Hiv Risk And Multiple Vulnerabilities
When we speak about intersecting vulnerabilities, we refer to the specific barriers to HIV prevention, treatment, and care within at-risk populations. The more barriers there are, the greater the risk. Conversely, identifying these barriers enables public health agencies to employ culturally specific programs and strategies to better overcome them.
Epidemiological and clinical research has shown that, as a group, gay black men are at a fundamental risk of HIV due to a number of obvious and not-so-obvious reasons. Among them:
Stigma Discrimination And Violence
Gender norms in many cultures sanction the ill-treatment of men who have sex with men. As a result, a large proportion of men who have sex with men worldwide have reported experiencing violence due to their sexual orientation. This is especially evident in particularly machismo cultures and patriarchal societies.99
In some areas, public officials, police and healthcare workers are committing these offences. The fear of being identified as homosexual deters many men from accessing HIV services, avoiding healthcare check-ups and treatment in order to keep their orientation secret.100101
Evidence is also emerging that, in some settings, a high proportion of men who have sex with men are also experiencing intimate partner violence . A UK study among men who have sex with men involved in a trial for PrEP found around 45% had been a victim of IPV and around 20% had been a perpetrator.102
Why Is Hiv More Common In Men Who Have Sex With Men
Around the world, MSM are 25 times more likely than average to contract HIV, reports UNAIDS.
In the United States, gay men, bisexual men, and other MSM account for the majority of new HIV diagnoses.
Because HIV is more common among MSM, these men are more likely to have sex with someone who has the virus.
Several other factors also raise the chances of transmission across MSM.
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Lack Of Access To Education
Studies have shown that increasing educational achievement among women and girls is linked to better SRH outcomes, including delayed childbearing, safer births and safer abortions, lower rates of sexually transmitted infections and unintended pregnancies.35
Women with more education tend to marry later, bear children later and exercise greater control over their fertility. 36, DeNeve, JW et al. Length of secondary schooling and risk of HIV infection in Botswana: evidence from a natural experiment, Lancet Glob Health, Volume 3, No.8, p.e470e477 It has also been shown to be linked to reduced risk of partner violence, another factor that makes women and girls vulnerable to HIV.37 Despite this, in the least developed countries in the world, 60% of girls do not attend secondary school.38
Research has shown a direct correlation between girls educational attainment and HIV risk: uneducated girls are twice as likely to acquire HIV as those who have attended school.39 In Botswana, UNAIDS reports that every additional year of school a girl completes reduces her risk of acquiring HIV by 11.6%.40
How To Lower The Impact
Raising awareness about what HIV is and what it’s doing to the African-American community is a start. The CDC and other organizations are trying to shift ideas about HIV and AIDS so more black people feel safe talking about it and will get tested and treated.
To avoid HIV infections, practice safe sex. Ask your partner about their HIV status. Use a latex condom and water-based lubricant each time you have sex. If you think you may have an STD, see your doctor and get treatment.
Think about whether you should get tested for HIV whenever you get a medical checkup. Make it a part of staying healthy. Don’t be afraid to ask your doctor for an HIV test.
Always use clean needles and syringes for injected drugs don’t reuse one after someone else. Try counseling or treatment to help you stop using drugs.
CDC: “HIV Among African Americans,” “Prevention Challenges,” “Questions and Answers: Men on the Down Low,” “What African Americans Can Do,Ã¢â¬ï¿½ Ã¢â¬ÅHIV and African American People.Ã¢â¬ï¿½
Kaiser Family Foundation: “African Americans and HIV/AIDS,Ã¢â¬ï¿½ Ã¢â¬ÅBlack Americans and HIV/AIDS: The Basics.Ã¢â¬ï¿½
Journal of Acquired Immunodeficiency Syndrome: Ã¢â¬ÅHeterosexually transmitted HIV infection among African Americans in North Carolina.Ã¢â¬ï¿½
Journal of Health Communication: Ã¢â¬ÅHIV/AIDS coverage in Black newspapers, 1991-1996: implications for health communication and health education.Ã¢â¬ï¿½
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Statistics Can Be Easily Altered
Almost all of us on this site live in a certain society where the system is controlled and affected largely by religion, the same religion that condems each and every gay people, stating that they will go to hell for eternal damnation and pain just because of whom they may like.Statistics don’t hold any significance, as they are only a bunch of numbers that are published by people that don’t remotely have any interest on the topic. Many ‘scientific’ papers are done, only in order to be corrected 5 months later with the exact opposite idea that is fitting for the people controlling the research.Statistics are nothing but a bunch of made up numbers, and unless you have other evidences, your argument on this matter holds zero credibility.
Anal Sex Without A Condom
HIV can be transmitted through sex without a condom or other barrier method.
