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HIV/AIDS and Men Who Have Sex with Men (MSM)

February 27, 2007

The term men who have sex with men (MSM) refers to all men who have sex with other men, regardless of how they identify themselves (gay, bisexual, or heterosexual). In the United States, HIV and AIDS have had a tremendous impact on MSM.

AIDS has been diagnosed for more than half a million MSM.
Almost 300,000 MSM with AIDS have died during the past 20 years.
MSM made up about two thirds of all men living with HIV in 2004, even though only about 5% to 7% of men in the United States reported having sex with other men.
In a 2005 study, 46% of African American MSM were HIV-positive.

Since HIV/AIDS in MSM was first diagnosed 1981, gay and bisexual men have been leaders in dealing with the challenges of the epidemic. Gay organizations and activists, through their work, have contributed greatly to many of the guidelines for prevention, treatment, and the care of people living with HIV/AIDS. For complex reasons, HIV/AIDS continues to take a high toll on the MSM population. For example, the number of new HIV/AIDS cases among MSM in 2004 was 8% more than the number of cases in 2003. It is unclear whether this increase is due to more testing or to an increase in the number of HIV infections.

Whatever the reasons, in 2004, MSM still accounted for about 51% of all new HIV/AIDS cases and 70% of cases in male adults and adolescents. The HIV/AIDS epidemic continues to evolve. As old challenges remain and are addressed, new ones emerge, requiring new approaches to prevention and treatment. Despite many prevention successes, MSM face a wide range of risks for infection and barriers to prevention. Among them are the following:

Sexual Risk

Sexual risks account for most HIV infections in MSM. These risks include unprotected sex and sexually transmitted diseases (STDs). Not using a condom during anal sex with someone other than a primary HIV-negative partner continues to be a significant threat to the health of MSM. STDs (such as syphilis and gonorrhea) increase the risk for HIV infection and are persistent health issues for MSM. Not only do STDs increase one’s chances of becoming infected with HIV, they also can indicate high-risk sexual behavior, which facilitates the transmission of HIV infection.

Substance Use

Some MSM use alcohol and illegal drugs, contributing to increased risk for HIV infection and other STDs. The use of substances such as alcohol and illegal drugs can increase the likelihood of risky sexual behavior while under the influence, as well as the likelihood of sharing needles or other injection equipment. The use of methamphetamines, or “meth,” by MSM is a very important public health issue facing MSM.

Complacency about Risk Factors

HIV has been a threat for 25 years, yet many people believe they are at low risk of becoming infected or infecting their partner. This is especially true of young gay and bisexual men who, unlike older gay and bisexual men, have not experienced the toll of HIV/AIDS. At the same time, the success of new drug treatments may be contributing to increased risky behaviors among some MSM. For example, some MSM may mistakenly believe that they or their partners cannot spread the virus when they take HIV medication or that having HIV is minor condition with no life-threatening consequences. They may not understand that HIV treatment may not work for everyone and that for some, it may work only for a time.

Unknown HIV Sero-status

Approximately 25% of people in the United States who are infected with HIV do not know they are infected. In a study of young MSM, 77% of those who tested HIV-positive mistakenly believed that they were not infected. Young African American MSM in this study were especially likely to be unaware of their HIV infection. Many of these men had been tested for HIV, but not recently. CDC recommends that MSM be tested for HIV at least once a year. People who are not aware of their HIV infection cannot take advantage of medicine that can help them live longer, healthier lives. Nor do they have information that will help protect their sex and drug-using partners from HIV infection.

MSM Who Are HIV-positive

Studies have shown that many MSM reduce their risky behaviors after testing positive for HIV infection. However some MSM continue to engage in behaviors that put others at risk. Focusing on MSM living with HIV is especially important today, given the increasing number of MSM living with HIV because of the benefits of antiretroviral therapies.

The Internet

During the past decade, the Internet has created new opportunities for MSM to meet sex partners. Internet users can anonymously find partners with similar sexual interests without having to leave their home or having to risk face-to-face rejection if the behaviors they seek are not consistent with safer sex. Research has shown that MSM who meet partners on the Internet are more likely to take sexual risks than are MSM who do not seek sex partners on the Internet.

Source:
Centers of Disease Control and Prevention
http://www.cdc.gov/hiv/topics/msm/index.htm
http://www.cdc.gov/hiv/topics/msm/challenges.htm

Posted at 09:19 AM by Shantrie in the HIV & AIDS category/ies.