van Griensven Frits, de Lind van Wijngaarden Jan Willem, Eustaquio Patrick Castillo, Wignall Stephen, Azwa Iskandar, Veronese Vanessa, Ferradini Laurent, Phanuphak Nittaya, Mills Stephen
Institute of HIV Research and Innovation, 319 Phayathai Road, Pathumwan, Bangkok 10330, Thailand; and Center of Excellence in Transgender Health, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand; and Department of Epidemiology and Biostatistics, University of California at San Francisco, Mission Hall, Box 1224, 550 16th Street, San Francisco, CA 94158, USA; and Corresponding author. Email:
Independent consultant.
Sex Health. 2021 Mar;18(1):21-30. doi: 10.1071/SH20134.
Men who have sex with men (MSM) in Western urban areas have seen substantive decreases in new diagnoses of HIV infection. This paper explores whether such declines are present among MSM and transgender women (TGW) in Southeast Asia and discusses implications for HIV policies and programming. A scoping review was conducted of scientific publications and selected documents regarding the spread of HIV infection among MSM and TGW in major urban centres of the Association of Southeast Asian Nations (ASEAN) region. Continued high HIV prevalence and incidence among MSM are found in integrated behavioural and biological surveillance (IBBS) and research studies. HIV prevalence among MSM under IBBS decreased only in Bangkok from 28.6% in 2014 to 10.3% in 2018, whereas it was increasing in Kuala Lumpur, Ho Chi Minh City, Vientiane, and Phnom Penh. HIV/AIDS case reports regarding new HIV infection diagnoses among MSM have started to decrease in Singapore since 2011 and have been plateauing in Metropolitan Manila since 2017. Where data were available, it was found that HIV prevalence among TGW was high and if IBBS was conducted, it was increasing. HIV prevalence among TGW under IBBS in Jakarta had risen to 34.0% (2015) and 14.0% (2019) in Phnom Penh. These findings suggest that most ASEAN member states have so far failed to effectively implement and scale-up scientifically proven biomedical HIV prevention measures and counter stigma and discrimination that impedes access to appropriate HIV prevention and treatment services for MSM and TGW.
西方城市地区的男男性行为者（MSM）新感染艾滋病毒的诊断数量大幅下降。本文探讨东南亚的男男性行为者和跨性别女性（TGW）中是否也存在这种下降情况，并讨论对艾滋病毒政策和规划的影响。对有关东南亚国家联盟（东盟）地区主要城市中心男男性行为者和跨性别女性中艾滋病毒感染传播的科学出版物和选定文件进行了范围审查。在综合行为和生物学监测（IBBS）及研究中发现，男男性行为者中的艾滋病毒流行率和发病率持续居高不下。在IBBS下，只有曼谷的男男性行为者艾滋病毒流行率从2014年的28.6%降至2018年的10.3%，而吉隆坡、胡志明市、万象和金边的流行率却在上升。自2011年以来，新加坡关于男男性行为者新感染艾滋病毒诊断的艾滋病毒/艾滋病病例报告开始减少，自2017年以来，马尼拉大都会的报告数量一直持平。在有数据的地方，发现跨性别女性中的艾滋病毒流行率很高，而且如果进行了IBBS，流行率还在上升。雅加达IBBS下跨性别女性的艾滋病毒流行率升至34.0%（2015年），金边升至14.0%（2019年）。这些发现表明，到目前为止，大多数东盟成员国未能有效实施和扩大经科学验证的生物医学艾滋病毒预防措施，也未能消除阻碍男男性行为者和跨性别女性获得适当艾滋病毒预防和治疗服务的耻辱感和歧视。
