Men who have sex with men

CONTENT Data availability and population size estimates HIV prevalence and epidemiology Risk behaviors Vulnerability and HIV knowledge HIV expenditure National Response

Data availability and population size estimates

Data availability from sentinel and behavioural surveys among MSM, 2009-2012 Afghanistan, Bangladesh, Cambodia, China, Fiji, India, Indonesia, Japan, Lao PDR, Malaysia, Mongolia, Myanmar , Nepal, PNG, Philippines , Rep. of Korea, Singapore, Thailand, Timor-Leste, Viet Nam Afghanistan, Cambodia, India, Indonesia, Lao PDR, Mongolia, Nepal, PNG, Timor-Leste, Viet Nam Afghanistan, Bangladesh, Cambodia, China, Indonesia, Japan, Malaysia, Mongolia, Myanmar , Nepal, PNG, Philippines , Rep. of Korea, Thailand, Viet Nam Source: Prepared by www.aidsdatahub.org based on HIV Sentinel Surveys; Bio-Behavioural Surveys; www.aidsinfoonline.org

MSM size estimates, countries where data is available   Estimated MSM (a) Year of estimate HIV prevalence (b) 1 Bangladesh 21,833-110,581 2010 0 (2011) 2 Cambodia 21,327 2009 2.1 (2010) 3 China 4.1 million (2.7 - 5.4 million) 6.7 (2012) 4 Hong Kong SAR 120,000 2011 4.08 (2011) 5 India 420,000 [High risk MSM, interventions] 3,500,000 [MSM at-risk] 4.4 (2010-11) 6 Indonesia 695,026 ( 423,729- 1,358,527) 8.5 (2011) 7 Lao PDR 17,000 [High risk MSM] 49,330 [All MSM and TG] 4.4 (Vientiane, 2010) 8 Malaysia 173,000 12.6 (2012) 9 Maldives 4,100 0 (2008) 10 Mongolia 11,500 -15,000 (homo and bisexual) 2006 10.7 (2012) 11 Myanmar 224,000 2008 8.9 (2012) 12 Nepal 74,220 (65,864 – 82,330) [High-risk MSM] 256,600 [All MSM] 3.8 (2009) 13 Philippines 390,733-689,529 1.7 (2011) 14 Singapore 90,000 2.8 (2010) 15 Sri Lanka 31,000 (24,000-37,000) 0.9 (2011) 16 Thailand 550,571 7.1 (2012) 17 Timor Leste 11,197 1.3 (2011) 18 Viet Nam 285,388 16.7 (2009) Prepared by www.aidsdatahub.org ; Note: Please see next slide for references (a), (b) National HIV Sentinel Surveillance surveys and Integrated Biological and Behavioral surveys reported in Global AIDS Response Progress Report 2012 and UNAIDS.(2013).Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.

References , MSM population estimation UNAIDS. (2013). Global Report: UNAIDS Report on the Global AIDS Epidemic 2013. Khmer HIV/AIDS NGO Alliance (KHANA) and FHI estimation cited in “ National AIDS Authority.(2011).Cambodia Country Profile on HIV and AIDS 2009-2010: Onwards Towards Universal Access” UNAIDS China. (2009). China AIDS Fact Sheet 2009 Mok, P. (2011). Sex Between Men in Your City. Data provided by UNAIDS Country Office India. Ministry of Health . (2009). Estimasi Populasi Dewasa Rawan Terinfeksi HIV 2009 (In Indonesian Language) National Committee for the Control of AIDS Lao PDR. (2010). National Strategy and Action Plan on HIV/AIDS/STI 2011-2015. and National Committee for the Control of AIDS Lao PDR. (2012). Lao PDR Global AIDS Response Progress Report, 2012. Ministry of Health Malaysia, & World Health Organization. (2009). National Consensus Workshop: Estimation and Projection of the HIV Epidemic. WHO. (2009). HIV/AIDS in the South-East Asia Region 2009. National Committee on HIV/AIDS. (2010). National Strategic Plan on HIV, AIDS and STIs : 2010-2015. Ulaanbaatar. National AIDS Programme Myanmar (2009). HIV Estimates and Projections, Myanmar 2008-2015 HIV/AIDS and STI Control Board, & National Centre for AIDS and STD Control. (2011). Mapping and Size Estimation of Most-At-Risk-Population In Nepal-2011: Vol.1 Male Sex Workers, Transgender, and their Clients. Philippine National AIDS Council. (2011). Estimates of the Most At-Risk Population and People Living with HIV. National STD/AIDS Control Programme, World Bank, UNAIDS, UNFPA, et al. (2012). Technical Support to Design, Implement, and Monitor HIV Prevention Programmes among Female Sex Workers, Men who have Sex with Men and Transgender in Sri Lanka Peerapatanapokin, W. (2012). Estimated sizes of Men who have Sex with Men (MSM). Unpublished Power Point Presentation at Size Estimation Stake-Holder Seminar January 10th, 2012, Richmond Hotel, Nonthaburi, Thailand. National AIDS Programme, Ministry of Health as cited in WHO SEARO (2010).Timor Leste: Epidemiological Situation and Health Sector Response UNAIDS.(2013). Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.

