India must make an “extra effort” in addressing the medical needs of men who have sex with men (MSM) and transgender people affected by HIV and sexually-transmitted infections, a top WHO official said on Tuesday.

“Though India has addressed the HIV problem among MSM and transgender people, it has to make an extra effort in scaling up treatment and prevention services for HIV and sexually transmitted infections,” Dr. Gottfried Hirnschall, Director of HIV Department in World Health Organisation, told PTI.

In India, around 1.5 million transgender people and around 30.5 million MSM are vulnerable to the HIV and sexually-transmitted infections.

“In Asia, the odds of MSM being infected with HIV are 18.7 times higher than in the general population and the HIV prevalence ranges from 0 per cent to 40 per cent,” he said.

The WHO on Tuesday issued, for the first time, new public health recommendations to sensitise governments and health pressure groups in the developing world about the need to provide adequate medical treatment and prevention services to MSM and transgender people affected by HIV and sexually transmitted infections.

The guidelines call on governments to develop anti-discrimination laws and measures and provide more inclusive services for MSM and transgender people.

Health pressure groups must provide HIV testing and counselling followed by treatment for patients with CD4 count 350 or below.

Dr. Hirnschall said “criminalisation, and legal policy barriers play a key role in the vulnerability of MSM and transgender people to HIV.”

In many countries of Asia, transgender people lack legal recognition. Consequently, people affected by HIV among these two communities often face cultural stigma in seeking anti-retroviral treatment due to criminal sanctions.

“From a health systems’ perspective, MSM and transgender people may delay or avoid seeking health, STI or HIV-related information, care and services as a result of perceived homophobia, transphobia, ignorance and insensitivity,” according to WHO recommendations.

“The WHO guidelines both present evidence for effective prevention interventions for the populations and provide recommendations to help ensure that pervasive barriers like stigma and criminalization no longer stand in the way of life-saving services,” said George Ayala, executive director of the Global Forum MSM & HIV.

Unlike other countries in Asia and Africa, India has addressed the HIV among MSM and transgender communities, particularly in the North East and Western region.

Though around 2.5 million people with HIV/AIDS need second-line ARVs, the overall progress in access and services is impressive, said health analysts.