The chance of transmission is higher during anal sex without a condom or other barrier method than vaginal sex without a condom or other barrier method.
This is because the skin around the anus is thinner than the skin around the vagina, so small tears are more likely to occur during anal sex.
Someone without HIV is more likely to contract the virus during anal sex if they are the receptive partner .
Early diagnosis and treatment for HIV are important. Treatment with antiretroviral therapy prevents progression to AIDS. It can also reduce the virus to undetectable levels, at which point it cant be transmitted to others.
The CDC recommends that MSM get tested for HIV at least once a year. People at higher risk of HIV may benefit from more frequent testing, such as every 3 to 6 months.
Not all MSM follow these recommendations. As a result, some may have HIV without realizing it. This can lead to delays in treatment and increase the chances of transmission.
As of 2018, approximately 1 in 6 MSM with HIV in the United States didnt know they had the virus, reports the . In that same year, per the CDC, only 65 out of 100 gay and bisexual men with HIV in the United States received some HIV care.
Some MSM dont seek testing or treatment due to homophobic stigma or fear of discrimination.
Medications are available to reduce your likelihood of acquiring HIV.
In 2017, the CDC reported, PrEP was taken by:
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Why Hiv Spreads Less Easily In Heterosexual Couples
HIV particles invade a human immune cell. When HIV is transmitted through sex, only the strongest versions of the virus establish long-term infection. Chris Bjornberg/ScienceSourcehide caption
HIV is sexist.
A woman is twice as likely to catch the virus from an infected partner in a heterosexual relationship than a man is.
And homosexual men are at even greater risk. They’re more than 20 times as likely to get infected from an HIV-positive partner than partners in a heterosexual relationship.
Now scientists at Microsoft Research and the Zambia-Emory HIV Project have a clue about why these disparities exist.
Only the strongest, most evolutionary “fit” versions of the virus tend to infect a man when he has sex with an HIV-positive woman, scientist report Thursday in the journal Science.
Young Gay And Bisexual Men Are More Likely To Use Drugs
A review of several studies found young gay and bisexual men are more likely to report drug use. This can increase exposure to HIV in two major ways: First, needles are the riskiest way to transmit HIV outside of sex. Second, people who use drugs before sex are more likely to engage in risky sexual behaviors, like not using a condom.
To that end, the CDC survey of high school students also found that young gay and bisexual men are much more likely to report injecting illegal drugs and using drugs or alcohol before their last sexual intercourse encounter.
These trends are stark. Compared to young men who have sex with women, those who have sex with men are nearly 10 times as likely to have ever injected illegal drugs, and they’re over 50 percent more likely to use drugs or alcohol prior to sex.
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Causes Of Increased Risk
Understanding the stark differences in lifetime HIV risk is not always easy. The common, knee-jerk response might be to conclude, dispassionately, that sexual practices paired with cultural attitudes and behavior are the sole factors that place gay black men at such profoundly high risk.
But the simple fact is that gay black men in the U.S. sit in the epicenter of numerous intersecting vulnerabilities, which together make infection all but inevitable in certain individuals.
From a broader social perspective, it is known that any epidemicbe it HIV or any other communicable diseasetends to strike groups that are stigmatized well in advance of the disease event. This happens because there are generally few systems in place to intervene, either medically and legally, and often little interest to act from those outside the stigmatized population.
We saw this in the early part of the AIDS epidemic in the 1980s, when gay men, just emerging from an era of police abuse and judicial apathy, were hit by a wave of infections with no means to stop it, There was nothing in the way of gay health services or advocacy groups to combat inaction on either the state or federal level.
So, with deaths rising from the hundreds to thousands, the gay community took it upon themselves , to mount their own healthcare services and civil action groups .
It’s a vicious cycle that only further stigmatizes gay black men while fueling the already high new infection rate.
Haart And Hiv Vaccination In Msm
We assume that only 20% of MSM with HIV-1 start to take HAART each year in China, although some of the simulations below permit variable rates of HARRT treatment. To model the effects of HAART, we add one additional compartment to each of the infected groups. We assume that individuals taking HAART extend their lifespan by 5 years, so their annual death rate is 0.069. Since HAART predictably decreases plasma HIV-1 RNA levels to below the level of detection of currently available assays , we also assume that individuals taking HAART are no longer infectious. This reduction of plasma HIV-1 leads to an increase in adverse behaviour , and we model this behaviour change by reducing condom use between MSM from cto zero . We also consider the effect of a potential vaccine, by adding one compartment for each of the uninfected groups. This vaccine has the property that vaccinated individuals may become infected, if the efficacy of the vaccine is less than 100%. In our baseline simulations, we assume that uninfected individuals are vaccinated at a rate of 20%, , and we explore vaccine efficacies of 30% and 70%. Equations for both the HAART model and the vaccination model can be found in Additional File .
