HIV Prevention among African-American and Latino Men Who Have Sex with Men

Abstract

Public health data indicate that the incidence of acquired immunodeficiency syndrome (AIDS) among racial and ethnic minority men who have sex with men (MSM) has been disproportionately high among African-American and Hispanic men in the United States.¹ AIDS cases due to male-to-male sexual contact account for 39% of AIDS cases among African Americans and 43% among Hispanic Americans.² Also, cross-sectional and cohort studies among these ethnic minority men have revealed they have maintained elevated levels of high-risk sexual behavior.^3-8 These data suggest that more effective human immunodeficiency virus (HIV) prevention programs are needed among homosexual and bisexual racial and ethnic minority men to achieve the significant reductions in HIV transmission reported among white gay and bisexual men.⁹ However, notable differences between white and nonwhite MSM increase the difficulty to provide effective intervention programs to minority men. The emphasis on HIV transmission among minority heterosexuals diverts attention from the substantial route of HIV transmission through male-to-male sexual activity. Also, the opportunity for HIV prevention with minority MSM is greatly diminished by the influence of prejudice and discrimination toward nonwhite MSM by both minority culture and mainstream gay culture. Finally, these efforts are hampered by the lack of sufficient prevention research to guide further development of community programs. Despite these obstacles, such evidence is urgently needed to help provide directions for HIV prevention among minority MSM populations.