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A study published in the Lancet on
Friday warns that despite “decades of research and community, medical and
public health efforts,” “HIV remains uncontrolled in MSM [men who have sex with
men] in 2012.” The authors wrote, “This reality demands reinvigorated effort,
new approaches grounded in biology and epidemiology, and concerted effort to
reduce the structural risks that aid and abet” HIV’s spread among MSM.
HIV prevalence among MSM is 15
percent or higher in the United States, Spain, Chile, Thailand, Malaysia, South
Africa, and several other nations in Africa and the Caribbean, the researchers
reported.
Central to HIV’s disproportionate
impact on MSM is the greater transmission risk associated with unprotected
receptive anal sex - a 1.4 percent probability, which the authors said is 18
times higher than for penile-vaginal intercourse. Amphetamines and deliberate
avoidance of condoms also may play a role, the authors said.
“If the transmission probability of
receptive anal sex was similar to that associated with unprotected vaginal sex
... cumulative HIV incidence in MSM would be reduced by 80-98 percent” within
five years, the team wrote.
Warning that “Casual partnerships
are ... a substantial driver of the epidemic in MSM,” the authors continued:
“If unprotected anal intercourse in casual partnerships instead happened within
long-term main partnerships, HIV prevalences would be reduced by 29-51
percent.”
The team called for increased use of
antiretrovirals, both to reduce the infectiousness of HIV-positive men and to
lower the risk for those uninfected (pre-exposure prophylaxis). A rectal
microbicide to kill the virus in infected semen could also play a role someday.
The study, “Global Epidemiology of
HIV Infection in Men Who Have Sex with Men,” was published in the Lancet
(2012;doi:10.1016/S0140-6736(12)60821-6) as part of a series of articles called
“HIV in Men Who Have Sex with Men.”
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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