Closeted Calamity: The Hidden HIV Epidemic of Men Who Have Sex with Men

Published: August 25, 2010

The HIV pandemic has historically been thought of as either concentrated in specific populations—such as gay men, injection drug–users, sex workers—or generalized across the entire population in sub-Saharan Africa and the Caribbean. But as more and better epidemiological data has become available, the evidence is clear: men who have sex with men (MSM), regardless of whether or not they identify as gay, also are at the core of those generalized epidemics.

MSM in developing countries are 19 times more likely to be infected with HIV than the general population, according to a 2007 literature review.

Even in Africa, at the heart of the pandemic, in Malawi, 21 percent of MSM are infected with the virus compared with 11 percent of the general population, whereas Zambia’s rates are 33 percent versus 15 percent, respectively, says Chris Beyrer, director of the Johns Hopkins Center of Public Health and Human Rights.

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