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As the HIV/AIDS epidemic continues to spread, new research shows it's taking an increasing toll on men-having-sex-with men or MSM. The issue was addressed at the 18th International AIDS conference in Vienna, with calls for greater funding and human rights efforts.
Activists say men having sex with men have been hit hard by the epidemic, but have not received nearly as much attention or resources as many other groups. They're hoping scientific data on the effects of HIV on MSM - released at the conference - will change that.
Shivananda Khan of India is with Naz Foundation International, which provides technical and development assistance to MSM groups in South Asia. Khan says data from the Johns Hopkins School of Public Health comes none too soon.
"We've been waiting a long time for this data. I've been engaged in this area for 20 years and this is the first time I'm hearing this sort of data when from a day-to-day perspective we watch people every day for the last 20 years, getting infected and dying from HIV," he says.
Who are they?
UNAIDS says the term - Men Having Sex with Men - describes a behavior rather than a group of people. MSM includes self-identified gay, bisexual, or heterosexual men, many of whom, it says, may not even consider themselves gay or bisexual.
In 2008, U.N. Secretary-General Ban Ki Moon said, "In countries without laws to protect sex workers, drug users and men who have sex with men, only a fraction of the population has access to prevention." He added, "Not only is it unethical not to protect these groups; it makes no sense from a health perspective. It hurts all of us."
Khan warns of grave consequences if things don't change.
He says, "Right now, if you look at the data from Asia and the Pacific, if there is no increase in HIV interventions for MSM and transgenders, then something like by the year 2020 - which is only 10 years away - 50 percent of all new infections will be MSM or transgenders."
He says less than four percent of HIV/AIDS funding around the world goes to men having sex with men and transgenders.
"Nine out of ten, nine out of ten MSM and transgenders do not get services. And right now in Asia, every day there are about 200 people - MSM and transgenders - getting infected because they don't have services," he says.
Joel Nana of Cameroon says the answer to the problem is readily available.
"What else are we waiting for? I think we do have the solution. The solution is services that target all the populations."
Nana is executive director of African Men for Sexual Health and Rights. He says besides more prevention and treatment services, MSM need what he calls "an enabling environment."
"An enabling environment has three components. There is the law component. There is the law enforcement component and there is the access to justice component. So if any of these three is not fulfilled, you do not have an enabling environment," he says.
From the pulpit
Churches around the world often get involved in the debate over gay rights. Their reaction has ranged from strong support to tolerance to fierce opposition.
Presbyterian minister Dr. Nyambura Njoroge is program executive of the Ecumenical HIV and AIDS Initiative in Africa of the World Council of Churches.
"Sexuality of men having sex with men is one of the most difficult and contested areas and sometimes religious leaders and followers are known to use violent language in expressing their views. Violent language only creates fear and victimhood," he says.
She says it's important for the religious community to "dig deep" into religiosity and spirituality, adding, "For we know very well that human beings have physical, spiritual and sexual needs."
MSM is a controversial issue that triggers strong emotions. For example, in Malawi two men were prosecuted after they went public with their gay relationship. In Uganda, legislation imposing harsh penalties for homosexuality is before parliament. Similar stories can be found around the world.
Rev. Njoroge says the world's sacred writings all have the same message.
"Human life is sacred. And all human beings are created in the image of God. And so, there is no one who is a misfit in the eyes of God. And I think that is important for all of us who acknowledge," he says.
MSM and transgender activists hope to play a bigger role at the 19th International AIDS Conference in 2012, when it's held in the United States.