A new worldwide study of gay men and men who have sex with men (MSM) finds that there are some severe consistent barriers to accessing HIV prevention and treatment services. According to the Global Forum on MSM & HIV (MSMGF), homophobia and stigma serve as barriers to accessing condoms, lubricants, HIV testing, and HIV treatment across the globe, while community engagement and comfort with medical providers facilitated greater access. In addition, the lower a country’s income, the less access MSM in that country have to these important resources:
The report concludes that efforts must be made to ensure gay men/MSN have access to the HIV services required to truly combat the epidemic, including new pre-exposure prophylaxis (PrEP) prevention methods:
In summary, the study findings underscore the need to improve global efforts to ensure that gay men and other MSM have access to basic HIV prevention and treatment services. Structural, community/interpersonal, and individual barriers and facilitators to service access must be addressed at multiple levels; interventions must both disrupt the negative effects of barriers and support the protective effects of facilitators. When considering PrEP implementation, study findings indicate an urgent need for the dissemination of more and better information regarding HIV prevention strategies generally and PrEP in particular.
From the narratives of MSM who participated in this study, it is clear that local and global advocacy efforts are needed to create enabling sociopolitical environments that will increase access to HIV-related services and improve MSM health overall. Securing the human rights of MSM is essential to HIV prevention and treatment strategies, new and old.
The study’s focus groups from Africa noted that many providers proselytize against homosexuality instead of providing HIV prevention, diagnostic, or treatment services. This shaming demotivates MSM to access care in areas where HIV is most rampant. Previous studies have shown that abstinence-only programs (which typically demand celibacy of MSM) and anti-gay stigma and criminalization contribute to higher HIV rates.