place on a regional and country basis to address prevention amongst MSM, there has been very little work done in regards to the issues for MSM who are already positive. To fulfil this gap, community-based organisations of positive people linked to the Asia Pacific Network of People Living with HIV (APN+) through a participatory research methodology, learned to design and implement a study to explore the issues affecting positive MSM in the region. This study provides a timely critique on the lack of community-centred discussions surrounding sex, sexuality, and sexual identity. The ongoing global attention on quantifiable markers to health, universal access to treatment, medication adherence and condom use, while certainly important, only skim the surface of deeper quality of life for positive MSM; which necessarily depends on looking deeper into the meanings HIV has had on the lives and stories of those who have to live with it. Thus, it has been found that positive MSM in the Asia Pacific are left to mend their lives, their sexual identities, and relate anew post-HIV with the world outside, the best they can; in many cases with minimal social or institutional support. This gross injustice needs to be redressed if we are truly serious about being sensitive and responsive to the actual needs of communities affected by HIV. Perhaps only then will we have an enabling environment and politics that are yet to be.

The report is intended to provide an evidence-base for: policy makers working in government, regional and multilateral organizations; parliamentarians; members of the judiciary; civil society organizations; donor agencies; and sex workers and their organisations engaged in advocacy to improve the legal and policy enabling environment for HIV responses. The first Asia and the Pacific Regional Consultation on HIV and Sex Work (2010) highlighted the need to document laws and enforcement practices so as to inform advocacy and programming to address the human rights of sex workers. The study focuses on 48 countries of the Asia Pacific region. The study method involves: review of legislation, cases, published research and grey literature; consultations with sex workers, technical experts and UN agencies; and analysis. This consultation draft relates to the Pacific region, Australian and New Zealand. Separate consultation reports have been prepared for the Asian regions. The study focuses on laws and law enforcement practices affecting adults engaged in sex work. The study does not aim to map laws relating to children who are sexually exploited. Although the study considers the relevance of trafficking laws particularly as it affects adults voluntarily engaged in sex work, it does not map all trafficking legislation in detail.

After peaking at 3.2 percent in 1997, Cambodia's HIV prevalence among men and women aged 15 to 49 had dropped to 0.9 percent; it is expected to decline to approximately 0.6 percent by 2012 (Ministry of Health [MOH] 2007). HIV in Cambodia has evolved from a generalized epidemic to one concentrated among MARPs: men who are clients of sex workers as well as their spouses; people who inject drugs; male, female, and transgender sex workers, and MSM.

The present document aims to review the progress of the HIV response in the Asia-Pacific region, with a view to identifying the opportunities for further action afforded by the 2011 Political Declaration. In doing so, it also draws on the expressed commitments undertaken by ESCAP member States to address the HIV epidemic, including those reflected in resolutions 66/10, Regional call for action to achieve universal access to HIV prevention, treatment, care and support in Asia and the Pacific (19 May 2010) and 67/9, Asia-Pacific regional review of the progress achieved in realizing the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS (25 May 2011).

A total of 35 positive HIV cases were confirmed in the Federated States of Micronesia (FSM) as of December 2007 (UNAIDS 2008). The majority (62.8%) of these cases were aged between 25-44 years and 68.5% were male. The main mode of transmission is via heterosexual intercourse. Chuuk accounts for the majority of HIV positive cases in FSM, with a total of 22 cases having been detected up to the time of writing this report. Three of the 22 people who have tested positive a still alive.

The Integrated Behavioural and Biological Assessment is a significant component of the overall evaluation strategy of the Avahan programme. The first round of the IBBA was conducted between 2005 and 2007 and the second round between 2009 and 2010 in the six high prevalence states of India among FSW and their clients, high-risk MSM, transgender, IDU, and truckers.

Heterosexual transmission of HIV in India is driven by the male use of female sex workers (FSW), but few studies have examined the factors associated with using FSW. This nationally representative study examined the prevalence and correlates of FSW use among 31,040 men aged 15–49 years in India in 2006. Nationally, about 4% of men used FSW in the previous year, representing about 8.5 million FSW clients.

New data adds to a growing body of evidence that as well as saving lives, treating HIV can also help prevent HIV transmission, making the scale-up of treatment all the more urgent. In May 2011, a study called HPTN 052 supported by the US National Institutes of Health found a 96% reduction in transmission when HIV-positive persons in a relationship with an HIV-negative person were started early on antiretroviral therapy compared to people whose treatment was deferred.9 Early treatment also significantly reduced the development of tuberculosis, which remains the number one killer of people living with HIV/AIDS. If HIV treatment and prevention interventions are ambitiously expanded, according to UNAIDS, twelve million infections and more than seven million deaths can be averted by 2020. The number of new infections could be reduced by more than half by 2015.