When President George Bush signed into law the U.S. Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act on July 30, he extends the President’s Emergency Plan for AIDS Relief (PEPFAR) for another five years. The bill also increases America’s financial commitment to fight against the global HIV/AIDS, tuberculosis and malaria epidemics from $15 billion under the old legislation to up to $48 billion through 2013.
Krista Lauer, manager of international policy at AIDS Project Los Angeles, was one of the influential voices shaping the reauthorization process, and successfully ensured funds would be for the first time allocated towards men who have sex with men (MSM). Laurer spoke with us at the International AIDS Conference in Mexico City, about lobbyist’s efforts to achieve “a moment for MSM.”
What is the difference between the 2003 and 2008 bills?
PEPFAR is not a perfect bill, but one of the biggest victories is that for the first there is language for prevention specifically targeting men who have sex with men.
How much does MSM impact the HIV epidemic globally?
Well going back to that 2007 study, it has been shown that MSM’s in low and middle income countries are nineteen times more likely to have HIV than the general population. It is really difficult to know. There are risks associated with disclosure, but what is clear is that MSM are at high risk of HIV and also that they are not being effectively reached right now with services. And there is also some misinformation because of that.
There was a session I was at this conference where a provider from West Africa indicated that some of the men accessing their health service felt they had no risk of HIV transmission because when they were asked how many women they had sex with they said none. They felt they no risk of HIV transmission because they didn’t know that HIV could be transmitted between men. That highlights this will go a long way to get desperately needed services to people who need them.
There are 15 focus countries that receive a combined $10 billion in aid. How were those chosen?
When the program was initiated in 2003 they were some of the hardest hit countries in the world such that more than half of the global AIDS burden was concentrated in those 15 countries
How long have you been working with the AIDS Project Los Angeles on PEPFAR?
When I came on board with APLA in December 2007, I linked immediately into global advocates in Washington D.C. who have been working on this. There are a lot of issues in this bill, but AIDS Project Los Angeles focused on the inclusion of men who have sex with men in the reauthorization.