amfAR, The Foundation for AIDS Research

New Report Documents Widespread Neglect by Governments and Donors

Underfinancing, Discrimination, and Stigma Undermine Fight Against HIV Among Gay Men, Other Men Who Have Sex with Men, and Transgender People

Media Contact:
Joana Casas, Program Communications Manager

NEW YORK, May 16, 2013 - Today amfAR, The Foundation for AIDS Research and the Center for Public Health and Human Rights (CPHHR) at The Johns Hopkins University jointly released a new report that provides the first ever comprehensive analysis of the financing and implementation of HIV programs for gay men, other men who have sex with men (MSM) and transgender individuals in six countries – Botswana, Malawi, Namibia, Swaziland, Zambia, and Zimbabwe.  The report, “Achieving an AIDS-Free Generation for Gay Men and Other MSM in Southern Africa,” was released on the eve of International Day Against Homophobia (IDAHO), May 17.  It emphasizes the role stigma and discrimination play in undermining the fight against HIV in the region. 


Above: Achieving an AIDS-Free Generation for Gay Men and Other MSM in Southern Africa (Executive Summary). Click here for the full report.

In particular, the report highlights the negligible amount of funding provided by the two largest sources of international donor support for HIV: the US President’s Emergency Plan for AIDS Relief (PEPFAR) and The Global Fund to Fight AIDS, Tuberculosis and Malaria. Despite clear policy commitments and recent progress in addressing the epidemic among this population, as of 2012 the majority of PEPFAR budgets contained few dedicated funds for these groups and only 0.07 percent of all Global Fund resources for HIV were targeted to them.

It is clear that reaching gay men, other MSM and transgender individuals for prevention, treatment and care programs is difficult and that some who are receiving these services may not be identified as members of these groups. It is also true that dedicated services are needed to ensure these men and women have equal access to the programs being offered to the overall adult population.

The report also found that laws criminalizing same-sex sexual practices persist in all of these countries despite nearly a decade’s worth of investment in HIV programs. Furthermore, widespread homophobia among government officials and religious figures remain a formidable barrier to the implementation and uptake of HIV programs.

For example, in Swaziland, where HIV prevalence is the highest in the world at 26 percent, the Swazi government’s reluctance to address the needs of gay men, MSM and transgender people creates a challenging environment for tracking available HIV programs for this population. And in Malawi, where approximately 910,000 people have HIV, many are unwilling to disclose their sexual orientation for fear of harassment, denial of healthcare, and arrest.

“This report shines a much-needed spotlight on the neglect of a population that is particularly vulnerable to HIV,” said amfAR CEO Kevin Robert Frost.  “If we want to effectively combat the HIV epidemic in this region, we must implement programs that address stigma and discrimination.”

“For years it was asserted that gay men and transgender people didn’t exist in Southern Africa, but that’s simply not true,” said Owen Ryan, amfAR’s deputy director of public policy and a lead author of the report.  “International donors have taken far too long to recognize and respond to HIV among these men and women.”   

The report also includes recommendations for national governments, PEPFAR, the Global Fund, and other donors to address the needs of this population. Among them:

  • National governments should decriminalize same-sex sexual practices and support programs that reduce stigma and discrimination against marginalized groups.
  • PEPFAR should institute clearer budgeting and reporting practices that make the implementation of national strategic plans and the allocation of resources more transparent.
  • The Global Fund should help countries reprogram existing grants to address the needs of GMT in the region and institute stronger accountability mechanisms to ensure that approved programs are actually implemented.
  • UNAIDS should improve the quality and scope of technical assistance it provides countries by increasing the number of staff with expert knowledge of issues related to key populations, particularly GMT.
  • All countries receiving international assistance for HIV should conduct biennial epidemiological surveillance that includes key populations, especially GMT.

Despite harsh conditions, the report shows several examples of small, community-led organizations that deliver desperately needed programs to these men and women. These include efforts by groups, like the Lesbians, Gays, and Bisexuals of Botswana (LeGaBiBo) and the Botswana Network on Ethics, Law and HIV/AIDS (BONELA), which are strategic implementers of a national government plan to increase the accessibility and availability of condoms by removing barriers for at-risk populations. In Malawi, the Centre for the Development of People (CEDEP) has conducted important epidemiological research on the prevalence of HIV among its MSM and the impact of stigma.

“We hope that the comprehensive data detailed in this report will help inform the paradigm shift in policy and programs needed to change the trajectory of the HIV epidemic among GMT in Southern Africa,” said Dr. Stefan Baral of the Johns Hopkins Bloomberg School of Public Health and one of the lead authors of the report.  “We must go beyond what’s written in strategy documents and donor plans and work toward tangibly addressing HIV among men who have sex with men, and transgender people. It will be impossible for the US government to achieve its goals of an AIDS-free generation without this.”           

The report can be found here:

The individual country profiles can be found here:

About amfAR
amfAR, The Foundation for AIDS Research, is one of the world’s leading nonprofit organizations dedicated to the support of AIDS research, HIV prevention, treatment education, and the advocacy of sound AIDS-related public policy. Since 1985, amfAR has invested more than $366 million in its programs and has awarded grants to more than 2,000 research teams worldwide. For more information, please visit

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