Implementing Comprehensive Hiv And Sti Programmes With Men Who Have Sex With Men PDF Download

In all countries of the European Union and European Economic Area, men who have sex with men (MSM) are disproportionately affected by HIV and other sexually transmitted infections including gonorrhoea, syphilis, chlamydia and hepatitis B and C. In several countries in the region, the incidence of these infections has increased among MSM, in some cases markedly, over the last decade. There is evidence that services to prevent, diagnose and treat infections are not being delivered at the appropriate scale to impact on transmission patterns. Based on a systematic review of the literature and expert opinion, the European Centre for Disease Prevention and Control suggests that there is good evidence to ensure that the following key components are considered for inclusion in national and sub-national public health programmes in countries in Europe.^The evidence indicates that these services and interventions can effectively prevent and reduce HIV and STI transmission among MSM, address the needs of MSM who are living with HIV, as well as promote sexual health among all MSM. 1. Vaccinations: Promote and deliver vaccination to protect against hepatitis A and B. Consider vaccination for human papilloma virus (HPV). 2. Condoms: Provide easily accessible condoms and condom-compatible lubricants and promote their effective use. 3. HIV and STI testing: Provide voluntary and confidential HIV and STI counselling and testing via a variety of modalities that are easy to access for the target group. Voluntary partner referral can support the early diagnosis and treatment of contacts. 4. Treatment: Timely provision of treatment for HIV, viral hepatitis and STI should be ensured. Preventive benefits of treatment are significant. 5.^Health promotion: Provide accurate and accessible information that enables men to understand and assess sexual health-related risks and prevention efficacy, and that promotes awareness of one's own HIV and STI status. 6. MSM-competent health services: MSM-competent points of care offering a comprehensive sexual health programme including health promotion, counselling, peer support, prevention, adequate diagnostics and treatment will increase service uptake. Ensure target group involvement and training for providers on how to offer comprehensive care for MSM. 7. Targeted care for MSM living with HIV: Provide antiretroviral treatment for HIV and vaccination; regular STI screening using adequate diagnostics; treatment for STIs; individual counselling, sexual health promotion and peer-support groups for men living with HIV.^Prevention services for MSM should be targeted following the analysis of relevant and reliable epidemiological data, so that services are directed at the appropriate scale to those geographical and risk populations most at risk of HIV and STI infection. Combinations of the suggested key interventions should be offered to MSM in order to achieve synergy and the highest levels of effectiveness. Prevention needs and preferences of MSM vary across and within country settings, by individual and over time. Offering and implementing prevention packages in collaboration with the target group, or where appropriate, by the target group, is crucial to the success of national and sub-national prevention programmes. As many countries in Europe experience constrained public health budgets, it is more important than ever to implement targeted and evidence-based measures that address the groups most affected by the HIV epidemic as well as those most at-risk for disease acquisition and transmission.^The promotion of sexual health using positive messages framed in an empowering environment in relation to individual needs, will ensure greater effectiveness of the prevention efforts resulting in increased sexual health and reduced new infections of HIV and other STI in Europe.