This report provides a comprehensive analysis to date of HIV-related funding and programming for MSM in six Southern African countries (Botswana, Malawi, Namibia, Zambia, Zimbabawe and Swaziland). The report also suggests actionable steps to improve the HIV response among MSM. A careful examination of MSM-related policies through donor and multilateral agencies reveals improved efforts but persistently inadequate investments and limited accountability for better results. On-the-ground consultations in the six countries highlighted some models for success combined with persistent, widespread stigma in all contexts and a lack of even the most basic HIV prevention services for MSM in most. The research in this report confirms that countries that criminalize same-sex sexual practices spend fewer resources on HIV-related health services for MSM, do less to track and understand the epidemic in their nations, and are more likely to repurpose donor funds intended to fight the epidemic among MSM. However, criminalization is only one obstacle to effective HIV programs for MSM. Stigma and discrimination in all contexts play equally important roles.