The overwhelming presence of civil society at the meeting allowed the NGO Delegation more consultation and more influence in its negotiations, especially in the drafting room (where the wording of the decisions are discussed and agreed). In the end, the key decision points passed, notably the decision point on the agenda item “Reducing HIV transmission among men who have sex with men and transgender people.” This decision took note of the update report from UNAIDS on Reducing HIV transmission among men who have sex with men and transgender people, and “calls on UNAIDS and all partners to intensify efforts to meet the health needs of men who have sex with men and transgender people in the context of HIV and to ensure non-discrimination,” and to increase their “direct participation in national, regional and global HIV policy and programming.” Iran disassociated itself from this decision point at the end of the meeting.

In this climate of harmonization, collaboration, increased accountability, and spurred by pressure to make more significant headway toward reaching the Millennium Development Goals (MDGs) in the next five years, the political and programmatic importance of linking sexual and reproductive health (SRH) and HIV responses has been increasingly gaining momentum. The rationale, laid out since 2004, is indisputable – the majority of HIV infections are sexually transmitted or are associated with pregnancy, childbirth and breastfeeding; and the risk of HIV transmission and acquisition can be further increased due to the presence of certain sexually transmitted infections (STIs). Moreover, sexual and reproductive ill-health and HIV share root causes, including economic inequality, limited access to appropriate information, gender inequality, harmful cultural norms and social marginalisation of the most vulnerable populations.