The rate of new HIV infections is coming down in many countries around the world, "but that is not happening among men who have sex with men (MSMs)," Chris Beyrer said at that XIX International AIDS Conference.
"The consistent pattern, in developed and developing countries, in low and middle income countries, in wealthy countries, is of expanding HIV epidemics," said the Johns Hopkins University epidemiologist.
The factors that account for this are the greater risk of transmission through anal intercourse, regardless of the partner’s sex; a more rapid transmission within the networks of MSMs; stigma and discrimination that limits access to prevention and treatment services; and even when persons have access to healthcare, they are less likely to fully suppress their virus.
"All of those structural barriers allow for continued transmission," Beyrer said. "We must address those structural and social realities," as well as develop new biological interventions designed for the needs of men who have sex with men.
There is a huge denial that MSM even exist, Ugandan physician Paul Semugoma told a plenary session of the conference. "In the fourth decade of the HIV pandemic, we still have countries in the world which do not have HIV statistics for men who have sex with men."
Even though the rate of HIV infection is higher among MSMs in every country in the world, resources are not targeted to that population because same sex activity remains criminalized. He said, "Less and less gets to the MSMs because of the stigma, because they are criminals."
And often MSMs are targets of discrimination. Semugoma used the example of Senegal where in the mid-2000s the epidemic was concentrated among MSMs. Prevention activities were largely targeted to this population. The results of this work were presented at a regional AIDS conference in Africa.
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