The
HIV/AIDS
epidemic
continues
to
evolve. As old
challenges
remain
and are
addressed,
new ones
emerge,
requiring
new
approaches
to
prevention
and
treatment.
Despite many prevention successes, MSM face
a wide range of risks for infection and
barriers to prevention. Among them are the
following.
Sexual Risk
Sexual risks account
for most HIV infections in MSM. These risks
include unprotected sex and sexually
transmitted diseases (STDs).
- Not using a condom
during anal sex with someone other than
a primary HIV-negative partner continues
to be a significant threat to the health
of MSM.
- STDs (such as
syphilis and gonorrhea) increase the
risk for HIV infection and are
persistent health issues for MSM. Not
only do STDs increase one’s chances of
becoming infected with HIV, they also
can indicate high-risk sexual behavior,
which facilitates the transmission of
HIV infection.
Substance
Use
Some MSM use alcohol
and illegal drugs, contributing to increased
risk for HIV infection and other STDs. The
use of substances such as alcohol and
illegal drugs can increase the likelihood of
risky sexual behavior while under the
influence, as well as the likelihood of
sharing needles or other injection
equipment. The use of methamphetamines, or “meth,”
by MSM is a very important public health
issue facing MSM.
Complacency
about Risk Factors
HIV has been a
threat for 25 years, yet many people believe
they are at low risk of becoming infected or
infecting their partner. This is especially
true of young gay and bisexual men who,
unlike older gay and bisexual men, have not
experienced the toll of HIV/AIDS. At the
same time, the success of new drug
treatments may be contributing to increased
risky behaviors among some MSM. For example,
some MSM may mistakenly believe that they or
their partners cannot spread the virus when
they take HIV medication or that having HIV
is minor condition with no life-threatening
consequences. They may not understand that
HIV treatment may not work for everyone and
that for some, it may work only for a time.
Unknown HIV
Serostatus
Approximately 25% of
people in the United States who are infected
with HIV do not know they are infected. In a
study of young MSM, 77% of those who tested
HIV-positive mistakenly believed that they
were not infected. Young African American
MSM in this study were especially likely to
be unaware of their HIV infection. Many of
these men had been tested for HIV, but not
recently. CDC recommends that MSM be tested
for HIV at least once a year. People who
are not aware of their HIV infection cannot
take advantage of medicine that can help
them live longer, healthier lives. Nor do
they have information that will help protect
their sex and drug-using partners from HIV
infection.
MSM Who Are
HIV-positive
Studies have shown
that many MSM reduce their risky behaviors
after testing positive for HIV infection.
However some MSM continue to engage in
behaviors that put others at risk. Focusing
on MSM living with HIV is especially
important today, given the increasing number
of MSM living with HIV because of the
benefits of antiretroviral therapies.
The Internet
During the past
decade, the Internet has created new
opportunities for MSM to meet sex partners.
Internet users can anonymously find partners
with similar sexual interests without having
to leave their home or having to risk
face-to-face rejection if the behaviors they
seek are not consistent with safer sex.
Research has shown that MSM who meet
partners on the Internet are more likely to
take sexual risks than are MSM who do not
seek sex partners on the Internet. |