For years, there has been silence at the global level about the disproportionate impact that HIV and AIDS have on men who have sex with men (MSM). This silence has led to unabated epidemics and especially weak HIV prevention programming at national levels for MSM across the globe. Perpetuating this silence is a dearth of ethically implemented and methodologically sound surveillance, epidemiologic and social science research that could sensitively inform HIV prevention and advocacy responses around the world. Complicating this situation is the fact that HIV-related services tend to be poorly resourced. This is particularly true for HIV prevention programs targeting MSM. Many authorities have commented on the global prevention funding gaps, indicating that prevention services reach only 1 in 10 MSM. A significant crunch in the availability of resources has led to flat-funded prevention programs, ineffective use of limited resources, and therefore a general failure to curb new infections. Moreover, draconian public health policies and/or neglect of the health-related needs of MSM are permitted to flourish, justified by claims about the absence of data. Sensitively conducted, reliable research is necessary to substantiate funding and political investment in comprehensive HIV prevention and sexual health programs for MSM. However, HIV prevention approaches and guidance issued for their broad-based adoption are only as good as the principles underlying their implementation. Research and public health guidance must be balanced by rights-based principles of practice if they are to have their intended impact on the fight against AIDS among MSM.
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