Financing the response to HIV among gay men and other men who have sex with men: Case studies from eight diverse countries

Abstract

Despite reductions in the number of new HIV infections globally, the HIV epidemic among men who have sex with men (MSM) is expanding. This study characterises financing of HIV programmes for MSM and the impact of criminalisation on levels of funding, using data from five countries that criminalise same-sex sexual practices (Ethiopia, Mozambique, Guyana, India and Nigeria) and three that do not (China, Ukraine and Vietnam). For each country, all publicly available documents from the Global Fund to Fight AIDS, Tuberculosis and Malaria for approved HIV/AIDS grants in Rounds 5–9 and Country Operational Plans detailing investments made through the President's Emergency Plan for AIDS Relief (PEPFAR) from US fiscal year (FY) 2007–2009 were examined. Eleven of 20 HIV proposals to the Global Fund contained programmes for MSM totalling approximately $40 million or 6% of proposed budgets. In six countries providing activity-level data on MSM programming, PEPFAR funding that served this population and others ranged from $23.3 million in FY2007 to $35.4 million in FY2009, representing 0.5–25.9% of overall, non-treatment funding over this period. Countries that criminalise same-sex sexual practices spend fewer resources on HIV programmes serving MSM. However, they also show consistent underfunding of programmes serving MSM regardless of context or geography.

Keywords:

• HIV
• men who have sex with men
• PEPFAR
• the Global Fund
• criminalisation

Funding

This work was supported by amfAR, The Foundation for AIDS Research, the Ford Foundation Southern Africa and Oxfam International. The research of the Johns Hopkins team was supported in part by the Global Fund to Fight AIDS, Tuberculosis and Malaria and in-kind by the Center for Public Health and Human Rights at the Johns Hopkins Bloomberg School of Public Health.