HIV in MSM : anal penetration and role reversal the engine of the epidemic

 

JCHS-(update)-(5x35)

 

Lancet Special Issue on HIV in Men who have Sex with Men (MSM)

 

Executive Summary
The Lancet MSM and HIV series show us that HIV epidemics among MSM are fundamentally different  from other groups at risk. These differences help explain why HIV epidemics among MSM expanding in  low, middle, and high income countries, including the U.S., and why current HIV prevention and treatment programs for MSM are not working as well as they should. Biological, network, and social/structural factors combine for MSM and lead to more rapid and efficient HIV spread in MSM  communities—individual risk behaviors for HIV infection contribute only modestly to these dynamics.

New and more effective HIV prevention programs for MSM must reduce infectiousness through markedly expanding testing and treatment of positive men, and reduce risk of acquisition among negative men, through the use of PrEP, the development of a rectal microbicide, and increased access  to and coverage for condoms and condom-compatible lubricant. Current prevention tools could reduce new HIV infections in MSM substantially, but more and better tools will be needed to achieve an AIDS  free generation for young MSM. Stigma, discrimination, and social and health care level homophobia
continue to limit access and uptake to essential services from testing to treatment, and from condoms to  PrEP. Policy reform and structural changes will be key to expanding coverage and reaching men with  culturally competent care. These realities are most clearly demonstrated among minority MSM in the U.S., where black MSM have much higher rates of HIV infection then other MSM, despite having lower individual risks for HIV. But black MSM also have lower rates of testing, health care access, health insurance, and successful HIV treatment—impacts seen at each step of the treatment cascade. Urgent  reform is needed, in approaches, programs and policies, if we are to make real gains against HIV  among MSM. Future efforts must be more biologically based, focus on delivery of effective interventions, address each gap in the testing to treatment cascade, and ensure safe and affirming spaces for prevention, treatment, and care.

 

In 2012, HIV epidemics in MSM are expanding in countries of all incomes. Available
incidence data from Thai, Chinese and Kenyan samples of MSM suggest those epidemics
are in rapid expansion phases.
 HIV infection rates among MSM are substantially higher than those of general population adult males in every epidemic assessed. A comprehensive review of the burden of HIV disease in MSM worldwide found that pooled HIV prevalence ranged from a low of 3% in the  Middle East and North Africa to a high of 25.4% of MSM in the Caribbean.
 Biological and behavioral factors make the dynamics of the MSM epidemic different than for  general populations.

The disproportionate HIV disease burden in MSM is explained largely by the high per act and per-partner transmission probability of HIV transmission in receptive anal sex.
Modeling suggests that If the transmission probably of receptive anal sex was similar
to that associated with unprotected vaginal sex, five year cumulative HIV incidence in
MSM would be reduced by 80-90%.
o Many MSM practice both insertive and receptive roles in sexual intercourse, which
helps HIV spread in this population. Were MSM limited to one role, HIV incidence in
this population over five years would be reduced 19-55% in high-prevalence
epidemics.
o Taking both factors (per act transmission probability and role versatility) into
account explains 98% of the difference between HIV epidemics among MSM
and heterosexual populations—behavioral differences account for 2% of the
difference

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This entry was posted in Gay is Good, Gay Pride, Homophobia, International Day Against Homophobia, Jamaica's buggery law, secular wisdom, World Health Organization and Sexual Orientation. Bookmark the permalink.

1 Response to HIV in MSM : anal penetration and role reversal the engine of the epidemic

  1. GLBTQJA says:

    Ahhhh the usual screw ass bound to get AIDS ploy lol ………………. oh lord you need help and by the way ………………………….

    Homophobia has never been listed as part of a clinical taxonomy of phobias, neither in Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Statistical Classification of Diseases and Related Health Problems (ICD); homophobia is usually used in a non-clinical sense. Today despite its etymology it has come to mean and or encompasses a range of negative attitudes and feelings toward homosexuality or people who are identified or perceived as being lesbian, gay, bisexual or transgender (LGBT). It can be expressed as antipathy, contempt, prejudice, aversion, or hatred, and may be based on irrational fear.

    In 1992, the American Psychiatric Association, recognizing the power of the stigma against homosexuality, issued the following statement, reaffirmed by the Board of Trustees, July 2011: “Whereas homosexuality per se implies no impairment in judgement stability, reliability, or general social or vocational capabilities, the American Psychiatric Association (APA) calls on all international health organizations, psychiatric organizations, and individual psychiatrists in other countries to urge the repeal in their own countries of legislation that penalizes homosexual acts by consenting adults in private. Further, APA calls on these organizations and individuals to do all that is possible to decrease the stigma related to homosexuality wherever and whenever it may occur.”

    Others in criticizing the etymological issue surrounding the word suggest homosexophobia but it is clear the that modern Pharisees and Sadducees are at work and are getting large financial support from somewhere yet children are hungry, missing and in lock ups with adults and these same voices are silent in that department. Who were Jesus’ opponents I ask?

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