AIDS and Behavior

, Volume 20, Supplement 3, pp 330–340

Engagement of Gay Men and Other Men Who Have Sex with Men (MSM) in the Response to HIV: A Critical Step in Achieving an AIDS-Free Generation

  • Shauna Stahlman
  • Chris Beyrer
  • Patrick S. Sullivan
  • Kenneth H. Mayer
  • Stefan D. Baral
Original Paper

Abstract

Men who have sex with men (MSM) continue to be at elevated risk for HIV acquisition and transmission secondary to biological and behavioral characteristics, social and sexual network characteristics, community environmental factors, and structural factors. HIV incidence rates remain high among MSM in both low- and high-income settings, and in both concentrated and more generalized HIV epidemic settings. While data quality tends to be poorer, the best estimates collectively suggest that MSM have up to 20 times the odds of living with HIV as compared to other reproductive aged adults across low- and middle-income countries. Recent prevention strategies to lower biological HIV transmission and acquisition risks, including the early use of antiretrovirals to decrease infectiousness for those living with HIV, and pre-exposure prophylaxis for those at significant risk of HIV acquisition, have demonstrated the potential to change the trajectory of the HIV epidemics among MSM. However, the coverage and effectiveness of these approaches is limited by structural factors including the punitive legal frameworks and institutional discrimination that contribute to limited uptake, challenges to adherence, and suboptimal health-seeking behaviors among MSM. More intensive efforts will be required to reach MSM who do not currently have access to relevant and effective prevention and treatment services or elect not to access these services given enacted and/or perceived stigma. Respect for human rights, including efforts to aggressively confront and combat the forms of stigma that are preventing us from achieving an AIDS-Free generation, are needed for all people including gay men and other MSM.

Keywords

Men who have sex with men MSM HIV Epidemic Risk factors 

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Shauna Stahlman
    • 1
  • Chris Beyrer
    • 1
  • Patrick S. Sullivan
    • 2
  • Kenneth H. Mayer
    • 3
    • 4
  • Stefan D. Baral
    • 1
  1. 1.Department of Epidemiology, Center for Public Health and Human RightsJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaUSA
  3. 3.Fenway HealthThe Fenway InstituteBostonUSA
  4. 4.Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA

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