HIV and AIDS Data Hub for Asia-Pacific Review in slides Male Sex Workers Last updated: December 2015

HIV and AIDS Data Hub for Asia-Pacific 2 Data availability and population size estimates HIV prevalence and epidemiology Risk behaviors Vulnerability and HIV knowledge National response CONTENT

Data availability and population size estimates

HIV and AIDS Data Hub for Asia-Pacific Male sex workers (MSW) size estimates, countries where data is available, Country Estimated male sex workers Year of Estimate 1 Bangladesh32, Malaysia5, Nepal12, Highway Districts4, , Kathmandu Valley5, , Pakistan63, Thailand18, Source: Prepared by based on 1.Bangladesh Global AIDS Response Progress Reporting 2014; 2. Ministry of Health Malaysia, & World Health Organization. (2009). National Consensus Workshop: Estimation and Projection of the HIV Epidemic; 3. 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; 4 Pakistan Global AIDS Response Progress Report (Country narrative report); 5. Sub-Technical Working Group on Projection and Estimation, Situation Analysis Working Group. (2012). Size Estimation for Sex Workers, Power Point Presentation at Size Estimation Stakeholder Seminar, 10th January, 2012, Richmond Hotel, Nonthaburi; and 6. Nepal HIV Investment Plan ( ) cited in Nepal Global AIDS Response Progress Report (Country narrative report).

HIV and AIDS Data Hub for Asia-Pacific Inclusion of MSW in latest available sentinel and bio- behavioral surveys 5 Country Sentinel and/or Bio-behavioral surveys Behavioral surveysComment 1 BangladeshIcddr,b Survey among MSM, MSW, and Hijra in Bangladesh 2 Fiji-Behavioural study NepalIBBS 2012 MSM/MSW/TG-SW in Kathmandu valley 4 PakistanSGS PNGIBBS PhilippinesIHBSS Thailand IBBS 2010 HSS 2013 IBBS Source: Prepared by based on HIV Sentinel Surveys and Bio-Behavioral Surveyswww.aidsdatahub.org

HIV and AIDS Data Hub for Asia-Pacific Proportion of MSM who sold sex to men, Source: Prepared by based on 1) Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys; 2) Lan, W., Lu, W., L.Norris, J., Dong-min, L., Wei, G., Zheng-wei, D., & Ning, W. (2012). HIV Prevalence and Influencing Factors Analysis of Sentinel Surveillance among Men who have Sex with Men in China, Chinese Medical Journal, 125(11), ; 3) Bavinton, B., Singh, N., Naiker, D. S., Deo, M. N., Talala, M., Brown, M.,Navokavokadrau, S. (2011). Secret Lives, Other Voices: A Community-based Study Exploring Male-to-Male Sex, Gender Identity and HIV Transmission Risk in Fiji.

HIV prevalence and epidemiology

HIV and AIDS Data Hub for Asia-Pacific HIV prevalence among MSW, countries where data is available, Source: Prepared by based on 1.Integrated Biological and Behavioural Surveys; 2.HIV Sentinel Surveillance Surveys; 3. National AIDS Committee. (2015). Thailand Ending AIDS. Thailand AIDS Response Progress Report Reporting Period: Fiscal Year of 2014; 4.J Zhao, W. Cai, L. Chen, J. Cheng, H. Ma, & X. Wang. (2012). A Comparison of HIV infection and Related Risk Factors between Money Boys and Non-commercial Men who have Sex with Men in Shenzhen, China. Poster presented at the IAS 2012, Washington, D.C., USA.; and 5. * Capital city, **Shenzhen, *** Port Moresby # Average for 5 provinces (Bangkok, Chiang Mai, Phuket, Ratchaburi and Chonburi )

HIV and AIDS Data Hub for Asia-Pacific HIV prevalence data on MSW is scarce but it indicates higher HIV prevalence than FSW in most of the countries, Source: Prepared by based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; 3) icddr,b. (2015). A Survey of HIV, syphilis and risk behaviors among males having sex with males, male sex workers and hijra. Global Fund Rolling Continuation Channel Project of icddr,b; 4) National AIDS Committee. (2015). Thailand Ending AIDS. Thailand AIDS Response Progress Report Reporting Period: Fiscal Year of 2014 ; and * FSW data is for 2011 ** Kathmandu data reported as national; FSW data is for 2011 *** Port Moresby; FSW data is for 2010 **** FSW data is for 2012

