HIV in Men who have Sex with Men (MSM) – The first duty of Intelligent Men.

            Sometimes the first duty of intelligent men is the restatement of the obvious.

George  Orwell

A)

The  Hard  Cell  Playroomhttp://www.hardcell.org.uk/playroom.htm  lists  anal penetration, fisting, felching, rimming, scat, farming, watersports etc  as  options  which  Men who have  Sex  with Men (MSM)  exercise.

B)

The  following  indicate  a  persistently  high  and  increasing  rates  of  HIV  and  other  sexually  transmitted  diseases  among  MSM.

AIDS Behav. 2011 Apr;15 Suppl 1:S9-17.

Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States.

Wolitski RJ, Fenton KA.

Source

Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton RD NE (E-35), Atlanta, GA 30333, USA. RWolitski@cdc.gov

Abstract

The sexual health of gay, bisexual, and other men who have sex with men (MSM) in the United States is not getting better despite considerable social, political and human rights advances. Instead of improving, HIV and sexually transmitted infections (STIs) remain disproportionately high among MSM and have been increasing for almost two decades. The disproportionate and worsening burden of HIV and other STIs among MSM requires an urgent re-assessment of what we have been doing as a nation to reduce these infections, how we have been doing it, and the scale of our efforts. A sexual health approach has the potential to improve our understanding of MSM’s sexual behavior and relationships, reduce HIV and STI incidence, and improve the health and well-being of MSM.

Population-based HIV-1 incidence in France, 2003-08: a modelling analysis.

Le Vu S, Le Strat Y, Barin F, Pillonel J, Cazein F, Bousquet V, Brunet S, Thierry D, Semaille C, Meyer L, Desenclos JC.

Source

Institut de Veille Sanitaire, Saint-Maurice, France. s.levu@invs.sante.fr

Erratum in

  • Lancet Infect Dis. 2011 Mar;11(3):159.

Abstract

BACKGROUND:

Routine national incidence testing with enzyme immunoassay for recent HIV-1 infections (EIA-RI) has been done in France since January, 2003. From the reported number of HIV infections diagnosed as recent, and accounting for testing patterns and under-reporting, we aimed to estimate the incidence of HIV infection in France in 2003-08.

METHODS:

We analysed reports from the French National Institute for Public Health Surveillance for patients who were newly diagnosed with HIV between January, 2003, and December, 2008. Missing data were imputed with multiple imputation. Patients were classified with non-recent or recent infection on the basis of an EIA-RI test, which was calibrated with serial measurements from HIV seroconverters from the French ANRS-PRIMO cohort. We used an adapted stratified extrapolation approach to calculate the number of new HIV infections in men who have sex with men (MSM), injecting drug users (IDUs), and heterosexual men and women by nationality. Population sizes were obtained from the national census and national behavioural studies.

FINDINGS:

After accounting for under-reporting, there were 6480 (95% CI 6190-6780) new diagnoses of HIV infection in France in 2008. We estimate that there were 6940 (6200-7690) new HIV infections in 2008, suggesting an HIV incidence of 17 per 100 000 person-years. In 2008, there were 3550 (3040-4050) new infections in heterosexuals (incidence of 9 per 100 000 person-years), 3320 (2830-3810) in MSM (incidence of 1006 per 100 000 person-years), and 70 (0-190) in IDUs (incidence of 86 per 100 000 person-years). Overall HIV incidence decreased between 2003 and 2008 (p<0·0001), but remained comparatively high and stable in MSM.

INTERPRETATION:

In France, HIV transmission disproportionately affects certain risk groups and seems to be out of control in the MSM population. Incidence should be tracked to monitor transmission dynamics in the various population risk groups and to help to target and assess prevention strategies.

FUNDING:

French National Institute for Public Health Surveillance (InVS) and French National Agency for Research on AIDS and Viral Hepatitis (ANRS).

Copyright © 2010 Elsevier Ltd. All rights reserved.
J Acquir Immune Defic Syndr. 2011 Dec 1;58(4):408-16.

Men who have sex with men have a 140-fold higher risk for newly diagnosed HIV and syphilis compared with heterosexual men in New York City.

Pathela P, Braunstein SL, Schillinger JA, Shepard C, Sweeney M, Blank S.

Source

Bureau of Sexually Transmitted Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA. ppathela@health.nyc.gov

Abstract

OBJECTIVES:

To describe the population of men who have sex with men (MSM) in New York City, compare their demographics, risk behaviors, and new HIV and primary and secondary (P&S) syphilis rates with those of men who have sex with women (MSW), and examine trends in infection rates among MSM.

DESIGN:

Population denominators and demographic and behavioral data were obtained from population-based surveys during 2005-2008. Numbers of new HIV and P&S syphilis diagnoses were extracted from city-wide disease surveillance registries.

METHODS:

We calculated overall, age-specific and race/ethnicity-specific case rates and rate ratios for MSM and MSW and analyzed trends in MSM rates by age and race/ethnicity.

RESULTS:

The average prevalence of male same-sex behavior during 2005-2008 (5.0%; 95% CI: 4.5 to 5.6) differed by both age and race/ethnicity (2.3% among non-Hispanic black men; 7.4% among non-Hispanic white men). Compared with MSW, MSM differed significantly on all demographics and reported a higher prevalence of condom use at last sex (62.9% vs. 38.3%) and of past-year HIV testing (53.6% vs. 27.2%) but also more past-year sex partners. MSM HIV and P&S syphilis rates were 2526.9/100,000 and 707.0/100,000, each of which was over 140 times MSW rates. Rates were highest among young and black MSM. Over 4 years, HIV rates more than doubled and P&S syphilis rates increased 6-fold among 18-year-old to 29-year-old MSM.

CONCLUSIONS:

The substantial population of MSM in New York City is at high risk for acquisition of sexually transmitted infections given high rates of newly diagnosed infections and ongoing risk behaviors. Intensified and innovative efforts to implement and evaluate prevention programs are required.

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1 Response to HIV in Men who have Sex with Men (MSM) – The first duty of Intelligent Men.

  1. The number of new HIV infections among MSM at public HIV-testing sites in San Francisco and Los Angeles did not increase during 1999–2002, a period when syphilis cases among MSM increased substantially in both cities. Within the SFCC population, no temporal correlation was detected between an increase in the number of MSM P&S syphilis cases and the rates of new HIV infections among MSM who received HIV testing at this STD clinic. Whether the syphilis outbreaks are sentinel events indicating increased risk behavior that could eventually result in increased HIV incidence is not known.

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