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Tops Bottoms And Prep: What You Need To Know About Hiv Prevention
Nearly 70% of people living with HIV are homosexual and bisexual men and thankfully the use of PrEP for HIV prevention is increasing among this group. According to a recent study, the number of gay and bisexual males taking PrEP increased by 500% from 2014 to 2017. However, only 35% of gay and bisexual males who were at high-risk of HIV transmission were taking the medication.
It is important that everyone takes the proper precautions to protect themselves from HIV transmission. While some people are at more risk than others due to lifestyle choices or other practices, there is a common misconception that your risk of HIV transmission is higher or lower depending on your sexual orientation or preferred sexual position.
PrEP is designed to help protect any person regardless of sexual orientation from HIV transmission. But, you may be wondering if PrEP could affect you differently or be more or less effective depending on if you are a top, bottom, or vers.
For instance, many tops assume they do not need to take PrEP since they are at a lower risk of contracting HIV than a bottom since they are not penetrated.
So, does PrEP work differently for tops and bottoms?
Well first, lets explain what puts you most at risk for HIV transmission and why you should consider taking PrEP in the first place regardless of sexual orientation.
What Are The Signs And Symptoms Of Hiv
Within a few weeks of getting HIV, some people get flu-like symptoms that last for a week or two, but others have no symptoms at all. After initial infection, people may not have any symptoms for years. HIV can be controlled with the right medical treatment and care. However, if its left untreated, it may develop into AIDS .
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The Hiv Transmission Rate
The key to quantify the transmission of HIV is the parameter yx, the transmission rate that an individual from compartment y infects his partners from compartment x. We shall use the following formula to estimate the HIV transmission rate through either insertive or receptive AI:
The HIV transmission rate through anal sex in MSM depends on six quantities:
the number of different AI sex partners per year, nx, for individuals from compartment x
the number of AI with each sex partner per year, cx, for individuals from compartment x
the viral transmission probability per anal sex act, hyx
the level of protection against HIV infection due to condom usage , where cis the condom efficacy and cis the proportion of condom use)
the proportion of infected MSM who know that they are infected, y. This term denotes the effect of the 2008 HIV census in MSM population, where many men discovered they were HIV positive ydenotes the proportion of these infected MSM who begin to control their behaviour to avoid the spreading of HIV, if they did not use condoms before they knew that they have been infected by HIV.
other STIs increase both the rate of transmission and acquisition of HIV
Debunking Common Myths About Hiv
Read responses to myths that ‘HIV is a gay disease’ or a ‘death sentence,’ and find other important information about getting tested.
Myths about who contracts HIV
MYTH: HIV is a gay or LGBT disease.REALITY: While rates of HIV are disproportionately higher among members of the LGBTQ community, HIV is by no means confined to LGBTQ people. Anyoneregardless of sexual orientation, gender identity, gender expression or other factorscan acquire HIV. Calling HIV a gay or LGBTQ disease is medically untrue and only serves to perpetuate harmful stereotypes about people living with HIV and members of the LGBT community.
MYTH:I am over 50! I dont need to worry about HIV.REALITY: HIV transmission is about behavior, not how old you are. Moreover, according to the CDC, older Americans are more likely to be diagnosed with HIV at a later stage of the disease.
MYTH:I am in a monogamous relationship. I dont have to worry about HIV.REALITY: It is still important to get tested for HIV even if youre in a monogamous relationship. According to the latest estimates, 68 percent of new HIV transmissions among gay and bisexual men occur in the context of a primary relationship . Be sure to talk to your partner your sexual health and practices and theirs. You might even consider getting tested together for HIV and other sexually transmitted infections .
Myths about who contracts HIV
Myths about HIV testing and treatment
Myths about HIV prevention and safer sex
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What Factors Put Men Who Have Sex With Men At Risk Of Hiv
The fact that HIV prevalence among men who have sex with men is so high in many countries means that members of this group have an increased chance of being exposed to the virus. This is mainly due to having unprotected sex.10 However, there are other factors that put men who have sex with men at heightened risk of HIV.
Model Analysis: The Basic Reproductive Ratio R0
Following the next-generation operator method of , we linearize the second, the fourth and the sixth equations of our model around the disease-free state and look for conditions that guarantee the growth of the three infected classes, IT, IVand IB.
For simplicity, we write VTinstead of . Other parameters labelled xyhave similar meanings. The Jacobian matrix of the second, the forth and the sixth equations of our model at the disease-free state can be rewritten in the following form:
R0 is the spectral radius of the next-generation matrix. Therefore, to find R0 we must find the largest eigenvalue of .
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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.