Size estimates of MSM as proportion of adult male population (15-49) years Regional median 1.4%; Range 0.1% - 4.3% Source: Prepared by www.aidsdatahub.org based on size estimates of MSM ( please see the information provided in the previous 2 slides) and the data on adult male population (15-49) years is retrieved from the UN Population Division at http://esa.un.org/unpd/wpp/index.htm

Percentage of men who ever had sex with men, countries where data is available, 2000-2006 * in the last 12 months Sources: Prepared by www.aidsdatahub.org based on 1) FHI, ICDDR, B., & USAID. (2006). Assessment of Sexual Behavior of Men in Bangladesh: A Methodological Experiment; 2) National AIDS Programme Myanmar. (2005). Behavioral Surveillance Survey 2003: General Population and Youth. 3)National Institute of Medical Statistics, & National AIDS Control Organisation. (2008). National Behavioural Surveillance Survey (BSS) 2006: Youth (15-24 Years); 4)Hong Kong,and Lao PDR_ power point presentation by Frits van Grensven, Thai MOPH-US CDC Collaboration, Recognizing and confronting the epidemic of HIV among MSM in South-East Asia, September 2006: and 5) National Statistics Office Philippines, & ORC Macro. (2004). Philippines National Demographic and Health Survey 2003

Prevalence of male-to-male sex among adult male population, their heterosexual behavior and marital status, 2003-2007 Source: Prepared by www.aidsdatahub.org based on Cáceres, C. F., Konda, K., Segura, E. R., et al. (2008). Epidemiology of Male Same-Sex Behaviour and Associated Sexual Health Indicators in Low- and Middle-Income Countries: 2003–2007 Estimates

HIV prevalence and epidemiology

Countries with >5% HIV prevalence among MSM in national estimates from surveys, 2009-2012 Source: Prepared by www.aidsdatahub.org based on UNAIDS.(2013).Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.

HIV prevalence among MSM in selected geographical locations, 2009-2012 Bkk revised Source: Prepared by www.aidsdatahub.org based on National AIDS Committee Thailand. (2012). Thailand Global AIDS Response Progress Report, 2012; HIV Sentinel Surveillance Reports; Integrated Biological and Behavioral Surveillance Reports

Countries/cities with rising HIV prevalence trend among MSM, 2000-2012 China trend updated Source: Prepared by www.aidsdatahub.org based on HIV Sentinel Surveillance Reports; Integrated Biological and Behavioral Surveillance Reports

Cities with stabilizing/ declining HIV prevalence trend among MSM, 2000-2012 Source: Prepared by www.aidsdatahub.org based on HIV Sentinel Surveillance Reports; Integrated Biological and Behavioral Surveillance Reports

HIV prevalence among MSM by region, latest available year, 2008-2012 Lao PDR revised Source: Prepared by www.aidsdatahub.org based on HIV Sentinel Surveillance Reports; Integrated Biological and Behavioral Surveillance Reports; UNAIDS.(2013).Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.

Syphilis prevalence among MSM, 2009-2012 ** Western Province * Capital city Source: Prepared by www.aidsdatahub.org based on 1) HIV Sentinel Surveillance Reports; 2) Integrated Biological and Behavioral Surveillance Reports; 3) Lan, W., Lu, W., L.Norris, J., et al. (2012). HIV Prevalence and Influencing Factors Analysis of Sentinel Surveillance among Men who have Sex with Men in China, 2003-2011. Chinese Medical Journal, 125(11), 1857-1861; 4) WHO, UNAIDS, & UNICEF. (2011). Global HIV/AIDS Response Epidemic Update and Health Sector Progress towards Universal Access Progress Report 2011.

Proportion of newly reported and cumulative HIV cases attributable to homosexual transmission, 2011-2012 * both homo and bisexual ** cumulative HIV and AIDS cases Source: Prepared by www.aidsdatahub.org based on data from Ministry of Health HIV statistics and AIDS registry; Country Global AIDS Response Progress Reports 2012

Correlation between reported homo sexual mode of transmission and HIV prevalence among MSM Source: Prepared by www.aidsdatahub.org based on data from Ministry of Health HIV statistics and AIDS Registry; HIV Sentinel Surveillance Reports; Country Global AIDS Response Progress Reports 2012

Risk behaviours

Mean number of sexual partners among MSM in the last month, countries where data is available, 2006-2010 * Capital city; ** Last 6 months Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys

Proportion of MSM who sold sex to men, 2008-2012 Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys

Proportion of MSM who reported buying sex from male and female, 2006-2012 Bought sex * from male = last month, from female = last 12 months; ** last month for both male and female; *** from male= last 12 months, from female = ever; Mongolia: last 12 months; India: ever for both male and female Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys

Proportion of MSM who had vaginal sex with female in the last year, 2006- 2012 * Capital city; ** Last 6 months, *** Ever Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys

Proportion of MSM reported condom use at last anal sex with male partners, 2009-2012 updated Source: Prepared by www.aidsdatahub.org based on Country Global AIDS Response Progress Reports 2012 and UNAIDS.(2013).Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.

