Abstract: 'The failure to respond adequately to the human rights and public health needs of men who have sex with men and transgender people is reflected in epidemiological data. Almost universally, even in generalized HIV epidemics, men who have sex with men are more affected by HIV than the general population. Biologically, unprotected receptive anal sex poses a much higher risk than unprotected receptive vaginal sex, whether that anal sex is heterosexual or homosexual.

In addition, people with marginalized sexual or gender identities or behaviours sometimes lack

the ability or desire to protect themselves from infection, due to structural factors including selfstigmatization, discrimination and lack of access to information and services. In certain studies, HIV prevalence among men who have sex with men has been found to be as high as 25% in Ghana, 30% in Jamaica, 43% in coastal Kenya and 25% in Thailand. Among transgender people, HIV prevalence is thought to be even higher. Data presented at the 2008 International AIDS Conference in Mexico showed HIV prevalences of over 25% among transgender people in three Latin American countries and prevalences ranging from 10% to 42% in five Asian countries.'