HIV among men who have sex with men in the Caribbean: reaching the left behind

Abstract

Objectives. To present the epidemiology, social and cultural factors driving the HIV epidemic among men who have sex with men (MSM) in the Caribbean region and to highlight the regional and national responses, and what remains to be addressed to close the gaps in order to ending AIDS by 2030. Methods. A literature review was performed in the following databases: PubMed and Scopus. Articles published in the past 10 years were selected. The outcomes of interest were sociocultural risk factors, description of regional and national efforts and potential challenges and barriers to effective control of the epidemic among MSM. This report concentrates exclusively on publications related to MSM living in the Caribbean countries. Results. 11 peer-reviewed studies, 9 grey literature reports and programme frameworks were thematically analysed. The prevalence of HIV among MSM is high and the rates also do vary among Caribbean countries. Several factors influence the epidemic among MSM in the Caribbean but stigma and discrimination underlie the social vulnerability and play a central role in driving the HIV epidemic. Conclusions. To end the AIDS epidemic by 2030, MSM can no longer be kept unchecked in the era of the Sustainable Development Goals with the motto ‘Leave no one behind’.

Factors associated with discussing HIV pre-exposure prophylaxis (PrEP) among Jamaican medical providers

“…33 These experiences may discourage longer-term relationships, and encourage anonymous and condomless sex, as well as avoidance of health services. 1,4,30 Over 50% of MSM in Jamaica report having sex with females. 1,30 HIV stigma and homophobia intersect in Jamaica, which may be driving the HIV epidemic among MSM and undermining uptake of HIV prevention and support services.…”

“…1,4,30 Over 50% of MSM in Jamaica report having sex with females. 1,30 HIV stigma and homophobia intersect in Jamaica, which may be driving the HIV epidemic among MSM and undermining uptake of HIV prevention and support services. 32 Studies elsewhere have shown that provider stigma and discrimination including heterosexism can undermine access to PrEP.…”

Barriers to the right to HIV prevention health care for men who have sex with men (MSM) in Barbados: an examination of anti-gay prejudice

“…One frequently cited contextual HIV risk factor in the Caribbean is anti-gay prejudice (Beck et al , 2017; Dunbar et al , 2021). Research suggests that MSM who experience homophobia are more likely to engage in risk behaviours associated with HIV transmission (Takada et al , 2020).…”

Factores asociados a la discriminación en hombres que tienen relaciones sexuales con hombres, Bogotá, Medellín, Cali - Colombia, 2019

“…En este país, en Salvador de Bahía, el 57,7% habían experimentado algún tipo de discriminación y el 43,5% informaron no haberle dicho a sus padres, sobre su atracción sexual por otros hombres 26 . Existe mayor discriminación en los HSH jóvenes 27 , como se presentó en Brasil (menores de 30 años), que han estudiado por más de ocho años, con poca participación y apoyo de la comunidad, presencia de violencia física y sexual, ideación suicida en los últimos seis meses 25 , evitar servicios de prevención ante el VIH 28 .…”