UNAIDS - 18 March 2010

The data, presented at CDC's 2010 National STD Prevention Conference, found that the rate of new HIV diagnoses among men who have sex with men (MSM) in the U.S. is more than 44 times that of other men and more than 40 times that of women.

"While the heavy toll of HIV and syphilis among gay and bisexual men has been long recognized, this analysis shows just how stark the health disparities are between this and other populations," said Kevin Fenton, M.D., Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. "It is clear that we will not be able to stop the U.S. HIV epidemic until every affected community, along with health officials nationwide, prioritize the needs of gay and bisexual men with HIV prevention efforts."

According to CDC many aspects contribute to the high rates of HIV and syphilis among gay and bisexual men in this country. Homophobia and stigma can prevent MSM from seeking prevention, HIV testing and counselling, and treatment services. Other causes include limited access to prevention services, unsafe sex practices and complacency about HIV risk due to existence of treatment, particularly among young gay and bisexual men. Also, the risk of HIV transmission through anal sex is much greater than the risk of transmission via other sexual activities.

"It seems like we have come full circle in the United States," said UNAIDS Executive Director Michel Sidibe. "Efforts must be redoubled to include gay and bisexual men in AIDS programming and reach out to and address the HIV prevention needs of all men who have sex with men."

Prevention programmes

According to UNAIDS, HIV prevention measures for men who have sex with men should include consistent and proper use of condoms, and access to water-based lubricants. High quality HIV-related services, like voluntary counseling and testing in a non-discriminatory environment,, should be made available as well as specific and targeted information on prevention and risk reduction strategies designed to appeal to and meet the needs of men who have sex with men. Further quality treatment for sexually transmitted infections with referral for HIV services must be made available.

The U.S. Department of Health and Human Services notes that in the United States men as a whole, are less likely to use the health care system than women. Men often seek care when they are experiencing critical health problems. Men who have sex with men who do not access health care may not know they are infected with HIV or an STD, thus compromising their own health status. The persistence of stigma and homophobia compounds the situation still further.

CDC officials noted that the new analysis underscores the importance of the HIV and STD prevention efforts to reach gay and bisexual men recently announced as part of the U.S. President's fiscal year 2011 national budget proposal.

The new analysis is the first step in more fully assessing the extent of HIV among MSM and other populations in the United States. The CDC is developing more detailed estimates of infection rates among MSM by race and age, as well as among injection drug users. Ultimately, these data can be used to better inform national and local approaches to HIV and STD prevention to ensure that efforts are reaching the populations in greatest need.

Resources:

Policy and guidance:

Men who have sex with men - Technical policies of the UNAIDS Programme - http://www.unaids.org/en/KnowledgeCentre/Resources/PolicyGuidance /Techpolicies/men_men_sex_technical_policies.asp

Men who have sex with men: Key operational guidelines of the UNAIDS Programme - http://www.unaids.org/en/KnowledgeCentre/Resources/PolicyGuidance /OperationGuidelines/men_men_sex_operational_guidelines.asp

Sexual Minorities - UNAIDS Guidance for Applicants to the Global fund to Fight AIDS, TB and Malaria Round 8 Call for proposals (pdf,127 Kb.) - http://data.unaids.org/pub/BaseDocument/2008/20080228_Rd8_SexualM inorities_en.pdf

Related information:

Men who have sex with men - http://www.unaids.org/en/PolicyAndPractice/KeyPopulations/MenSexM en/default.asp

Speeches:

Speech by UNAIDS Executive Director ôUniversal access for men who have sex with men: winds of change; signs of hopeö (pdf,34.8 Kb.) - http://data.unaids.org/pub/SpeechEXD/2009/20090916_sp_ms_msmwashi ngtondc_en.pdf

Feature stories:

Universal access in the Caribbean must include men who have sex with men (16 March 2010) - http://www.aegis.org/news/unaids/2010/UN100323.html

External links:

Centers for Disease Control and Prevention - http://www.cdc.gov/hiv/

Publications:

UNAIDS Action Framework: Universal Access for Men who have Sex with Men (pdf, 324 Kb) - http://data.unaids.org/pub/Report/2009/jc1720_action_framework_ms m_en.pdf

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