On March 10, 2010, the Centers for Disease Control and Prevention (CDC) released its most recent data analysis report examining the disproportionate impact of new HIV and primary and secondary Syphilis infections among gay men, bisexual men, and men who have sex with men. Individuals in this risk category, known generally as men who have sex with men (MSM), face much higher rates of HIV and Syphilis infections than other risk groups. Though MSM make up only about two percent of the U.S. population, they account for 53 percent of new HIV infections every year. The CDC calculated these rates based on new estimates of the size of the population of men who have sex with men. They define MSM as any man who reports having engaged in same-sex behavior within the past five years.[i]
Men who have sex with men have more than 44 times the rate of new HIV infections as other men and more than 40 times that of women, with an estimated rate of 522 to 989 new infections per 100,000 MSM each year. Their Syphilis rates are even more staggering: rates of primary and secondary Syphilis infections among MSM are 46 times higher than other men and 71 times higher than women.[ii] Furthermore, MSM are the only group in which the U.S. annual HIV infection rates are increasing.[iii]
Obtaining accurate data on disease rates allows for better targeting of prevention and education efforts. Kevin Fenton M.D., director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, acknowledged this, stating, “We need intensified prevention efforts that are as diverse as the gay community itself. Solutions for young gay and bisexual men are especially critical, so that HIV does not inadvertently become a rite of passage for each new generation of gay men.”[iv] By identifying the highest-risk groups, it is possible to ensure that the most at-risk populations are receiving the services and information they need to protect themselves and their partners.
Several factors have been cited that contribute to the prevalence of HIV and Syphilis among MSM including increased infection patterns and complacency about HIV and STD risk especially among young men. There is also a general lack of awareness of the symptoms and transmission methods of Syphilis infections. Moreover, homophobia and stigma can deter MSM from seeking necessary testing and counseling services.[v]
To compound the problem, the Department of Health and Human Services has reported that men in America are less likely than women to use the healthcare system, typically only seeking medical care once they exhibit symptoms of critical health problems.[vi] If men do not utilize preventative care or testing services, they risk compromising their own health and the health of their partners.
According to the United Nations Programme on HIV/AIDS, prevention efforts designed to meet the needs of MSM should include education on consistent, proper use of condoms, access to water-based lubricants, non-discriminatory counseling, and specific, targeted information on risk reduction strategies.[vii]
Improved sex education is also critical to ensure that any person who is sexually active knows how to effectively protect themselves. “For the vast majority of people, the sex education they receive in school will be the last, and only, time they hear about these issues in a formal setting,” said Joseph DiNorcia, Jr., president and CEO of the Sexuality Information and Education Council of the United States (SIECUS). “This is why we need to make comprehensive, school-based sex education the foundation of prevention efforts in the National HIV/AIDS Strategy. There is no time to waste in adopting policies that work and will adequately address the needs of those populations most at risk, including men who have sex with men.”
[i] The Centers for Disease Control, “CDC Analysis Provides New Look at Disproportionate Impact of HIV and Syphilis Among U.S. Gay and Bisexual Men,” Press Release published 10 March 2010, accessed 19 March 2010 <http://www.cdc.gov/nchhstp/Newsroom/msmpressrelease.html>
[iii] HIV and AIDS Among Gay and Bisexual Men (Georgia: Centers for Disease Control, 2010), accessed 19 March 2010 <http://www.cdc.gov/nchhstp/Newsroom/docs/FastFacts-MSM-FINAL508COMP.pdf>
[iv] CDC, “CDC Analysis Provides New Look at Disproportion Impact of HIV and Syphilis”
[vi] “Disproportionate Impact of HIV on Men Who Have Sex With Men in US Underlines Need for Better Outreach,” United Nations Programme on HIV/AIDS, (18 March 2010), accessed 19 March 2010, <http://www.unaids.org/en/KnowledgeCentre/Resources/FeatureStories/archive/2010/20100316_MSM_CDC.asp>