HIV and AIDS Data Hub for Asia-Pacific Syphilis prevalence among MSW, countries where data is available, Source: Prepared by based on 1.J Zhao, W. Cai, L. Chen, J. Cheng, H. Ma, & X. Wang. (2012). A Comparison of HIV infection and Related Risk Factors between Money Boys and Non-commercial Men who have Sex with Men in Shenzhen, China. Poster presented at the IAS 2012, Washington, D.C., USA. ; 2.Kelly, A., Kupul, M., et al. (2011). Askim Na Save (Ask and Understand): People Who Sell and Exchange Sex in Port Moresby. Key Quantitative Findings. Sydney: Papua New Guinea Institute of Medical Research and the University of New South Wales.; 3. icddr,b. (2015). A Survey of HIV, syphilis and risk behaviors among males having sex with males, male sex workers and hijra. Global Fund Rolling Continuation Channel Project of icddr,b.; 4.Ministry of Health Viet Nam. (2011). Integrated Biological and Behavioural Survey 2009; 5. National Centre for AIDS and STD Control. (2012). Integrated Biological and Behavioral Surveillance (IBBS) Survey among Men who have Sex with Men (MSM) and Transgender (TG) People in Kathmandu Valley, Nepalwww.aidsdatahub.org

Risk behaviours

HIV and AIDS Data Hub for Asia-Pacific Average duration in the profession of selling sex among MSW, countries where data is available, Source: Prepared by based on 1. icddr,b. (2015). A Survey of HIV, syphilis and risk behaviors among males having sex with males, male sex workers and hijra. Global Fund Rolling Continuation Channel Project of icddr,b ; and 2. National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011www.aidsdatahub.org

HIV and AIDS Data Hub for Asia-Pacific Average number of clients among MSW in the last month, Source: Prepared by based on 1. icddr,b. (2015). A Survey of HIV, syphilis and risk behaviors among males having sex with males, male sex workers and hijra. Global Fund Rolling Continuation Channel Project of icddr,b ; 2. Ministry of Health Viet Nam. (2011). Integrated Biological and Behavioural Survey 2009; 3. National Centre for AIDS and STD Control. (2012). Integrated Biological and Behavioral Surveillance (IBBS) Survey among Men who have Sex with Men (MSM) and Transgender (TG) People in Kathmandu Valley, Nepal; 4. National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011; anc National HIV and STI Surveillance and Strategic Information Unit, National Epidemiology Center, DOH. (2014) Integrated HIV Behavioral and Serologic Surveillance (IHBSS) Report. Manila, Philippines.

HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW who reported condom use at last sex, Source: Prepared by based on 1. icddr,b. (2015). A Survey of HIV, syphilis and risk behaviors among males having sex with males, male sex workers and hijra. Global Fund Rolling Continuation Channel Project of icddr,b. 2. National AIDS Committee. (2015). Thailand Ending AIDS. Thailand AIDS Response Progress Report Reporting Period: Fiscal Year of 2014 ; and 3.

HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW who reported consistent condom use with male clients, Source: Prepared by based on 1. icddr,b. (2015). A Survey of HIV, syphilis and risk behaviors among males having sex with males, male sex workers and hijra. Global Fund Rolling Continuation Channel Project of icddr,b.; 2. National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011.; 3. National Centre for AIDS and STD Control. (2012). Integrated Biological and Behavioral Surveillance (IBBS) Survey among Men who have Sex with Men (MSM) and Transgender (TG) People in Kathmandu Valley, Nepal. ; 4.Askim Na Save (Ask and Understand): People Who Sell and Exchange Sex in Port Moresby. Key Quantitative Findings. Sydney: Papua New Guinea Institute of Medical Research and the University of New South Wales.; 5. Cai, W.-D., Zhao, J., Zhao, J.-K., et al. (2010). HIV Prevalence and Related Risk Factors among Male Sex Workers in Shenzhen, China: Results from a Time–location Sampling Survey. Sexually Transmitted Infections, 86(1), * with one time paying male anal sex partner

HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW who reported transactional sex with female, Source: Prepared by based on 1. icddr,b. (2015). A Survey of HIV, syphilis and risk behaviors among males having sex with males, male sex workers and hijra. Global Fund Rolling Continuation Channel Project of icddr,b..; 2. National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011.; 3.Cai, W.- D., Zhao, J., Zhao, J.-K., et al. (2010). HIV Prevalence and Related Risk Factors among Male Sex Workers in Shenzhen, China: Results from a Time–location Sampling Survey. Sexually Transmitted Infections, 86(1), ; 4.Ministry of Health Viet Nam. (2011). Integrated Biological and Behavioural Survey 2009; 5. National Centre for AIDS and STD Control. (2012). Integrated Biological and Behavioral Surveillance (IBBS) Survey among Men who have Sex with Men (MSM) and Transgender (TG) People in Kathmandu Valley, Nepalwww.aidsdatahub.org

HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW with overlapping risk behaviors, countries where data is available, Source: Prepared by based on 1. icddr,b. (2015). A Survey of HIV, syphilis and risk behaviors among males having sex with males, male sex workers and hijra. Global Fund Rolling Continuation Channel Project of icddr,b. : Technical Report.; 2. National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011.; 3. Ministry of Health Viet Nam. (2011). Integrated Biological and Behavioural Survey 2009; 4. National Centre for AIDS and STD Control. (2012). Integrated Biological and Behavioral Surveillance (IBBS) Survey among Men who have Sex with Men (MSM) and Transgender (TG) People in Kathmandu Valley, Nepalwww.aidsdatahub.org * In the last 12 months; (for Philippines, data is for male entertainment establishment workers) ** In the last month *** In the last 6 months; **** Ever injected drugs; Had sexual partner who inject drugs

Vulnerability and HIV knowledge

HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW with comprehensive HIV knowledge, Source: Prepared by based on 1. UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.; 2. National HIV and STI Surveillance and Strategic Information Unit, National Epidemiology Center, DOH. (2014) Integrated HIV Behavioral and Serologic Surveillance (IHBSS) Report. Manila, Philippines. * Male sex workers and transgender sex workers ** Male entertainment establishment workers

National response

HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW reached with HIV prevention programmes, Source: Prepared by based on National AIDS Committee. (2015). Thailand Ending AIDS. Thailand AIDS Response Progress Report Reporting Period: Fiscal Year of 2014 ; and Definition of reach : Know where to go to receive an HIV test and had been given condoms in the last 12 months

HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW who received an HIV test in the last 12 months and knew their results, Source: Prepared by based on National AIDS Committee. (2015). Thailand Ending AIDS. Thailand AIDS Response Progress Report Reporting Period: Fiscal Year of 2014 ; and * denominator is only those who answered HIV testing related questions and not all surveyed population. 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.

HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response in South Asia 23 Sources: Prepared by based on UNAIDS, AIDS Data Hub, UNODC, UNFPA, and UNDP. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific (October 2014) Sex WorkersMen who have sex with men Criminalize sex work in private Criminalize soliciting Criminalize male- to-male sex Afghanistan YES Bangladesh NOYES Bhutan YES India NOYES Maldives YES Nepal NOYESNO Pakistan YES Sri Lanka NOYES

HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response in South-East Asia 24 Sex WorkersMen who have sex with men Criminalize sex work in private Criminalize soliciting Criminalize male-to- male sex Brunei NOT ILLEGALYES Cambodia NOYESNO Indonesia NOT ILLEGAL NO Lao PDR YES NO Malaysia NOT ILLEGALYES Myanmar YES Philippines YES NO Singapore NOYES Thailand YES NO Timor-Leste NO Viet Nam YES NO Sources: Prepared by based on UNAIDS, AIDS Data Hub, UNODC, UNFPA, and UNDP. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific (October 2014)

HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response in East Asia 25 Sex WorkersMen who have sex with men Criminalize sex work in private Criminalize solicitingCriminalize male-to- male sex ChinaYES NO JapanYES NO MongoliaYES NO DPR KoreaYES NO Republic of KoreaYES NO Sources: Prepared by based on UNAIDS, AIDS Data Hub, UNODC, UNFPA, and UNDP. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific (October 2014)

HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response in the Pacific 26 *Federated States of Micronesia Sex WorkersMen who have sex with men Criminalize sex work in private Criminalize soliciting Criminalize male- to-male sex Fiji NOYESNO Kiribati NOYES Marshall Islands YES NO FSM* YES NO Nauru NO NO INFO YES Palau YES NO Papua New Guinea YESNOT ILLEGALYES Samoa NOYES Solomon Islands NOYES Tonga NOYES Tuvalu NOYES Vanuatu NOYESNO Sources: Prepared by based on UNAIDS, AIDS Data Hub, UNODC, UNFPA, and UNDP. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific (October 2014)

HIV and AIDS Data Hub for Asia-Pacific 27 THANK YOU slides compiled by 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 if slides are lifted directly from this sitewww.aidsdatahub.org