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Glob Public Health. 2016 Aug-Sep;11(7-8):902-22. doi: 10.1080/17441692.2016.1143523. Epub 2016 Feb 15.

From marginal to marginalised: The inclusion of men who have sex with men in global and national AIDS programmes and policy.

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a Center for Medicine, Health and Society, Vanderbilt University , Nashville , TN , USA.
b RWJF Health Policy Research Program , University of California , Berkeley , CA , USA.


In the last decade, gay men and other men who have sex with men (msm) have come to the fore of global policy debates about AIDS prevention. In stark contrast to programmes and policy during the first two decades of the epidemic, which largely excluded msm outside of the Western countries, the Joint United Nations Programme on HIV/AIDS now identifies gay men and other msm as 'marginalized but not marginal' to the global response. Drawing on archival data and five waves of United Nations Country Progress Reports on HIV/AIDS (2001-2012), this paper examines the productive power of international organisations in the development and diffusion of the msm category, and considers how international organisations have shaped the interpretation of msm in national policies and programmes. These data show that the increasing separation of sexual identity and sexual behaviour at the global level helped to construct notions of risk and disease that were sufficiently broad to accommodate the diverse interests of global policy-makers, activists, and governments. However, as various international and national actors have attempted to develop prevention programmes for msm, the failure of the msm category to map onto lived experience is increasingly apparent.


HIV/AIDS; Men who have sex with men; UNAIDS; implementation; policy

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