The Expanding Epidemics of HIV Type 1 Among Men Who Have Sex With Men in Low- and Middle-Income Countries: Diversity and Consistency

Abstract

Men who have sex with men (MSM) have borne a disproportionate burden of human immunodeficiency virus (HIV) infection and remain a markedly underresourced population globally. To better describe HIV epidemics among MSM in low- and middle-income countries, the authors conducted a systematic review of published and unpublished literature available after January 1, 2000 (2000-2009). A total of 133 HIV prevalence studies from 50 countries met the search criteria. Data were used to develop an algorithmic approach to categorize these epidemics. The authors found that the HIV epidemic in low- and middle-income countries may be described using the following 4 scenarios: 1) settings where MSM are the predominant contributor to HIV cases; 2) settings where HIV transmission among MSM occurs in the context of epidemics driven by injection drug users; 3) settings where HIV transmission among MSM occurs in the context of well-established HIV transmission among heterosexuals; and 4) settings where both sexual and parenteral modes contribute significantly to HIV transmission. The authors focused on Peru, Ukraine, Kenya, and Thailand to describe the diversity across and similarities between proposed epidemic scenarios. This scenario-based categorization of HIV epidemics among MSM may assist public health agencies and civil societies to develop and implement better-targeted HIV prevention programs and interventions.

Sex tourism among Chinese men who have sex with men: a cross-sectional observational study

“…[16][17][18][19][20][21] All Chinese and international prevalence data were taken from the most recent published source. Analysis of MSM HIV prevalence among was completed by comparing the MSM HIV prevalence at the origin and destination of each journey made by a sex tourist.…”

Brief communication (Original). Challenges of providing treatment and care to men who have sex with men and with HIV/AIDS in Bangkok

“…Thailand was one of the first countries in Asia to implement a national plan for HIV/AIDS, including a commitment to provide universal access to antiretroviral drugs [8]. However, MSM were not specifically identified in the national HIV/AIDS plan and HIV surveillance system until 2007 [3,8].…”

“…However, because many MSM may not report their sexual orientation to healthcare providers or HIV testing centers because of fear of stigma [8], prevalence of HIV/AIDS among MSM maybe under-reported [4]. HIV-positive MSM in Thailand experience stigma associated with being MSM and significant discrimination because of their HIV status [8], putting them at risk for poorer healthcare utilization and negative health outcomes [13].…”

How partnership type and HIV seroconcordance affect HIV transmission risk in regular sexual partnerships: a cross-sectional survey of Australian gay and bisexual men

“…The majority of HIV infections in most developed and many developing countries are in gay and bisexual men (GBM), 1,2 with condomless anal intercourse (CLAI) as the primary transmission route. 3 Approximately one-third of infections among newly diagnosed men in Australia are estimated to be from regular partners, [4][5][6] whereas modelling from the US estimates that 68% of infections in GBM are from 'main' partners.…”