Top2btm Symposium on Health Care for Men Who Have Sex with Men (MSM) (Conference Report)‪ ‬

Until recently, African MSM have been under-researched and under-resourced, and this has contributed to their stigmatisation. Fortunately this deficiency has been recognised locally and a number of innovative programmes have been developed to address this. The Top2btm symposium on prevention, treatment and care of MSM sought to bring together these programmes to share experiences. The symposium was held in Cape Town, organised by the Anova Health Institute with support from USAID and PEPFAR. The conference attracted 188 delegates from across Africa as well as Europe and North America, including local MSM community representatives, a variety of NGOs, government leaders and health care workers as well as prominent MSM researchers. Dr Yogan Pillay, South Africa's Deputy Director General of Strategic Planning in the Department of Health, opened the conference on behalf of the Minister of Health. He affirmed government's commitment to implementing targeted HIV and sexually transmitted infection (STI) prevention and treatment programmes for MARPs, including MSM. He highlighted the importance of MSM-targeted HIV testing programmes, considering pre-exposure prophylaxis (PrEP), promoting post-exposure prophylaxis (PEP), encouraging MSM-related research and embracing the concept of antiretroviral treatment as prevention. Consideration is being given to providing state-funded ART to everyone at a CD4 count of 350 cells/[micro]l or less; this would be especially beneficial to MSM, since the risk of HIV transmission is much higher during unprotected penileanal sex than during unprotected penile-vaginal sex, and lowering the viral load of positive MSM is likely to provide a large reduction in HIV transmission.