HIV infection among men who have sex with men in East and South-East Asia – time for action

Although the early HIV epidemic in Asia was characterised by HIV spread predominantly through injecting drug use, sexual transmission of HIV has increased throughout many parts of Asia. 1 For the past 5 years, alarming rates in HIV infection have been observed among men who have sex with men (MSM) across urban areas in many Asian countries, 2,3 with the HIV prevalence rates ranging from 30.8% in Bangkok, 3 3.2% in Singapore, 4 4% in Malaysia, 5 5.7% in Tokyo, 6 8.5% in Taiwan, 7 4.3% in Hong Kong, 8 12.5% in Chongqing (China) 9 and to 4.8% in Beijing.10 Although HIV surveillance among MSM in these countries remains patchy and incomplete, recent epidemiological studies have consistently shown that HIV infections among MSM are increasing, a trend that has also been observed in MSM in other parts of the world.11 International agencies such as the Joint United Nations Program on HIV/AIDS, 12 the Global Fund to Fight AIDS Tuberculosis and Malaria, 13 US Agency for International Development, 14 and the American Foundation for AIDS Research, 15 have increased funding for research and HIV prevention programming for MSM in this region.Additionally, at the local level, various community-based organisations have emerged to provide preventive services for MSM communities.16 Up until now, little attention has been given to the HIV epidemic among MSM in more developed parts of Asia.The 9th International Congress on AIDS in Asia and the Pacific in Bali 2009 was a symposium focussing on HIV and MSM in developed East and South-East Asian countries.The symposium highlighted epidemiologic data and prevention responses in seven countries and territories namely, Singapore, Malaysia, Thailand, Japan, Taiwan, Hong Kong and mainland China.We outline common challenges encountered in addressing HIV among MSM in these countries and lessons that should be learned.