- Category: HIV Populations
- Published on Wednesday, 26 September 2012 00:00
- Written by Liz Highleyman
Thursday is the fifth annual observance of National Gay Men's HIV/AIDS Awareness Day (NGMHAAD), an opportunity to raise awareness about the epidemic among men who have sex with men. Young gay and bisexual men -- especially African Americans -- are the only population whose HIV incidence rate continues to rise.
According to the National Association of People with AIDS (NAPWA), which started NGMHAAD in 2008, some 720,000 American men who have sex with men (MSM) -- or nearly 1 in 8 -- are now living with HIV, and at least a quarter-million more have died over the 31 years of the epidemic.
According to the Centers for Disease Control and Prevention (CDC), gay and bisexual make up approximately 2% of the U.S. population but account for more than half of all new HIV infections. In 2009 MSM accounted for 61% of all new infections, and young gay/bisexual men accounted for 69% of new infections in the 13-29 year age group. While new infections were relatively stable among gay/bisexual men overall from 2006 through 2009, they increased by 34% among young MSM, and by a staggering 48% among young black MSM.
Men who have sex with men bear a disproportionate burden of the epidemic on a global scale as well, and in many countries homophobia and discrimination make it more difficult for gay men to access HIV prevention services and care.
The July 28, 2012, issue of The Lancet featured a series of articles on HIV among gay and bisexual worldwide. According to an epidemiological overview by Chris Beyrer and colleagues, the disproportionate burden of HIV among MSM can largely be explained by the high per-act and per-partner probability of transmission during receptive anal sex. They calculated that if the probability of transmission via anal sex was similar to that associated with unprotected vaginal sex, 5 year cumulative HIV incidence rates for MSM would be 80%-98% lower. Although the risk of transmission via insertive anal sex is much lower, a large proportion of gay men have sex as both tops and bottoms over time. Casual partnerships, the authors added, "are also a substantial driver of the epidemic in MSM."
As recounted in the August 27, 2012, issue of NAPWA's Positive Voice newsletter, "NAPWA founded NGMHAAD in 2008 because we want [gay men] to know the epidemic isn't over. We want them to know how high their HIV risk really is -- because so many are already infected, and too many don't know it. And we want them to know that we've come a long way since AIDS was first reported in 1981, and even further since Stonewall, but stigma is still driving this epidemic and gay men don't have to take it anymore."
As the first population to be affected by HIV/AIDS, gay men -- and the LGBT community more broadly -- played a pioneering role in developing prevention strategies, establishing care and services, and demanding effective treatments.
"On National Gay Men’s HIV/AIDS Awareness Day, we honor the remarkable history of gay men’s leadership in the fight against the HIV epidemic," said Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention. "Three decades ago, extraordinary community and public health prevention efforts led to dramatic declines in new HIV infections among men who have sex with men."
"Yet infection rates are now increasing among young gay and bisexual men, particularly men of color," he continued. "We must not allow another generation to be devastated by this disease. Together we can, and must, revitalize the passion and dedication that helped turn back the HIV epidemic among gay men during its darkest days."
"One of the most important things every gay and bisexual man can do to stop the spread of HIV is to get tested for the disease at least once a year," Fenton urged. "If you test negative, you’ll have peace of mind and can redouble your efforts to stay safe. And if you test positive, you can get the medical care and support that you need to keep healthy and protect others from infection."
AIDSinfo. Fifth Annual Awareness Day Highlights HIV Among Gay Men. AIDSinfo At-A-Glance 8(41). September 21, 2012.
NAPWA. Facing Hard Truths. Positive Voice 3(11). August 27, 2012.
FJ Oldham. The Diversity of Gay Men. Positive Voice 3(12). September 10, 2012.
C Beyrer, SD Baral, Frits van Griensven, et al. Global epidemiology of HIV infection in men who have sex with men. The Lancet 380(9839):367-377. July 28, 2012.
CDC. CDC Statement for National Gay Men's HIV/AIDS Awareness Day (Sept. 27). Media statement. September 25, 2012.