Why Are Gay Men More At Risk For Hiv
Dr. David explains whats behind the higher rates of HIV among gay men.
One reason some groups and areas have been more affected by HIV/AIDS than others is because the HIV prevalence the percent of the population that has HIV is already high. In other words, the chances of coming in contact with the virus and thus also the risk of infection is greater.
A common misconception is that groups with higher rates of HIV are acting less responsibly. In fact, research shows that this is not the case. Groups more at-risk for HIV are generally found to get tested more frequently, use condoms more often, and take other precautions to protect against HIV as compared with other groups. The chance of being exposed to the virus is just greater in these social networks and so the response must also be greater.
Increased access to HIV treatment and care, along with earlier diagnosis, and use of PrEP has been shown to bring down rates of HIV even among areas with higher prevalence.
#AskTheHIVDoc is a video series from Greater Than AIDS featuring top HIV doctors providing answers to commonly-asked questions about HIV prevention, testing and treatment.
This information is shared for educational purposes only and should not be used as a substitute for professional medical advice. The views expressed are those of the featured medical professional and reflect information available to that professional at time of filming. Always consult a health care provider for any personal health decision.
Hiv Resources For Gay Black Men
The CDC has designed a number of initiatives to address these shortcomings, including the Testing Makes Us Stronger social marketing campaign aimed at gay black men aged 18 to 44.
Spearheading activism and awareness in the gay black community is the CDC-supported Black Men’s Xchange , which operates 11 chapters in the U.S., and the Center for Black Equity, which works with local pride organizations.
To find programs and services within your community or state, contact your regional 24-hour AIDS hotline. For free, confidential HIV testing, contact 800-CDC-INFO for referrals, or use the online AIDSVu HIV testing site locator organized by the Rollins School of Public Health at Emory University.
Access To Antiretroviral Treatment For Men Who Have Sex With Men
Accurate statistics comparing treatment access among men who have sex with men is rarely available. What evidence exists suggests uptake is fairly limited.80
Worldwide, only 40% of men who have sex with men living with HIV are thought to be accessing treatment. Those living in low- and middle-income countries generally report the lowest access to ART, with especially low rates in countries which criminalise same-sex behaviour.81 Reasons cited for such low access include homophobia, stigma and discrimination. These can cause men who have sex with men to delay, interrupt or avoid treatment altogether. Experiencing these reactions from healthcare workers is also given as a predominant reason.82
For example, between 10% and 40% of HIV-positive men who have sex with men in Burkina Faso, Côte dIvoire, Eswatini and Lesotho avoid or delay healthcare due to fear of stigmatising behaviour towards them from healthcare providers.83
In Moscow, where LGBT rights are broadly denied, a survey looking at the treatment care cascade among men who have sex with men found that just 36% of those who knew their HIV status were accessing antiretroviral therapy, and just under two-thirds of those accessing treatment were virally suppressed.84
WHO has produced comprehensive guidance on HIV services for men who have sex with men and recommends that adherence can be increased significantly by addressing HIV stigma and discrimination.
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What Should I Do If I Think Im At Risk For Hiv
If you think youre at risk for getting HIV, or that you might already have HIV, get tested and learn about the effective HIV prevention and treatment options available today.
Testing is the only way to know for sure if you have HIV. Find out whether testing is recommended for you.
Many HIV tests are now quick, free, and painless. Ask your health care provider for an HIV test or use the HIV Services Locator to find a testing site near you. You can also buy an FDA-approved home testing kit at a pharmacy or online.
Knowing your HIV status gives you powerful information to help you take steps to keep you and your partner healthy:
- If you test positive, you can start HIV treatment to stay healthy and prevent transmitting HIV to others.
- If you test negative, you can use HIV prevention tools to reduce your risk of getting HIV in the future.
The Epidemiology Of Hiv In Canada
This fact sheet provides a snapshot of the HIV epidemic in Canada. All epidemiological information is approximate, based on the best available data. Most of the data contained in this fact sheet come from the latest estimates from the Public Health Agency of Canada, which are for the year 2018. More information can be found in the section Where do these numbers come from? at the end of the fact sheet.
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Social And Cultural Factors
Many men who have sex with men have experienced homophobic stigma, discrimination and violence. This drives men who have sex with men to hide their identity and sexual orientation. Many fear a negative reaction from healthcare workers. As a result, men who have sex with men are less likely to access HIV services than heterosexuals.37
Men who have sex with men are more likely to experience depression due to social isolation and being disconnected from health systems. This can make it harder to cope with aspects of HIV such as adherence to medication.3839
Hiv And Men Who Have Sex With Men
Since reports of the human immunodeficiency virus began to emerge in the United States in the 1980s, the HIV epidemic has frequently been linked to gay, bisexual, and other men who have sex with men by epidemiologists and medical professionals. The first official report on the virus was published by the Center for Disease Control on June 5, 1981 and detailed the cases of five young gay men who were hospitalized with serious infections. A month later, The New York Times reported that 41 homosexuals had been diagnosed with Kaposis Sarcoma, and eight had died less than 24 months after the diagnosis was made. By 1982, the condition was referred to in the medical community as Gay-related immune deficiency , “gay cancer,” and “gay compromise syndrome.” It was not until July 1982 that the term Acquired Immune Deficiency Syndrome was suggested to replace GRID, and even then it was not until September that the CDC first used the AIDS acronym in an official report.
