Monday 17 December 2012

The CSIS/Lancet panel session on MSM and HIV

In July 2012, a special edition of The Lancet focusing on the global HIV epidemic among men who have sex with men (MSM) was launched at the International AIDS Conference in Washington D.C.  To complement this, The United States’ Center for Strategic and International Studies (CSIS) convened a panel session where several authors who contributed to the edition discussed their papers.

Policy Implications of The Lancet MSM & HIV Series from CSIS on Vimeo.

Click on the time-code links below to jump to a specific section of the video:

0:00     Introduction: Stephen Morrison and Sharon Stash (Center for Strategic and International Studies)

5:03     Chris Beyrer (Johns Hopkins University) discusses how the HIV epidemic among MSM differ from HIV epidemics in other populations, and why they are different for biological, network, and population level reasons.

14:44    Patrick Sullivan (Emory University) presents findings of his review of prevention interventions, and implications of the type of interventions to be implemented moving forward. He discusses how we can have an impact by packaging together the tools we already have, and the need to keep developing new prevention technologies (especially those relevant to MSM) to broaden the stable of HIV prevention technologies. Patrick also discusses the significant role structural interventions have, as well as the need for a commitment of resources to ensure there sufficient scale of these interventions.

22:32    Ken Mayer (Fenway Health and Harvard Medical School) examines comprehensive health services for MSM and the importance of culturally competent care. He discusses how, at a population level, MSM may be at higher risk of co-existing epidemics such as depression, issues around substance use and other adverse health outcomes, and how these are very much a function of a lack of societal acceptance. Ken also explores the need for the development of culturally competent models of care. He discusses how healthcare professionals are not sufficiently equipped to provide supportive services to non-heterosexuals and gender diverse people, and how the lack of acceptance is a substantial structural problem that is impeding an effective response to the epidemic.

28:24    Greg Millett (U.S. Centers for Disease Control and Prevention [CDC]) discusses the disparities among MSM and black MSM in the United States and abroad. He examines the large disparities related to HIV between Black MSM and other MSM in the United States, as well as great disparities in structural issues such as income, unemployment, education, incarceration, poverty and insurance. Greg explores how black MSM are more likely to be HIV positive globally, and even more likely to be HIV positive in African and Caribbean countries where homosexuality is criminalised. He also looks at how focusing on macro level structural issues may have a bigger impact than focusing on sexual or drug use issues.

38:42    Chris Collins (amfAR - The American Foundation for AIDS Research) gives a synthesis and overarching summary of the presentations, and explores the policy implications going forward. Chris looks at the issues of prevention as well as treatment, in addition to treatment as prevention. He also discusses the scale up of basic tools such as such as condoms and lube in many places in the world, drug pricing in richer countries for population impact, and the need for gay people and MSM to be counted in research. Chris explores the involvement of gay people and MSM from communities in the design of programs and development at strategic levels. He also examines the need for better research and data, appropriate services, and equity in delivering testing and treatment.

47:25    Caroline Ryan (Office of the U.S. Global AIDS Coordinator) gives a response to the panel presentations.

56:26    Discussion with Q&A from the floor: including discussions around intermittent PrEP, scaling of biological interventions, the amalgam of different interventions, relationship and couple level strategies, re-engaging the LGBT community to reinvest in the epidemic, increases among young MSM, human rights, criminalisation subverting public health not using a public health issue like HIV as justification for criminalisation, communicating increased risk through anal sex without further stigmatising gay man and MSM, addressing stigma and discrimination.

The Policy Implications of The Lancet MSM & HIV Series event was hosted by CSIS. 
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