Newspapers Examine Challenges In HIV Prevention Among MSM

Main Category: HIV / AIDS
Also Included In: Men's health
Article Date: 08 Aug 2008 - 5:00 PDT

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Rising HIV prevalence among men who have sex with men, "[h]omophobia, biology and misplaced confidence that AIDS has become a treatable chronic illness are contributing to a disturbing flashback among scientists and activists" and concern among public health officials that many countries "appear to be repeating the early patterns of the epidemic," the Washington Post reports.

HIV/AIDS was labeled a "homosexual disease" when it first appeared in the 1980s, but then "an enormous grassroots movement ... sparked government action, and more significantly, effective prevention campaigns" among MSM, the Post reports. However, HIV infections among MSM have been increasing, particularly among communities where there is a stigma against homosexuality, according to the Post.

Michael Sidibe, assistant secretary general of the United Nations, said, "We have come full circle. In the beginning, gay men in places like San Francisco and New York proved we could do prevention. When we moved from that and started talking about the broad scope of the epidemic, suddenly men who have sex with men became marginalized."

"'Prevention fatigue,' confidence in new antiretroviral drugs, the use of methamphetamines and the arrival of a generation of young men who did not experience the ravages of the 1980s" is contributing to the situation, according to Richard Wolitski, acting director of CDC's HIV/AIDS prevention division. Wolitski added that HIV is "transmitted more easily via anal sex than vaginal sex."

Many MSM in the U.S. engage in "serosorting," where they try to calculate risk based on their own and their partner's HIV status, the Post reports. However, many men do not know they have HIV and can unknowingly spread the disease, Wolitski said.

"The same kinds of stigma and discrimination and institutionalized homophobia that failed gay men in America is now failing MSM in the rest of the world," Kevin Frost, CEO of the American Foundation for AIDS Research, said. Frost added that increased HIV incidence among MSM, in many cases, is "directly related to the institutionalization of homophobia" (Connolly, Washington Post, 8/7).

An AmfAR report released Monday at the XVII International AIDS Conference in Mexico City found MSM are at an increased risk of HIV. According to the report, despite a unanimous commitment that all U.N. member countries made in 2001 to monitor HIV among high-risk groups, 71% of countries said they did not have any information on the percentage of MSM contacted by HIV prevention groups. Of 128 countries, 44% failed to provide HIV data on MSM.

According to the report, Benin, Ghana, Jamaica, Kenya and Thailand are the countries with the highest reported HIV prevalence among MSM. Although data were scarce, the study found MSM were 33 times more likely to be living with HIV than the general population in Latin America, 18 times more likely in Asia and at least four times more likely in Africa (Kaiser Daily HIV/AIDS Report, 8/6).

Sexual activity between men is criminalized in 85 countries and is punishable by death in seven countries and by imprisonment in 76 countries, according to the International Lesbian and Gay Association.

Craig McClure, executive director of the International AIDS Society, said, "It's difficult to provide services to men who have sex with men in countries where they don't acknowledge they exist" (Washington Post, 8/7).

Post reporter Ceci Connolly on Thursday will discuss her series on HIV/AIDS along the U.S.-Mexico border and her coverage of the XVII International AIDS Conference (Washington Post Live Discussion, 8/7). A resource page on HIV/AIDS and the XVII International AIDS Conference also is available online from the Post.

Additional Newspaper Coverage on MSM

• Globe and Mail: The HIV community has "failed to bring down the incidence of HIV/AIDS in MSM because we have not tried," Jorge Saavedra, director of Mexico's national HIV/AIDS program CENSIDA, said at the AIDS conference. McClure added that providing human rights protections for MSM and addressing the stigma of same-sex relationships are necessary to slow the spread of HIV. UNAIDS Executive Director Peter Piot at the AIDS conference called on countries to revise policies that criminalize same-sex activity, saying that the laws discourage MSM from seeking HIV testing and treatment. "Homophobia kills. We must kill homophobia," Piot said (Picard, Globe and Mail, 8/7).
  
  
• New York Times: The Times on Thursday examined men who have sex with men in Mexico and Latin America. According to the Times, "Because machismo is pronounced in Mexico and homosexuality is far from accepted, social conditions in the country and in other parts of Latin America force much sexual behavior into the shadows. That increases the challenges that AIDS experts say they face in combating the risky sexual practices that fuel the disease." The Times reports that MSM in Mexico who "live lives in denial" frequently engage in high-risk sex but do not acknowledge it to anyone. MSM also are often hard to reach in HIV prevention and education campaigns because they tend to ignore prevention messages if they believe they are targeted toward gay men (Lacey, New York Times, 8/7). A video on the Times Web site on Wednesday highlighted how sexual ambiguity, including denial and discrimination, in Mexico forces some people to be secretive about their behaviors, which hinders efforts to fight HIV/AIDS (New York Times video, 8/6).
  

Multimedia Coverage
NPR's "All Things Considered" on Wednesday included a discussion about the AmfAR report. The segment includes comments from an HIV-positive MSM living in North Carolina (Wilson, "All Things Considered," NPR, 8/6). Audio of the segment is available online.

Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference. A webcast on MSM is available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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