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How Mental Health Issues Can Worsen Hiv Among Bisexual People
Bisexual people often also have worse mental health outcomes, often as a result of biphobia and bisexual erasure. For instance, many bisexual people deal with being told that their sexuality is either nonexistent or invalid. This includes being told that bisexuals are greedy, confused, or sexually promiscuous.
Bisexual people have a number of measurably worse mental health outcomes than their straight and gay counterpartseach of which can lead to increased HIV risk and poorer health while living with HIV.
How Many New Hiv Infections Are There In Canada Each Year
According to national HIV estimates, there were 2,242 new HIV infections in Canada in 2018. This means that for every 100,000 Canadians, six people became HIV positive in 2018 .
There was a small increase in the number of new HIV infections in 2018 compared with 2016, when there were an estimated 1,960 new HIV infections.
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The Aids Epidemics Lasting Impact On Gay Men
19 Feb 2018
Turning points in gay history
In the 20th century, the gay community saw such watershed moments as the targeting of gay people by the psychiatric enterprise and the McCarthy era witch-hunts, the birth of gay liberation, lesbian feminism, and queer culture, homosexualitys and demedicalisation, the legalisation of gay marriage, and the overturning of bans on gay people serving in the military.
As with all watersheds, these events impacts were filtered through such characteristics as gender, ethnicity, class, and age at the time of the event. For gay men and women born before 1930, whom I interviewed in 1995 and who came of age in an era of political, medical, and scientific oppression, the emergence of gay liberation was the most significant event shaping their experience of gay life.
Peak of the AIDS epidemic
While these older gay people were aged 50-70 in 1980, when HIV / AIDS emerged in the west, gay male baby boomers were aged 34-16.
For them, the high number of AIDS deaths at the epidemics peak shaped their personal, social, psychological, and community lives, during the epidemic, throughout their life course, and into later years. AIDS killed 324,029 men and women in the USA between 1987 and 1998 .
AIDS killed 324,029 men and women in the USA between 1987 and 1998.
Silence = Death: Direct action in response to the AIDS Crisis
Devastating numbers of AIDS deaths in major cities
Impact on survivors of the AIDS epidemic
Ongoing impact of HIV/AIDS
Does Hiv Affect Gay And Bisexual Men
In the United States, gay and bisexual men are the population most affected by HIV. According to the Centers for Disease Control and Prevention , in 2019, adult and adolescent gay and bisexual men accounted for 69% of the new HIV diagnoses in the United States and dependent areas.
In the United States, gay and bisexual men are the populationmost affected by HIV.
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Mental Health: A Major Issue Affecting Hiv In Lgbtq Communities
LGBTQ people are disproportionately at risk for a variety of mental health issues, including major depression, bipolar disorder, and generalized anxiety disorder. These issues can lead to detrimental outcomes, like drug use, suicideand, of course, HIV.
Poor LGBTQ mental health comes from a myriad of factors. Some are societal, including the stigma and shame associated in some communities with having a queer or transgender identity. Others are interpersonal, like the need to stay in the closet or the fear of being outed. Often, queer and transgender children are told that they are not good at performing their assigned gender, which can lead them to internalize a sense of failure early in their lives.
Most of the research studying LGBTQ people and mental health centers around gay and bisexual men. Researchers tend to consider mental illness and HIV to be a syndemic in gay and bisexual men, meaning they intertwine with one anothereach epidemic perpetuates the other. Depression, trauma, and substance use are all linked to HIV acquisition risk in different ways.
In addition, as with so many other health disparities in the U.S., racism worsens the impact of mental health issues on people living with HIV.
National Gay Mens Hiv/aids Awareness Day 2021
In 2019, there were 587,355 Gay and Bisexual Men living with HIV, representing over half of all people living with HIV in the U.S.
Gay and Bisexual Men face multiple HIV prevention challenges, such as racism, discrimination, homophobia, and stigma, that put them at higher risk for HIV and prevent them from accessing quality health care that allows them to be aware of their status and take steps to improve their health. These factors are even more prominent for Gay and Bisexual Men of color. From 2008 to 2019, Black Gay and Bisexual Men and Hispanic/Latino Gay and Bisexual Men experienced a 2% decrease and 18% increase respectively in new HIV diagnoses, compared to a 34% decrease among white Gay and Bisexual Men.
Racial disparities are also visible along the HIV care continuum, a public health model that outlines the stages of care people living with HIV go through from diagnosis to achieving and maintaining viral suppression. In 2019, Black Gay and Bisexual Men and Hispanic Gay and Bisexual Men living with HIV had lower rates of viral suppression, 62% and 67% respectively, compared to white Gay and Bisexual Men living with HIV .
