Sri Lanka’s HIV epidemic is considered low-level, with 1,544 cumulative reported cases and an estimated 3,000 people living with HIV. 14 Infections related to sex between men account for approximately one-eighth of total reported cases. Other key affected populations include injecting drug users and female sex workers. HIV risk among MSM is low relative to other countries in the region but is increasing, both in HIV prevalence and as a proportion of total infections. There is little evidence to suggest that Sri Lanka’s epidemic will become generalized in the future.
Since the first detected case in 1987, Sri Lanka has demonstrated a progressive commitment to a comprehensive response. Socio-economic and cultural factors are taken into account when designing programmes. To-date, the National STD and AIDS Control Programme (NSACP) has been unsuccessful in scaling prevention programmes targeted to MSM and is yet to develop community sensitive clinical services. The NSACP’s attention to MSM is characterized by a non-continuous series of awareness programmes primarily in Colombo, Kandy, and Anuradhapura and occasional support to groups working for the human and political rights of LGBT communities in Sri Lanka. Despite strong civil society interest in operating targeted HIV prevention interventions, limited and inconsistent funding has limited the expansion of such activities. In addition, the limited capacity of MSM community groups in administration and financial management contributes to funding issues.