TY - JOUR
T1 - Global epidemiology of HIV infection in men who have sex with men
AU - Beyrer, Chris
AU - Baral, Stefan D.
AU - Van Griensven, Frits
AU - Goodreau, Steven M.
AU - Chariyalertsak, Suwat
AU - Wirtz, Andrea L.
AU - Brookmeyer, Ron
N1 - Funding Information:
This report was supported by grants to the Center for Public Health and Human Rights at Johns Hopkins from amfAR the Foundation for AIDS Research and from the Bill & Melinda Gates Foundation. The Johns Hopkins Center for AIDS Research ( NIAID, 1P30AI094189-01A1 ) provided partial support to CB. We thank Marco Ambrosio, Shirina Kakayeva, Madeleine Schlefer, and Darrin Adams for the data extraction from the comprehensive searches for this report. We also thank Susan Buchbinder and colleagues for assistance with the modelling, which was based on work done for their Prevention Umbrella for MSM in the Americas (PUMA; NIAID, R01-AI083060).
PY - 2012/7
Y1 - 2012/7
N2 - Epidemics of HIV in men who have sex with men (MSM) continue to expand in most countries. We sought to understand the epidemiological drivers of the global epidemic in MSM and why it continues unabated. We did a comprehensive review of available data for HIV prevalence, incidence, risk factors, and the molecular epidemiology of HIV in MSM from 2007 to 2011, and modelled the dynamics of HIV transmission with an agent-based simulation. Our findings show that the high probability of transmission per act through receptive anal intercourse has a central role in explaining the disproportionate disease burden in MSM. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiological data show substantial clustering of HIV infections in MSM networks, and higher rates of dual-variant and multiple-variant HIV infection in MSM than in heterosexual people in the same populations. Prevention strategies that lower biological transmission and acquisition risks, such as approaches based on antiretrovirals, offer promise for controlling the expanding epidemic in MSM, but their potential effectiveness is limited by structural factors that contribute to low health-seeking behaviours in populations of MSM in many parts of the world.
AB - Epidemics of HIV in men who have sex with men (MSM) continue to expand in most countries. We sought to understand the epidemiological drivers of the global epidemic in MSM and why it continues unabated. We did a comprehensive review of available data for HIV prevalence, incidence, risk factors, and the molecular epidemiology of HIV in MSM from 2007 to 2011, and modelled the dynamics of HIV transmission with an agent-based simulation. Our findings show that the high probability of transmission per act through receptive anal intercourse has a central role in explaining the disproportionate disease burden in MSM. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiological data show substantial clustering of HIV infections in MSM networks, and higher rates of dual-variant and multiple-variant HIV infection in MSM than in heterosexual people in the same populations. Prevention strategies that lower biological transmission and acquisition risks, such as approaches based on antiretrovirals, offer promise for controlling the expanding epidemic in MSM, but their potential effectiveness is limited by structural factors that contribute to low health-seeking behaviours in populations of MSM in many parts of the world.
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U2 - 10.1016/S0140-6736(12)60821-6
DO - 10.1016/S0140-6736(12)60821-6
M3 - Review article
C2 - 22819660
AN - SCOPUS:84864288314
SN - 0140-6736
VL - 380
SP - 367
EP - 377
JO - The Lancet
JF - The Lancet
IS - 9839
ER -