A systematic review of HIV prevalence among MSM in Asia, Latin America, and Africa from 2000-2008
Background: In the high income countries of Europe and North America, gay, bisexual and men who have sex with men (MSM) have long been at risk populations for HIV infection. An increasing number of publications in recent years suggest that MSM in the lower and middle income countries in Asia, Latin America, and Africa are also at high risk for HIV infection.
Methods: A systematic review of HIV prevalence studies between 2000 and Feb, 2008 in Asia, Latin America, and Africa was completed. General population prevalence estimates of reproductive age adults (15-49) were obtained from data reported in 2006 by UNAIDS.
Results: The review evaluated 59508 men from 30 countries and demonstrated an overall HIV prevalence among MSM of 14.5% (95% CI 13.8-15.2). Studies from 16 Latin America countries included 38013 MSM with an HIV prevalence of 16.1% (95% CI 15.1-17.0), compared to a regional general population HIV prevalence of 0.5%. Studies from ten Asian countries included 19142 men with an HIV prevalence of 11.4% (95% CI 10.1-12.7,), compared to a regional prevalence of 0.1-0.3%. Limited data were available from Africa, where studies from four countries included 2353 MSM with an HIV prevalence of 13.0%(95% CI 10.6-18.1) compared to a regional prevalence of 5.0%.
Conclusions: HIV Prevalence data among MSM were only available from 47% (16/34) of countries in geographic Latin America, 43% (10/23) in Asia, and 9% (4/46) in Africa. Where data are available a significantly increased risk of HIV infection exists among MSM compared to the general population. All countries affected by the HIV pandemic should begin or expand efforts to include MSM in national surveillance systems to better characterize their burden of disease. Evidence-based HIV prevention strategies targeting MSM should be adopted and appropriately funded to engage a population which has been neglected in HIV prevention in many settings to date.
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