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The increase in global HIV epidemics in MSM.

Chris Beyrer1, Patrick Sullivan, Jorge Sanchez

  • 1aCenter for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland bRollins School of Public Health, Emory University, Atlanta, Georgia, USA cImpacta, Lima, Peru damfAR, The Foundation for AIDS Research, Washington DC eDepartment of Emergency Medicine, Johns Hopkins Medical Institute, Baltimore, Maryland, USA fLaTrobe University, Melbourne, Australia gCenter for the Development and Education of People, Blantrye, Malawi hFenway Community Health Center and Harvard University, Boston, Massachusetts, USA.

AIDS (London, England)
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Human Immunodeficiency Virus (HIV) epidemics continue to grow among men who have sex with men (MSM) globally. Current strategies are insufficient, necessitating comprehensive bio-behavioral interventions and structural reforms.

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Area of Science:

  • Public Health
  • Epidemiology
  • Social Sciences

Background:

  • HIV epidemics persist and expand among men who have sex with men (MSM) globally.
  • Young MSM experience consistently high rates of new HIV infections.
  • Existing prevention and treatment strategies are inadequate for current epidemic trends.

Purpose of the Study:

  • To conduct comprehensive reviews of HIV prevalence, incidence, risks, prevention, care, stigma, discrimination, and policy.
  • To identify key factors driving HIV spread in MSM populations.
  • To inform effective strategies for epidemic control.

Main Methods:

  • Systematic reviews of existing literature on HIV in MSM.
  • Analysis of molecular epidemiologic data.
  • Examination of social, structural, and policy determinants.

Main Results:

  • High per-act transmission probability, network effects, and social/structural factors contribute to disproportionate HIV burdens.
  • HIV spreads rapidly through large MSM networks, with significant transmission from recent infections.
  • Subepidemics among minority MSM populations are particularly severe.

Conclusions:

  • Antiretroviral-based prevention shows promise but is hindered by structural barriers like discrimination and criminalization.
  • Effective HIV control requires integrated bio-behavioral interventions, clinically competent healthcare, and community engagement.
  • Addressing expanding HIV epidemics in MSM demands sustained research, resources, policy reform, and strategic programming.