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MEN WHO HAVE SEX WITH MEN AND HIV/AIDS
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On
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SURVEILLANCE |
- In
2006, an estimated 26,989 men were diagnosed
with AIDS in the United States. Male-to-male
sexual contact was the HIV transmission
category in 59.3 percent of those cases.1
- Estimated
new AIDS cases related to the male-to-male
sexual contact transmission category increased
from 2005 to 2006 while the number of
male-to-male sexual contact/injection
drug use (IDU) cases fell.1
- Male-to-male
sexual contact was the HIV transmission
category for 60 percent and male-to-male
sexual contact/IDU was the HIV transmission
category for 8 percent of men estimated
to be living with AIDS at the end of 2006.1
- Of
all men estimated to be living with AIDS
at the end of 2006, White men were most
likely to list male-to-male sexual contact
as their transmission category. Male-to-male
sexual contact accounted for 75 percent
of cases among White men compared to 49
percent among Black men.3
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CRITICAL
ISSUES |
Like
many racial and ethnic minorities, minority
MSM often face poor access to health care
because of lack of health insurance and poverty.
In addition, MSM must cope with many types
of stigma—racial/ethnic minority, MSM,
and HIV positive. MSM of color, therefore,
may fear condemnation from their families,
communities, and service providers.2
In
one study on prevention activities targeting
Black MSM, respondents called this population
“hidden” due to a lack of “gay-affirming”
venues in their community or a general fear
of being “out” in public. House
parties were identified as a social venue
and sexual partners were often sought online—making
prevention, testing, and counseling infinitely
more challenging.2 In addition,
many minority MSM identify with their racial
identity more than their sexual identity;
thus, messages aimed at the gay community
often do not reach them.4
For
MSM of color who date within their race,
increased prevalence, coupled with a smaller
dating community, place them at increased
risk. Poor self-esteem, loneliness, and
internalized homophobia are linked to high-risk
behaviors and also increase risk for HIV.2
In
a five-city Centers for Disease Control
and Prevention study on MSM, 25 percent
of participants tested positive for HIV.
Approximately one-half (48 percent) of the
HIV-positive MSM (of which young, Black
MSM were disproportionately represented)
were unaware of their status.5
Crystal
methamphetamine use among MSM has spiked
over recent years, increasing sexual risk-taking
behaviors and often interfering with HIV
drug regimen adherence. With continued use,
crystal methamphetamine can decay teeth,
making HIV-positive MSM more susceptible
to oral infections.6
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HRSA'S
RESPONSE |
Experiences
of providers funded through the Ryan White
HIV/AIDS Program have revealed program components
that are key to reaching MSM. Providers must
cultivate and then provide high-quality, nonjudgmental
services that help MSM acknowledge their risk,
get tested, and stay in care over time. The
use of peer educators can be critical.
The
Health Resources and Services Administration
(HRSA) continues to adapt to the changing
climate of HIV/AIDS to better reach—and
serve—people living with HIV/AIDS.
Today, outreach workers go out into the
community to find the hard-to-reach, they’re
also going online to target young MSM and
the growing population of individuals turning
to the Internet to help define their sexual
identities and to seek out sexual partners.
(To learn more, visit http://careacttarget.org/Library/SPNSBulletin/spnsbulletin.aug06.pdf
(PDF – 129KB). )
HRSA
is also funding a Special Projects of National
Significance (SPNS) initiative on Outreach,
Care, and Prevention to Engage HIV Seropositive
Young MSM of Color. The initiative began
in 2004 and continues through 2009. (To
learn more, visit http://hab.hrsa.gov/special/ocp_index.htm.)
To
increase access to quality care for minorities
and respond to the need for more minority
providers of state-of-the-art care in underserved
communities, the Ryan White HIV/AIDS Program
funds the National Minority AIDS Education
and Training Center. More information is
available at www.nmaetc.org. The National
Minority AIDS Initiative has been codified
into the law and is now Part F of the Ryan
White HIV/AIDS Program. To learn more, go
to www.hab.hrsa.gov/treatmentmodernization/minority.htm.
Today,
CARE Act grantees are making concentrated
efforts to bring MSM into care in the earliest
stages of disease. In addition, Title I
and Title II grantees are striving to achieve
greater involvement of MSM of color in the
community planning process.
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END
NOTES: |
1 |
Centers
for Disease Control and Prevention (CDC).
HIV/AIDS Surveillance Report.
2006;18:13. Table 3. Available at: 2006report/table3.htm.
Accessed June 10, 2008. www.cdc.gov/hiv/topics/surveillance/resources/reports/
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2 |
National
Alliance of State & Territorial
AIDS Directors. Findings from targeted
interviews on HIV prevention activities
directed toward Black men who have sex
with men (MSM). Black MSM Issue
Brief No. 3. Washington, DC: Author;
2008. |
3 |
CDC.
HIV/AIDS Surveillance Report.
2006;18:23. Table 11. |
4 |
Clarke-Tasker
VA, Wutoh AK, Mohammed T. HIV risk behaviors
in African American males. ABNF J. 2005;16:56-9. |
5 |
CDC.
HIV prevalence, unrecognized infection,
and HIV testing among MSM—five
U.S. cities, June 2004–April 2005.
MMWR. 2005;54:597-601. |
6 |
CDC.
Methamphetamine use and risk for HIV/AIDS.
January 2007. Available at: www.cdc.gov/hiv/resources/factsheets/meth.htm.
Accessed June 17, 2008. |
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