BISHKEK, Kyrgyzstan – Harassment, discrimination, public shaming, and even violence are daily realities for men who have sex with men (MSM) in the Eastern Europe and Central Asia region – realities that often keep them from accessing critical HIV and STI prevention, treatment, care, and support.

Some of these men are learning how to help each other address these crucial health concerns, however, thanks to a comprehensive approach developed by UNFPA and the Global Forum on MSM and HIV (MSMGF) in partnership with UNDP, WHO, USAID, and the Bill & Melinda Gates Foundation. It is one in a series of tools addressing comprehensive programmes for sex workers, transgender people, and a forthcoming tool for people who inject drugs.

The first-ever community level training on this tool, Implementing Comprehensive HIV and STI Programmes with Men Who Have Sex With Men (MSMIT), was held earlier this year in Bishkek by UNFPA, the Eurasian Coalition on Male Health (ECOM), the organisation Kyrgyz Indigo, and other civil-society partners. This two-day training of trainers introduced participants to the MSMIT and encouraged them to share experiences in small groups while discussing the existing situation in their countries and how the MSMIT could be used to improve programmes and interventions targeting men who have sex with men.

‘Focusing on the work with men who have sex with men and not for men who have sex with men is crucial, as at the end of the day the programmes intend to meet the needs of this community. It demonstrates equal partnership,’ one participant said.

The MSMIT is designed for use by public-health officials and managers of HIV and STI programmes; NGOs, including community and civil-society organisations; and health workers.

Men who have sex with men are among the key populations disproportionately affected by HIV, accounting for 6 per cent of new infections in Eastern Europe and Central Asia, a region where the epidemic is continuing to grow rapidly, with much higher rates in particular countries. Focusing HIV responses on key populations – which also include sex workers, people who inject drugs, and transgender people – rather than stigmatising or criminalising them is essential for containing the epidemic and reversing the trend. A full 33 per cent of new infections in the region are among sexual partners of key populations, including female partners of men who have sex with men.

Empowering all men who have sex with men to live with dignity, free of gender-based violence, and with HIV and STI prevention and treatment affordable and accessible is at the heart of the MSMIT.

‘Following the announcement by the Global Fund to Fight AIDS, Tuberculosis and Malaria on the reduction of its investments in the countries of Eastern Europe and Central Asia, the question arose about new platforms for dialogue and cooperation between communities and governments, in order to ensure treatment and support for gay men and other men who have sex with men in connection with HIV,’ said Gennady Roshchupkin, ECOM’s Technical Support Coordinator. ‘The MSMIT, with its co-ordinated and multi-level complex of medical and social interventions, offers such an opportunity. All of the recommendations in the MSMIT have been based on real-life practices and studies, which allows us to steer the discussion from “What can we do?” to “How can we do it better?”’

A second training has already been held for national partners in Kyrgyzstan, including NGOs, government institutions, and international organisations. UNFPA, ECOM, and community partner organisations are working together to assist governments, at their request, and civil society to roll out MSMIT as a backbone of the development and implementation of HIV programmes targeting men who have sex with men.