MSMGF held the Civil Society Hearings Side Event,: Unfinished Business – Taking bolder action to address HIV among gay and bisexual men and other men who have sex with men, at the United Nations in New York City in close consultation with the Global Platform to Fast Track the HIV and Human Rights Responses Among Gay, Bisexual Men and Other Men Who Have Sex with Men (The Platform), and supported by UNAIDS, UNDP, OGAC/PEPFAR, and the Global Fund.

1. Bridging gaps in the HIV
prevention and treatment
continuum of care
The role of MSM-led organizations in the
implementation of public policy
Rafael Mazín; MD;
MPH

3. Really?
• Incident cases have had a meager reduction (13%) in 10 yrs.
• Mortality hasn’t decreased in a significant manner (50K/yr.)
• Transgender persons and gay/MSM still strongly impacted.
• Worrisome trend among young MSM.
• Main emphasis on palliative-reparative paradigm.
The necessary response
seems to be in bad shape

4. Repeated erratic approaches
by IGO’s and governments
• Avoidance to address sexual health-related issues.
• Conflation of populations into amorphous “key” groups.
• Disappearance of members of groups once they are submerged
• into “cascades”.
• Division of labor or defense of territories?
• Tepid policies to face homophobia.

5. Repeated erratic
approaches by IGO’s
and governments
• Whole attention focused on minimally
impacted groups.
• Main interest placed on quantification
rather than on accountability.
• Public policies and plans are vertical
and prescriptive.
• Politically-driven agendas instead of
guided by public health evidence.
• Absence or weakness of mechanisms
to engage CSO’s,

6. • Low attention, if any, to male population;
• Sexual health restricted to reproductive
events;
• Values, beliefs/interests of decision-makers;
• Scarce provisions for dealing with stigma and
discrimination & their impact on health;
• Absence of optimal “packages of services” &
outreach strategies;
Features of the health sector
that affect access, coverage,
and utilization of services by MSM

7. • Incompatibility between working
hours/attention schedules;
• Inadequacy to deal with non-
heterosexual sexual activities;
• No continuum of prevention-care
whatsoever, care limited to
prescription/provision of
pharmaceuticals;
• Limited emphasis by services &
interest of users on prevention,
and of course,
• Homophobia
Features of the health sector
that affect access, coverage,
and utilization of services by MSM

8. • Recognize that affected individuals are often from
marginalized populations and subject to stigma and
discrimination;
• Emphasize prevention so HIV incidence remains
low;
• Plan service delivery to match the distribution of
people most-at-risk of infection and people living
with HIV;
• Define an optimal “package of services” and
outreach strategies.
The necessary responses
by the health sector…

9. • Reframe primary health care for all young &
adult men;
• Plan actions to allow for disclosure of sexual
activity;
• Prepare services and staff to meet the needs
of gay and MSM;
• Implement “packages of services” within safe
and inclusive spaces;
• Ensure appropriate referral and linkages with
other social services, including community
support and outreach actions.
Actions for Expanding Access,
Coverage & Utilization
of Services: the Case of MSM

10. • Identify the size and severity of HIV-related issues
impacting their communities;
• Evaluate the adequacy of the responses carried out by
governments and intergovernmental organizations;
• Participate in planning, monitoring and evaluation
processes in a deep manner, not only as tokens;
• Identify diverse levels of expertise for ensuring constant
representation in political, scientific, academic fora
Necessary Actions to be undertaken by
MSM-led groups and organizations

11. • Keep the community informed on issues relevant to their
health, wellbeing and quality of life;
• Create educational spaces and opportunities to have an in-
depth comprehension about developments on interventions in
the continuum prevention-care
• Conduct community-based surveillance to ascertain the
quality of services for men, particularly for MSM, are of quality
• Develop the capacity to collaborate in outreach, navigation,
referral, support to prevention and to treatment adherence
with peers
Necessary Actions to be undertaken
by MSM-led groups and organizations

12. Cascade of HIV Care Mexico, 2014
Source: National estimates by CENSIDA. México; July, 2015.

13. Cascade of HIV Care for Gay Men and Other MSM
and IDU,
Mexico, 2014
Source: National estimates by CENSIDA. México; July, 2015

14. The present and the future responses geared toThe present and the future responses geared to
gay men and othergay men and other MSM groups and populationsMSM groups and populations
• Praiseworthy activities carried out in Brazil,
Guatemala, Paraguay, Mexico, Argentina, Ecuador,
Peru, Nicaragua…
• Urgent need to expand actions for covering needs and
demands of the significant segment of male
populations in all countries;
• Big concern with allocation of resources and real
political will to address the epidemic among gay mengay men
and otherand other MSM;MSM;
• A lot is being done by persons, groups and

15. AcknowledgmentsAcknowledgments
To each and every individual and organization
members of GayLatino
Heartfelt thanks for their comments and
suggestions to:
• Simon Cazal
• Carlos Garcia de Leon
• Jorge Saavedra
• Toni Ramos
• Ruben Mayorga