Priority recommendations for the health sector

Priority recommendations for the health sector
1. Collect strategic information
• Countries should collect strategic information and conduct surveys of MSM and transgender populations,
at a minimum in urban settings (capital and main cities).
• Every country should conduct formative research (if not already undertaken) that focuses on the role and
impact of stigma and discrimination on MSM and transgender people.
• It is crucial for countries to know about and understand sexual networks, especially of young MSM.
• Countries should include appropriate information on MSM and transgender populations, agedisaggregated
wherever possible, during routine HIV and STI surveillance, and case reporting.
• Countries should regularly undertake monitoring and evaluation of interventions focused on MSM.
• Surveillance and surveys of, and research on, MSM and transgender people should adhere to the highest
standards of internationally accepted research ethics, and include them in research design, implementation
and dissemination of results.
2. Provide basic services for HIV and other STIs
• A minimum set of interventions for both service delivery settings and the broader health sector should
include safe access to information and education about HIV and other STIs, condoms, water-based
lubricants, HIV testing and counselling, and STI services.
6 Prevention and treatment of HIV and other sexually transmitted infections
among men who have sex with men and transgender populations
3. Adopt a sexual health approach for MSM and transgender people
• Interventions should be delivered within a framework of sexual health, which includes discussions of
relationships, self-esteem, body image, sexual behaviours and practices, spirituality, sexual satisfaction
and pleasure, sexual functioning and dysfunction, stigma, discrimination, and alcohol and drug use.
4. Define the role of the health sector
• The health sector specifically should address the needs of sexual partners (both male and female) of
MSM and transgender people in their programmes and services.
• The health sector should build on local expertise, and involve both experts and end-users of services in
adapting priority interventions and models of service delivery to address the specific local needs and
situation.
• WHO and its partners should review and revise existing guidelines and training materials for the prevention,
treatment and care of HIV and other STIs to ensure that they adequately address the needs of MSM and
transgender people in a non-stigmatizing way.
• Health-care professionals should be sensitized and helped to overcome their prejudicial, homophobic
and transphobic attitudes.
5. Ensure collaboration, partnership and advocacy
• WHO should promote partnerships between the public sector, civil society and private (for profit and not)
sector to address the prevention and treatment of HIV and STIs among MSM, transgender people and
their partners.
• National AIDS programmes in the ministries of health, with the support of WHO, should build and
strengthen coalitions among civil society and other key stakeholders, including other ministries, to address
the sexual health needs of MSM, transgender people and their partners.
• WHO should take the lead in advocating with other UN agencies and sectors (education, justice, home
affairs, gender, youth, human rights commissions, etc.) on promoting prevention of HIV and STI
transmission among MSM and transgender people, and address homophobia and transphobia, including
in health-care settings.
• WHO, the Joint United Nations Programme on HIV/AIDS (UNAIDS), United Nations Development
Programme (UNDP) and their partners should advocate for the inclusion of interventions to prevent HIV
and STIs among MSM and transgender communities as a part of overall prevention efforts. This can be
done at appropriate events such as ministerial meetings, the World Health Assembly, regional groupings,
among others.
6. Define the role of Regional Offices
• WHO Regional Offices should advocate, disseminate evidence and provide technical assistance to
countries to ensure universal access to HIV prevention, treatment and care for MSM and transgender
populations in all countries in their Regions.
7. Provide resources
• Resources (financial, logistical and human) to support all of the above recommendations must be ensured.
All countries and key funding agencies (including, but not limited to, the Global Fund to fight AIDS, TB and
Malaria) must commit adequate financial and other resources to the prevention, care and treatment of HIV
and other STIs in MSM, transgender people and their partners.
8. Suggested areas for further research
Throughout the consultation, an number of areas were identified, warranting further research which included
assessing the need for provision of human papillomavirus (HPV) vaccination for MSM and transgender
populations, use of rectal microbicides, the role of serosorting and prevention messages in settings where
same-sex relationships are illegal.