amfAR, The Foundation for AIDS Research

Mekong Region Beginning to Act on HIV and MSM

Purple Sky Network Helps Put MSM on National Agendas


September 2007—Only a year ago, the Purple Sky Network held its first formal meeting in Bangkok. An association of groups advancing HIV prevention and treatment among men who have sex with men (MSM) in the Greater Mekong Sub-region, the Network adopted immediate goals aimed at deepening communication between MSM groups across the region and strengthening MSM voices within their own countries. Confronted with societies and governments that largely ignored the issues surrounding HIV among MSM, Purple Sky members faced what promised to be an uphill struggle to gain recognition and support for stigmatized MSM.

But the last twelve months have generated a remarkable shift in the landscape. Not long ago, none of the six countries in the Greater Mekong Sub-region included MSM in their national strategic plans for tackling HIV/AIDS; today, all of them do but one. (China does not have a national MSM plan but the two provinces participating in the Purple Sky Network—Yunnan and Guanxi—now do.) A year ago, only Myanmar and Viet Nam had established a national MSM working group; today, every country but Thailand has done so.

"This is a huge change," said Clif Cortez, a member of the Purple Sky Network's advisory board and USAID's Bangkok regional senior advisor. "Prior to the work of the Purple Sky Network, none of the national governments in this region were anywhere near being at the table as partners on MSM and HIV."

As significant as the contributions of the Purple Sky Network have been, the changes unfolding in the Greater Mekong Sub-region are rooted in work that began at least three years before the Network was launched. In 2003, a US CDC study showed that HIV prevalence among MSM in Bangkok stood at 17.3 percent, far higher than 1.5 percent in the general population. This disturbing data kick-started a series of conversations and meetings that eventually resulted in a larger gathering in 2005 of government and community group representatives from the Greater Mekong countries along with international donors. Here, an agreement was reached to create a region-wide network that could give voice to MSM concerns in relation to HIV/AIDS.

"Many governments were invited to this meeting in 2005, and that was the first time government representatives in the Mekong region had come together to discuss MSM issues," said Jack Arayawongchai, coordinator of TREAT Asia's MSM program. This collective regional focus on HIV and MSM had a notable impact, added Martha Scherzer, deputy chief of the US CDC's GAP Asia Regional Program and a Purple Sky Network advisory board member. "There's now a sense that countries need to keep up-to-date with their neighbors in the region."

In Laos, for example, Ms. Scherzer explained that there was "no acknowledgement whatsoever that MSM even existed in their country" prior to 2007, when key government officials attended the nation's first national meeting on MSM and HIV. At the gathering's conclusion, the Laotian government announced that MSM would be included in its next five-year HIV/AIDS plan. "Without the regional approach we've taken," noted Ms. Scherzer, "our Laotian partners would have had a much more difficult time getting MSM into that document."

Comprising more than 80 organizations in the six countries of the Greater Mekong Sub-region—Cambodia, southern China (Yunnan and Guangxi provinces), Laos, Myanmar, Thailand, and Viet Nam—the Purple Sky Network is facilitated by a regional coordination secretariat, hosted by TREAT Asia. The Network first convened last August, and over the following months, national and provincial MSM working group meetings were held in Laos, Guangxi, Yunnan, Myanmar, and Cambodia. Bi-monthly teleconferences have also been held to further communication within the Network, and a skills-building workshop was staged in April to further the organizational and technical capacity of Network members.

In addition to its impact on policy formation within the Greater Mekong Sub-region and its growing organizational strength within individual countries, the Purple Sky Network serves as a "platform for regional collaboration," according to Mr. Arayawongchai. In April, when the Health Policy Initiative wanted to organize an advocacy training, they came straight to the Network, knowing that the secretariat could easily help facilitate such a gathering. UNESCO also approached Purple Sky when they wanted assistance finalizing a reference manual for peer education.

After a successful first year, the full membership of the Purple Sky Network convened for their annual meeting in late August, and one of the main items on the agenda involved planning for the future. "We've done an excellent job of reaching some of our targets and, more importantly, really putting forward the fact of MSM as a key risk group in this region," said Ms. Scherzer. As the epidemic spreads rapidly among MSM in Asia, the Purple Sky Network has shown that first steps can be giant steps in the fight against HIV/AIDS.