In EECA countries, alarming trends point to a worsening AIDS epidemic among MSM and trans* people. New evidence suggests that the number of HIV-positive MSM continues to increase rapidly in the region, but that the efforts of governments and civil society remain insufficient to stabilize the situation.
Data obtained between 2015-2016 shows that, in Eastern Europe and Central Asia, the HIV epidemic and other epidemics of sexually transmitted infections continue to develop rapidly among MSM.
Regular population studies of groups vulnerable to HIV infection were carried out in only 11 countries, with data from 6 countries (Georgia, Kyrgyzstan, Moldova, Tajikistan, Uzbekistan, and Ukraine) demonstrating a steady increase in the proportion of HIV-positive MSM: a catastrophic increase took place in Georgia (25% of MSM in Tbilisi were found to be HIV positive according to data in 2015, in comparison to 13% in 2012), whereas in the remaining countries, a rapid increase occurred (up to six times higher in Kyrgyzstan).
The prevalence of syphilis in the majority of the countries of the region remains stable (from 2% to 8% in different countries), whereas Tajikistan has seen a twofold increase over the past five years (from 5% in 2011 to 9% in 2015). The stability indicator demonstrates the inadequacy of prevention measures.
Global initiatives, such as “90-90-90”, are focused on accelerating the eradication of AIDS. In particular, these initiatives assume effective HIV testing coverage of vulnerable groups (90%) and beginning ARV therapy immediately after an HIV diagnosis.
However, in the majority of the countries of the region (9 out of 10, for which there is data), less than 60% of MSM are covered by HIV testing services, which is clearly insufficient for the effective control of the HIV epidemic. Data on the coverage of HIV-positive MSM with ARV therapy is available only in Ukraine.
As a whole in the region, the coverage of MSM with preventative services has stabilized around 40-60%. In order to increase coverage, it is necessary to develop new approaches to attract MSM and trans* people to participate in prevention programs with the support of community-based organizations, as well as to prevent discrimination and rights violations on the basis of sexual orientation and gender identity.
In order to properly plan the relevant national budgets, it is necessary to know the population sizes of vulnerable groups. However, special studies on the evaluation of population sizes are only regularly carried out in Georgia and Ukraine. For most countries, data on population sizes are outdated (dating from 5+ years ago).
Together with the increase in HIV prevalence, a decrease in funding from international sources is also taking place – until now, the Global Fund has been the main source of funding for programs targeting MSM, but is currently encouraging countries to transition to national funding for HIV programs. However, the governments of countries of the region refuse to fund targeted programs aimed at MSM and trans* people, arguing that, firstly, these two groups have no significant effect on the growth of the HIV epidemic in the country in general, and, secondly, that prevention and treatment programs aimed at the general population are effective for MSM and trans* people as well.
Changing the position of governments will only be possible by mobilizing organizations and activists from the LGBT community to participate in active advocacy, and by providing them with quality data on the effect of MSM and trans* people on the HIV epidemic and on the effectiveness of existing interventions.
In order to change the existing situation as quickly as possible, ECOM calls upon:
- GAY AND TRANS* COMMUNITIES: to strengthen advocacy sustainability and expand HIV services;
- GOVERNMENTAL STRUCTURES: to ensure national funding of targeted HIV programs for MSM and trans* people;
- INTERNATIONAL STRUCTURES: to provide technical support to communities and governmental structures in the region.