amfAR, The Foundation for AIDS Research

TREAT Asia to Serve as MSM Secretariat for Mekong Subregion


July 2006—TREAT Asia has signed a contract with Family Health International’s Asia Regional Program to serve as the Regional Coordination Secretariat for a new network of HIV programs for men who have sex with men (MSM) in the Greater Mekong Subregion. The Secretariat will be initially funded by the United States Agency for International Development’s Regional Development Mission/Asia and the US Centers for Disease Control and Prevention/Global AIDS Program.

“Although many people in Southeast Asia are especially vulnerable to HIV and AIDS, no population is experiencing as steep a rise in infection rates as men who have sex with men,” said TREAT Asia Director Kevin Frost. “Risky behaviors such as unprotected sex, commercial sex, and injection drug use tell us that targeted outreach to this population is vital to reducing the number of new infections and improving treatment for those already living with HIV and AIDS.”

Greater Mekong Subregion
The Greater Mekong Subregion encompasses southern China, Myanmar, Laos, Thailand, Cambodia, and Viet Nam.

As Regional Coordination Secretariat, TREAT Asia will be charged with facilitating regional and in-country collaboration among groups that serve MSM in the area. It will focus on enhancing and strengthening a network of more than 80 governmental and nongovernmental organizations in the Greater Mekong Subregion that fight HIV/AIDS among MSM. The hope is that prevention and treatment programs will benefit from greater information sharing, improved communications, better strategic planning, and proper monitoring and surveillance efforts.

The Greater Mekong Subregion stretches along the path of the Mekong River from southern China (Yunnan and Guangxi provinces) down through Myanmar, Laos, Thailand, Cambodia, and Viet Nam. In recent years, countries in this region have seen a rise in the number of HIV-positive MSM. For instance, surveys in Thailand show that in 2003 HIV prevalence among MSM in Bangkok was 17.3 percent. By 2005, that figure had risen to 28.3 percent, an alarming increase of 64 percent. Based on other research undertaken in the Greater Mekong Subregion, the estimated range of HIV prevalence in MSM is between 6 and 30 percent.

The increased prevalence of HIV and associated risk behaviors among MSM represent significant areas of concern, but programs targeting this community in the Greater Mekong Subregion face notable obstacles. Sex between men remains shrouded in shame, silence, and stigma, which, in turn, inhibit access to services. Reported condom use is low among MSM with multiple sex partners. Those MSM who are married remain difficult to reach with prevention, education, and treatment information, leaving them and their families vulnerable to infection. And the paucity of reliable data on MSM in the region limits the efficiency and strategic effectiveness of planned programs.

Local activists agree that a collaborative program is long overdue. “When I first came to Thailand I wanted to work with a gay/MSM-oriented HIV program. To my surprise, there were none,” said Paul Causey, an HIV program consultant in Bangkok who was responsible, with support from the U.S. Agency for International Development, Family Health International, and the U.S. Centers for Disease Control and Prevention, for coordinating and facilitating the initial meetings that eventually led to the creation of the Secretariat. “Now we’re finally working together through the MSM Regional Coordination Secretariat to build up the base of information about MSM in the Mekong region and to help bring regional groups to the same table to strengthen HIV prevention, care, support, and treatment for MSM. It’s an astounding breakthrough for MSM.”

The MSM Secretariat, which will be housed in TREAT Asia’s Bangkok regional office, will provide leadership and support to in-country working groups in three key areas: establishing an operational and administrative support structure; providing and/or coordinating technical assistance; and developing an effective network of groups working on MSM prevention, care, support, and treatment services in the Greater Mekong Subregion.