The World Bank pioneered global HIV and AIDS financing early in the emergency and remains committed to achieving Millennium Development Goal 6, to halt by 2015 and begin to reverse the spread of HIV and AIDS, through prevention, care, treatment, and mitigation services for those affected by HIV and AIDS.
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HIV and MSM in ThailandThailand has been hit hard by HIV. 440,000 people are living with HIV in Thailand and more than 1,200 people die each year from HIV-related causes.Thailand has successfully curb... Show More +ed the spread of HIV among sex workers and their clients. Its 100% Condom Use Program is world-renowned.However, its response to HIV among men who have sex with men (MSM) has been limited.HIV prevalence among MSM has risen sharply from around 6% in the late 1990s to as much as 30% today, and continues to grow.MSM account for over 40% of new HIV cases each year. This figure could go as high as 59% within the next 10 years, according to the Asian Epidemic Model estimate.MSM in Metropolitan BangkokThere are around 185,000 men who have sex with men living in metropolitan Bangkok, and 60,000 of whom are at high-risk of infection.Of the high-risk group, only 14,000 men were tested, and 4,000 were diagnosed positive.Yet fewer than 1,000 men who tested positive started taking anti-retroviral treatment (ART) medicine, despite being available for free.There are enough clinics and health personnel in Bangkok to support testing and treatment for all MSM who need it.Over 90 medical facilities in Bangkok could test and treat all MSM, yet they are left largely unused.Over 75% of HIV testing and treatment is done in just two research clinics.About 200,000 HIV tests are performed each year in Bangkok. Yet the medical facilities could perform an additional 400,000 tests each year. This means that more than 65% of HIV testing capacity goes unused each year.What Does it Take?Scaling up HIV testing and treatment services will not only save lives, it will also cut costs.An additional $55 million investment over the next decade – just a moderate increase over current levels – will help achieve universal treatment coverage in Bangkok.This could prevent over 5,000 HIV-related deaths and almost 4,000 new HIV cases (each year).Public facilities/hospitals can test and treat men who have sex with men effectively and at the lowest cost.They are the best tool to scale-up treatment among Bangkok’s MSM.They can be made more effective by drawing on the successful experiences of research clinics that have created welcoming environments for patients with convenient hours and friendly staff.Involving experts from research clinics and members of the MSM community in delivering HIV testing, treatment and prevention services will improve the overall quality of service.Employing multiple recruitment methods will help connect MSM to HIV testing and treatment services.For example, a peer follow-up system has been shown to be effective in helping MSM who test HIV positive get and sustain life-saving treatment so that they can live healthier and productive lives. Show Less -
BANGKOK, May 19, 2015 - There is an HIV epidemic among men who have sex with men (MSM) in Bangkok. Increasing the availability and use of free and anonymous testing and treatment of HIV infection amon... Show More +g all at-risk groups, especially MSM, can stem the epidemic and cut the number of HIV-related deaths in half over the next 10 years, according to a new study Scaling up HIV Treatment for MSM in Bangkok: What Does it Take?HIV intervention programs in Thailand have effectively targeted female sex workers and their clients. However, the national response to HIV among MSM has been largely limited. As a consequence the share of HIV positive men in the MSM community has remained high and has been increasing. In metropolitan Bangkok, it is estimated to have increased from 21 percent in 2000 to 28 percent in 2012 among the 120,000 - 250,000 MSM in the city.The new study recommends affordable public health strategies to halve HIV-related deaths and the rate of new infections by 2022. The study—produced by the World Bank in close cooperation with the Thai Red Cross, Ministry of Public Health, the Bangkok Metropolitan Administration (BMA) and UNAIDS—urges greater use of the free and anonymous testing and treatment services currently available at public health clinics. ”HIV/AIDS testing and treatment can save lives, maintaining people’s health and preventing new infections,” said Ulrich Zachau, World Bank Country Director for Southeast Asia. "With testing and treatment available for free at many public and community-based clinics, Thailand can slow, even stop, Bangkok’s HIV epidemic, among men who have sex with men and other groups. The time to act is now.”The report finds that while there is limited use of HIV testing services among MSM in Bangkok, there are enough clinics and health personnel available to support testing and treatment for all MSM who need it. Only one-fifth of treatment-eligible MSM are receiving antiretroviral treatment (ART) medicines, despite their availability free of charge.The report suggests that by utilizing this spare capacity at existing facilities, about 43,000 more MSM could be tested for HIV and 5,100 could then receive ART services by 2022. This would increase the percentage of MSM in Bangkok receiving ART from 20 percent to 44 percent by 2022, without increasing the current level of investment in HIV services. With additional investment of $55.3 million over the next decade, Bangkok could achieve universal treatment coverage within the same period by reaching additional 12,600 MSM with ART services.“The faster people get tested for HIV, the faster they can get treated and live normal lives,” said Dr. Sumet Ongwandee, Director Bureau of AIDS, Tuberculosis and Sexual Transmitted Infections, Ministry of Public Health.“Once you know your status, HIV/AIDS is like any other chronic disease where you can take medicine every day and learn how to be healthy again.”The report cites examples of initiatives that have been used to successfully increase testing at public facilities, including creating a patient-friendly environment to encourage testing and follow-up; BMA’s Gay BKK website promoting safe sex and HIV testing among MSM and its weekly night mobile clinics at Bangkok venues frequented by MSM; and convenient drop-in testing centers in major MSM hotspots in Bangkok.“Advancing efforts to end the global AIDS epidemic by 2030 requires a combination approach to HIV prevention that includes biomedical, behavior change and structural approaches,” said David Wilson, Director of the World Bank’s Global HIV/AIDS Program. “With its quality medical infrastructure, Bangkok now has the opportunity to prevent more than 5,000 needless deaths, to halve new infections by 2022, and to serve as a model for other cities.”The study was authored by researchers from the Kirby Institute of the University of New South Wales, the Thai Red Cross, and the World Bank. A version of this study was published in The Lancet Journal March 29, 2015 http://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018%2815%2900020-X/abstract. Show Less -