Wirtz, A.L., Kirey, A., Peryskina, A., et al. Drug and Alcohol Dependence (2013), E-publication ahead of print.
The authors reviewed 43 publications on evidence on the HIV prevalence and socio-behavioral risk factors of men who have sex with men (MSM) in five Central Asian countries and Mongolia, Afghanistan, and Xinjiang Province, China to understand HIV risks, identify data gaps, and suggest priorities for future research and surveillance. HIV research on MSM in Central Asia is still emerging; however, available data suggest that MSM in the region are at risk of HIV. Methodological, recruitment, and reporting variations among the studies made comparisons and generalization difficult. For example, surveillance data showed HIV prevalence between 1 and 2 percent in Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan, while a behavioral study found HIV prevalence as high as 20 percent in Kazakhstan; thus, differences in estimates were considerable. HIV risks among MSM included multiple and/or concurrent sexual partners, unprotected anal sex, transactional sex, and non-injection drugs and alcohol. HIV prevention and testing coverage for MSM ranged from 25 to 49 percent for Kyrgyzstan, Tajikistan, and Uzbekistan. MSM practices were documented among people who inject drugs. No current estimates of HIV treatment coverage were documented. The prevalence of violence, discrimination, and criminalization towards MSM was evident, and should be addressed. According to the authors, in-country leadership will be essential to improving the HIV response, and further research on risk behavior is needed.