Condom use at last sex and HIV prevention coverage among MSM (arranged by HIV prevalence),latest available year Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Condom use at last sex and HIV prevention coverage among MSM (arranged by level of coverage),latest available year Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Condom use at last anal sex and consistent use among MSM, 2009-2011 Median condom use 66%; Max 85% THL; Min 26% BGD; Count 18 Source: Prepared by www.aidsdatahub.org based on Country Global AIDS Response Progress Reports 2012; Integrated Bio-Behavioural Surveys; and Behavioural Surveillance Surveys

Proportion of MSM reported consistent condom with male commercial partners in the last month, 2006-2010 * Undefined period, HCMC = Ho Chi Minh City Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys

Proportion of MSM reported consistent condom use with non-commercial/casual partners, 2006-2011 Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys; 2) Chan, R., Chio, M., Lim, S., Lo, D., Tan, A., Wong, J., & Loh, B. (2013). Outreach HIV Testing Project in Venues Frequented by MSM - November 2011 to February 2012; 3) Bavinton, B., Singh, N., Naiker, D. S., et al. (2011). Secret Lives, Other Voices: A Community-Based Study Exploring Male-to-Male Sex, Gender Identity and HIV Transmission Risk in Fiji. Suva, Fiji: AIDS Task Force of Fiji

Proportion of MSM reported consistent condom use with male partners, 2009-2012 *Last 3 months; **Last 6 months; ***Last year Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys

Proportion of MSM who inject drugs, 2006-2012 * Capital city; ** Luang Prabang Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys

Vulnerability and HIV knowledge

Percentage of MSM with comprehensive HIV knowledge, by age group, countries where data is available, 2005-2009 * Manipur Source: Prepared by www.aidsdatahub.org based on UNGASS Country Progress Reports 2006,2008 & 2010

HIV Expenditure

Prevention spending in Asia and the Pacific – low on HIV prevention spending among MSM, latest available year reported by countries, 2009-2012 Prevention spending breakdown is not available for China and India Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

AIDS spending by category, 2009-2011 AIDS spending breakdown is not available for China and India Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Proportion of prevention spending by category, 2009-2011 Prevention spending breakdown is not available for China and India Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Amount and proportion of spending on MSM prevention programmes out of total prevention spending, 2009-2011 Data is not available for China Amount spending is not available for India Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org and India UNAIDS Country Office for India data

Trends in proportion of spending on MSM prevention programmes out of total prevention spending, countries with >5% HIV prevalence among MSM in national estimates from surveys Data is not available for China Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

National response

Proportion of MSM reached with HIV prevention programmes in the last 12 months, 2009-2012 Definition of reach : Know where to go to receive an HIV test and had been given condoms in the last 12 months Source: Prepared by www.aidsdatahub.org based on Country Global AIDS Response Progress Reports 2012 and www.aidsinfoonline.org

Proportion of MSM who received an HIV test in the last 12 months and know their results, 2007-2011 * Programme data It is not strictly comparable across countries since methods and sampling varied. In addition, many surveys were conducted in a few urban areas and it might not necessarily reflect prevailing conditions at the national level. Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org and Ministry of Health Indonesia.(2013). Recalculated HIV Testing Coverage for the Global AIDS Response Progress Report Online Reporting using IBBS 2011 Data.

Criminalisation of same-sex sexual activities between consenting adult males in South-East Asia and the Pacific countries South-East Asia   Pacific Brunei YES Fiji NO Cambodia Kiribati Indonesia Marshall Islands Lao PDR FSM* Malaysia Nauru Myanmar Palau Philippines Papua New Guinea Singapore Samoa Thailand Solomon Islands Timor-Leste Tonga Viet Nam Tuvalu Vanuatu Sources: Prepared by www.aidsdatahub.org based on UNAIDS, UNDP, UNFPA, and UNODC. (2013). Punitive Laws Hindering the HIV Response in Asia and the Pacific in August 2013 *Federated States of Micronesia

Criminalisation of same-sex sexual activities between consenting adult males in South Asia and East Asia countries South Asia   East Asia Afghanistan YES China NO Bangladesh Japan Bhutan Mongolia India DRP Korea Maldives Rep of Korea Nepal Pakistan Sri Lanka Sources: Prepared by www.aidsdatahub.org based on UNAIDS, UNDP, UNFPA, and UNODC. (2013). Punitive Laws Hindering the HIV Response in Asia and the Pacific in August 2013

slides compiled by www.aidsdatahub.org THANK YOU slides compiled by www.aidsdatahub.org Data shown in this slide set are comprehensive to the extent they are available from country reports. Please inform us if you know of sources where more recent data can be used. Please acknowledge www.aidsdatahub.org if slides are lifted directly from this site