Sexual Orientation and Behavior in HIV-infected Individuals in Southeast Asia

Abstract

The response of sexual behavior to HIV is an important input to predicting the path of the epidemic and to focusing prevention efforts. Existing estimates suggest limited behavioral response, but fail to take into account possible differences across individuals. Transmission through sexual contact is estimated to accounts for 75 to 85% of cumulative cases of HIV/AIDS to date. Mode of transmission is important predictors of risk. The statistical risk of infection through vaginal intercourse is notably low regardless of which partner is infected. Anal intercourse has higher infectivity due to the likelihood of damage to epithelial integrity. Generally, the environment for men who have sex with men (MSM), lesbians and transgender individuals is unsupportive and unsafe. They are usually victims of discrimination or more subtly as indifference. The stress on these individuals face as they cope with sexual orientation stigma may help to explain higher rates of risky sexual behaviors and injected drug use. Very little research has focused on Asian youth with altered sexual orientation. These individuals are at a higher risk of contracting the HIV virus than their heterosexual counterparts. Until we acknowledge these behaviors and work with people involved with these behaviors, we are not going to halt and reverse the HIV epidemic. Scaling up services adequately for key populations at higher risk for HIV infection globally, particularly in concentrated epidemics, is essential to halt and reverse epidemics at the population level. It is essential that the expansion of MSM HIV prevention and care services across Asia be driven by an agreed upon set of quality standards and guidelines.