“The difference between genius and stupidity is genius has its limits”
….. Albert Einstein….
Global epidemiology of HIV infection in men who have sex with men
Chris Beyrer et al.
- 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.
o The disproportionate HIV disease burden in MSM is explained largely by the highper- 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 ManyMSMpracticebothinsertiveandreceptiverolesinsexualintercourse,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.