WHO guidelines for HIV/STI prevention and care among MSM and transgender people: implications for policy and practice

摘要

Rates of sexually transmitted infections (STIs) in men who have sex with men (MSM) peaked in the late 1980s in the developed world and then declined and resurged in the late 1990s. Several high-income countries responded to those rises in STI rates by enhancing surveillance, expanding community-based treatment services and increasing STI screening programmes. Although the response has been varied, for the most part, there has not been a similar public health movement around STI control in low-income and middle-income countries. Legal policies in some countries directed against same-sex behaviour discourage safer sex and sexual health promotion among MSM and trans-gender people. Additionally, MSM and transgender people experience profound barriers to quality healthcare due to discrimination and ignorance regarding non-traditional gender identity within the medical community. Furthermore, while the literature on the epidemiology of same-sex behaviour and prevalence of STIs in low-income and middle-income countries is scant, evidence suggests that MSM and transgender people have a relatively higher burden of STIs than non-MSM or transgender people.