HIV Risk among Men who Have Sex with Men (MSM) and the Misallocation of HIV Prevention Investments in Countries with PEPFAR Partnership Frameworks

Abstract

Men who have sex with men (MSM) are found, in most places, to be disproportionately at risk of HIV infection. We conducted a descriptive analysis of national resource spending on HIV prevention activities that target MSM in 37 countries with a U.S. President's Emergency Plan for AIDS Relief (PEPFAR) Partnership Frameworks. We found that in most countries, the share of infections due to sex between men that was much greater than the share of HIV prevention expenditure that benefited MSM. Finally, we propose the use of a simple indicator, the investment equity ratio (IER), to quantify this misalignment between health spending and HIV burden.