The increase in global HIV epidemics in MSM

Christopher Beyrer, Patrick Sullivan, Jorge Sanchez, Stefan Baral, Chris Collins, Andrea Wirtz, Dennis Altman, Gift Trapence, Kenneth Mayer

Research output: Contribution to journalArticle

Abstract

Epidemics of HIV in men who have sex with men (MSM) continue to expand in most low, middle, and upper income countries in 2013 and rates of new infection have been consistently high among young MSM. Current prevention and treatment strategies are insufficient for this next wave of HIV spread. We conducted a series of comprehensive reviews of HIV prevalence and incidence, risks for HIV, prevention and care, stigma and discrimination, and policy and advocacy options. The high per act transmission probability of receptive anal intercourse, sex role versatility among MSM, network level effects, and social and structural determinants play central roles in disproportionate disease burdens. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiologic data show marked clustering of HIV in MSM networks, and high proportions of infections due to transmission from recent infections. Prevention strategies that lower biological risks, including those using antiretrovirals, offer promise for epidemic control, but are limited by structural factors including, discrimination, criminalization, and barriers to healthcare. Subepidemics, including among racial and ethnic minority MSM in the United States and UK, are particularly severe and will require culturally tailored efforts. For the promise of new and combined biobehavioral interventions to be realized, clinically competent healthcare is necessary and community leadership, engagement, and empowerment are likely to be key. Addressing the expanding epidemics of HIV in MSM will require continued research, increased resources, political will, policy change, structural reform, community engagement, and strategic planning and programming, but it can and must be done.

Original languageEnglish (US)
Pages (from-to)2665-2678
Number of pages14
JournalAIDS
Volume27
Issue number17
DOIs
StatePublished - Nov 13 2013

Fingerprint

HIV
Delivery of Health Care
Infectious Disease Transmission
Infection
Sexual Behavior
Cluster Analysis
Incidence
Research
Therapeutics

Keywords

  • Epidemiology
  • Global burden of disease
  • Health disparities
  • HIV
  • Human rights
  • MSM
  • Prevention

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Beyrer, C., Sullivan, P., Sanchez, J., Baral, S., Collins, C., Wirtz, A., ... Mayer, K. (2013). The increase in global HIV epidemics in MSM. AIDS, 27(17), 2665-2678. https://doi.org/10.1097/01.aids.0000432449.30239.fe

The increase in global HIV epidemics in MSM. / Beyrer, Christopher; Sullivan, Patrick; Sanchez, Jorge; Baral, Stefan; Collins, Chris; Wirtz, Andrea; Altman, Dennis; Trapence, Gift; Mayer, Kenneth.

In: AIDS, Vol. 27, No. 17, 13.11.2013, p. 2665-2678.

Research output: Contribution to journalArticle

Beyrer, C, Sullivan, P, Sanchez, J, Baral, S, Collins, C, Wirtz, A, Altman, D, Trapence, G & Mayer, K 2013, 'The increase in global HIV epidemics in MSM', AIDS, vol. 27, no. 17, pp. 2665-2678. https://doi.org/10.1097/01.aids.0000432449.30239.fe
Beyrer, Christopher ; Sullivan, Patrick ; Sanchez, Jorge ; Baral, Stefan ; Collins, Chris ; Wirtz, Andrea ; Altman, Dennis ; Trapence, Gift ; Mayer, Kenneth. / The increase in global HIV epidemics in MSM. In: AIDS. 2013 ; Vol. 27, No. 17. pp. 2665-2678.
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