Estimating the number of men who have sex with men in low and middle income countries

Abstract

Objectives: To collect and analyse published and unpublished surveillance and research data on the prevalence of same sex sexual activity among male adults (including male-to-female transgenders and sex workers) in low and middle income countries. Methods: Key indicators were operationalised (ever sex with a man, sex with a man last year, high risk sex last year (as defined by unprotected anal sex or commercial sex)) and a database was designed for data collection. Searches were conducted (PubMed, databases (US Census Bureau, World Bank, conferences)) and regional informants helped. Reference reports were used to assess the methodology and quality of information in each record. The best data available per region were identified and indicator estimates were used to propose regional range estimates. Results: Of 561 studies on male sexual behaviour and/or MSM population characteristics, 67 addressed prevalence of sex between men, with diverse numbers per region and virtual unavailability in sub-Saharan Africa, Middle East/North Africa, and the English speaking Caribbean. Overall, data on lifetime prevalence of sex with men (among males) yielded figures of 3-5% for East Asia, 6-12% for South and South East Asia, 6-15% for Eastern Europe, and 6-20% for Latin America. Last year figures were approximately half of lifetime figures, and prevalence of high risk sex among MSM last year was approximately 40-60% in all regions except South Asia, where it is 70-90%. Conclusions: Data available on the prevalence of male same sex sexual activity across regions are scarce (non-existent in some areas), with validity and comparability problems. In South and South East Asia, Eastern Europe, and Latin America, a lifetime prevalence of 6-20% was estimated, with smaller figures in East Asia. A cross cultural analysis of terminology and practices is needed, as is continued work on epidemiological and social analysis of male-male sexual practices in societies across regions. D ata on HIV transmission through sex between men, and on the incidence and prevalence of HIV and other STIs among men who have sex with men (MSM), are very poor in most of the developing world, perhaps with the exception of Latin America.1 The most glaring data gaps are in Africa, Central Asia, Eastern Europe, and the Middle East. Even in South and South East Asia, Latin America, and the Caribbean, where relatively more information is available, the contribution to the HIV/AIDS epidemic of male same sex sexual behaviour is not fully appreciated, in part due to either a lack of data or lack of analysis of the available data. A limited number of more detailed recent epidemiological studies have shown that both prevalence of same sex behaviour and prevalence of HIV among MSM are higher than previously thought.2 3 In regions where HIV prevalence among MSM is known to be high since the beginning of the epidemic (for example, in urban centres of Latin America), data show that HIV prevalence still remains very high among MSM, even though the epidemic has expanded to other...

Sexual Practices and HIV Prevalence amongst Men Who Have Sex with Men at a Community-Based Voluntary Counseling and Testing Centre in Malaysia

“…From these 3 groups, HIV is steadily expanding into lower-risk populations through transmission to the sexual partners of those most at risk [14]. e prevalence of male-to-male sex in 2008 in Southeast Asia was estimated to be between 6% and 12% [15]. Between 2005 and 2008, the MSM populations in several Southeast Asian countries have been estimated to be 766,000 in Indonesia, 240,000 in Myanmar, and 560,000 in ailand [13].…”

Asociación entre el consumo de alcohol y la infección por virus de inmunodeficiencia humana

“…La infección por VIH ha sido asociada a bajos niveles económicos así como a pobres niveles de educación 2,18,19 . En este estudio, la asociación es más fuerte con el ingreso económico.…”

A critical analysis of Peru's HIV grant proposals to the Global Fund

“…This was the case not only with the transgender population but also of sex worker sub-populations (Hwahng & Nuttbrock, 2007;Cáceres, Konda, Pecheny, Chatterjee, & Lyeria, 2006). Nevertheless, the term MSM was maintained in the last two proposals, and such generalisation delayed consideration of specific interventions targeting sub-populations, which would have improved the strategies in place.…”