This document discusses gaps in data, funding, and services for men who have sex with men (MSM) and transgender persons in addressing HIV/AIDS. It notes that while the 2011 Political Declaration specifically named MSM, it left out transgender persons. Many countries lack data on HIV incidence, access to treatment, and funding for MSM and transgender communities. The presentation focuses on 9 Asian countries and finds that most do not disaggregate data to show sexual transmission of HIV to MSM and transgender persons. It calls for improved surveillance, increased funding for prevention and treatment, and support for community-led interventions.

1. Zeroing in on the Gaps
The need for better HIV data, funding and services
for MSM and transgender persons
Presented by Clif Cortez
Practice Leader
HIV, Health and Development Practice
UNDP Asia Pacific Regional Centre

2. 2011 Political Declaration
First General Assembly resolution to specifically
name men who have sex with men (Para 29).
The declaration made a specific target of halving
sexual transmissions by 2015
Other commitments relating to human rights,
NSPs, prevention, treatment, advocacy.
However, it left out transgender persons in the
entire document.

3. Data Gaps
To meaningfully develop a set of indicators to measure
progress towards the Political Declaration, data is
missing in many areas, including:
•HIV incidence of MSM and transgender persons in
many countries
•% of MSM and transgender persons eligible for ARVs
accessing ARVs
•% of funding for MSM and transgender HIV services
and for community services and advocacy
•Availability of PEP or PrEP

4. Countries
This presentation will focus on the UNAIDS priority
countries supplemented by some additional countries:
•Cambodia
•China
•India
•Indonesia
•Myanmar
•Nepal
•Philippines
•Thailand
•Vietnam

5. Sexual Transmission
Cambodia, Nepal and Vietnam do not disaggregate
data on sexual transmission of HIV. Furthermore,
Myanmar and Thailand do not disaggregate MSM
sexual transmission. None of the 9 countries
disaggregates data for transgender sexual
transmission.
Surveillance methodologies need to be updated to
include MSM and transgender sexual transmission of
HIV and the data be disaggregated to be able to
measure the target of reducing HIV transmissions.

6. % of HIV transmission that is sexual
Source: AIDS Datahub

7. % of HIV transmission that is MSM
Based on imperfect data from the 4 out of 9 countries
that disaggregates for MSM
Source: AIDS Datahub

8. Prevalence of HIV

9. % prevention funding on MSM

10. Prevention coverage among MSM

11. % of condom use at last anal intercourse

12. Testing (past 12 months) & know results

13. Towards Zero: current gaps
• Gaps in data
– All countries need to collect and disaggregate data for MSM and
transgender persons, particularly incidence, prevalence,
prevention, treatment and funding data
• Gaps in resources and coverage
– Adequate funding for universal coverage, appropriate services
that are accessible and non-discriminatory, especially given
increasing trends
– Adequate funding for community led interventions, and
community led advocacy
• Gaps in law, policy and human rights
– Already discussed previously at RITA, but issues surrounding
criminalization, recognition of transgender status, non-
discrimination, access to justice are also key.

14. Steps forward
• Build accurate surveillance of HIV incidence among
MSM and transgender to provide baseline
• Increase funding for MSM and transgender HIV
prevention, improve prevention and treatment
coverage and increase the rates of consistent
condom use. The funding need to be
commensurate to the cost of reducing HIV
incidence among MSM and transgender
communities by 50% by 2015.
• Increase funding for community organizations
engaging in health service delivery, advocacy or
community mobilization.