HIV guidelines to help homosexuals, trans-gender people (Reuters)

GENEVA (Reuters) – Homosexual men and trans-gender people should get equal access to HIV/AIDS programs under the World Health Organization's first guidelines aimed at ending stigma that denies quality care to many, the U.N. agency said on Tuesday.

WHO also reported evidence of HIV infections surging again among men who have sex with men and people who change their gender, particularly in Western countries. The two groups are already hard hit by the AIDS epidemic that began 30 years ago.

"This is the first time that WHO, as a U.N. agency together with other partners, is putting this forward. It is sensitive but is right to the point and is really critical for the epidemic," Dr. Gottfried Hirnschall, director of the HIV/AIDS department at the WHO, told a news briefing.

The 21 recommendations form "the first global public health guidelines" to focus on homosexual men and trans-gender people, the WHO said in a statement. They are designed to help health care workers and policymakers overcome entrenched discrimination and offer them testing, counseling and life-saving treatment.

Homosexual men are 20 times more likely to be infected with the virus than males in the general population, and rates are even higher in Mexico, Thailand and Zambia, according to the United Nations agency. HIV infection rates among trans-gender people range from 8 to 68 percent, depending on the country.

An estimated 2 to 4 percent of males have reported having sex with another man during their lifetime, Hirnschall said.

"Certainly one thing that we know is that MSM behavior (men who have sex with men) exists in all cultures. Obviously, the level of acceptance and cultural mystification varies from culture to culture," he added.

CRIMINALISED SEXUAL Behavior

More than 75 countries criminalize same-gender sexual activity, according to the WHO. "And trans-gender people lack legal recognition in most countries," it said.

This forces many homosexuals and trans-gender people to risk criminal sanctions if they seek help from a health care worker. Police often have authority to harass support groups, it said.

"Because of the stigma, the discrimination, they will often access services late, they may not access them at all and often if they do access them the quality of services provided to them may be inferior," Hirnschall said.

"If a trans-gender, in many parts of the world, comes to a health service, she gets chased away at the door," he said. "If she ever makes it by the guy at the door, the next question is 'where do we put her, in which ward do we put her?.'"

George Ayala, executive officer of the San Francisco-based Global Forum on MSM and HIV, said that health care services should offer an environment that is "welcoming and safe."

"It is difficult to respond with even the best of interventions that we have available to us if individuals run the risk of violence, of ridicule, of other forms of humiliation on their way to accessing services," he said.

Hua Boonyapisomparn, a trans-gender activist from Thailand, said that trans-gender communities have been "invisible" in national and international health care programs.

"HIV guidelines are an important, historic step which is a hope for trans-gender community to ensure that their voice will be heard at all levels," she told reporters in Geneva.

(Editing by Alistair Lyon)

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New AIDS guidelines target global discrimination of gays (AFP)

GENEVA (AFP) – The World Health Organisation published Tuesday new global guidelines for expanding AIDS treatment, focusing for the first time on homosexuals, who face discrimination in many countries.

"If we do not pay major attention to the epidemic in key populations, we will not be able to eliminate HIV" -- the virus that can lead to AIDS, said Gottfried Hirnschall, WHO director of the HIV/AIDS department.

"Men having sexual relations with other men" as well as transsexuals represent those who were "disproportionately affected by the epidemic of HIV about 30 years ago and it continues to be so," Hirnschall said at a press conference in Geneva.

He added that the UN health agency has even seen a resurgence of the HIV epidemic, especially in industrialised countries.

"The dramatic fact is that MSM (men having sex with men) are estimated to be 20 times more likely to be HIV infected than the general population," he said.

In some countries and regions, up to 40 percent of homosexuals are estimated to be HIV positive, according to the WHO.

Given the sobering statistics, the WHO said it was launching new guidelines, aimed at the specific health needs of homosexuals.

The WHO said that many homosexuals suffer due to lack of access to adequate care, often because of discrimination against gays.

Homosexual activity is illegal in no fewer than 75 countries, most of them in Africa, and some also do not legally recognise transsexuals, the global health agency said.

"They are exposed to harassment, exclusion, discrimination, violence" in many aspects of their life, work, education, as well as the health care system, Hirnschall said.

"Because of the stigma, because of the discrimination, they often access services late," he said, or they may not be able to get treatment at all.

"There is quite a political backlash that we see in many parts of the world to actually give these groups the rights and the services that they need," he said.

The new guidelines in particular call for countries to adopt laws to end discrimination against gays and provide better access to treatment to reduce the number of new infections and save lives.

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