In addition to racial disparities, many Gay and Bisexual Men experience challenges in achieving and maintaining viral suppression due to disproportionate levels of homelessness, stigma, and a lack of mental health and culturally competent care that may prevent them from accessing treatment and necessary medications.
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How Gender Discrimination And Violence Affect Hiv Risk For Lesbians And Bisexual Women
Many bisexual and lesbian women are put at risk for HIV because of their gender. Gender-based discrimination and abuse extend to many fields of life, including in the medical field and in sexual relationships, two areas that can potentially impact a persons health status.
The 2010 National Intimate Partner Violence and Sexual Violence survey found that 44% of lesbian women and 61% of bisexual women experience intimate partner violencewhich is more common among people living with HIVat some point in their lives. This is compared to 26% of gay men and 37% of bisexual men experiencing intimate partner violence. LGBTQ youth are also much more likely to experience this than their heterosexual and cisgender counterparts.
Bisexual women are between 1.8 and 2.6 times more likely than heterosexual women to experience intimate partner violence.
Both men and women contribute to rates of intimate partner physical and sexual violence among lesbians and bisexual women. The CDC found that 89.5% of bisexual women reported only male perpetrators for instances of intimate partner physical violence, rape, and stalking, while a third of lesbian women who have experienced these forms of violence from intimate partners have had one or more male perpetrators.
One In Eight Sexually Active Gay Men In London Has Hiv Figures Reveal
ne in eight gay men in London has HIV according to figures released today, which reveal the disease is three times more prevalent in the capital than the rest of the country.
A report from Public Health England shows 13 per cent of gay men in London have HIV, compared to less than four per cent outside the capital.
The number infected with the virus reached a record high of 108,000 in the UK in 2013, with more than a quarter of carriers unaware they are infected according to Public Health England.
The situation has heightened concerns they are at risk of passing on the infection through unprotected sex and led to calls for gay men to be tested for HIV at least annually.
Last year London had the highest number of new diagnoses among gay men in the country, with 1,470 reported new cases.
The report states 3,250 gay and bisexual men in the capital were newly diagnosed with the virus in 2013, an all-time annual high.
Nationwide it is estimated that over 7,000 gay men have an HIV infection that remains undiagnosed and that an estimated 2,800 men acquired HIV in 2013.
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What Is Ending The Hiv Epidemic In The Us
Ending the HIV Epidemic in the U.S. is a bold plan announced in 2019 that aims to end the HIV epidemic in the United States by 2030. Agencies across the U.S. Department of Health and Human Services developed an operational plan to pursue that goal accompanied by a request for additional resources that were provided by Congress.
The plan leverages critical scientific advances in HIV prevention, diagnosis, treatment, and outbreak response by coordinating the highly successful programs, resources, and infrastructure of many HHS agencies and offices. In its first phase, the initiative is focusing on areas where HIV transmission occurs most frequently, providing 57 geographic focus areas with an infusion of additional resources, expertise, and technology to develop and implement locally tailored EHE plans.
What Factors Put Gay And Bisexual Men At Risk For Hiv Infection
The high percentage of gay and bisexual men who are living with HIV means that, as a group, they have a greater risk of being exposed to HIV.
Other factors may also put gay and bisexual men at risk for HIV infection:
- Anal sex. Most gay and bisexual men get HIV from having anal sex without using condoms or without taking medicines to prevent or treat HIV. Anal sex is the riskiest type of sex for getting HIV or passing it on to others .
- Homophobia, stigma, and discrimination. Negative attitudes about homosexuality may discourage gay and bisexual men from getting tested for HIV and finding health care to prevent and treat HIV.
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How Did We Achieve This
Because the decline in annual incidence started in 2013 when few men were taking PrEP, the remarkable decline in infections appears largely to be due to treatment as prevention, or what is often called ‘U=U’ when applied to individuals. Two factors made all the difference.
The first was a big increase in the number and frequency of HIV tests. The number of HIV tests in gay men at STI clinics nearly tripled from 60,000 in 2010 to 160,000 in 2018, and the average number of times gay men tested in a year increased from 1.4 to 1.8, thanks partly to a recommendation in 2012 that gay men at risk of HIV should test every three months rather than every six months.
The lesson for other high-income countries is that amplified testing and treatment as prevention have controlled the HIV epidemic in England.”
Probably even more crucial was the widespread adoption of immediate ART on diagnosis. In the first decade of this century treatment was not recommended until the CD4 count fell below 200 and as a result the proportion of people who had started treatment within six month of diagnosis stayed at around 30-35%. The CD4 threshold was changed to below 350 cells in 2008 and treatment for all was recommended in 2015. In 2018, 91% of diagnosed gay men started treatment within six months, with an average post-diagnosis wait of only 2-3 weeks.
With additional large-scale implementation of PrEP, elimination of HIV transmission is likely to be within reach by 2030.