The invisible worldwide HIV epidemic: MSM

by Bob Roehr, via the Windy City Times

“As a straight man, I have difficulty understanding this obsessive homophobia. It tells me that there is something going on in the heads of people—that must mean that they are having major problems with their own sexuality,” Piot said to laughter and applause. “It is totally absurd, but it is also true.”

Men who have sex with men ( MSM ) are at the heart of the HIV epidemic throughout the world, yet they remain invisible. It is because of denial, stigma, and violence that permeate societies and their governments on every continent.

Even in the United States—where the epidemic was first identified among gay men more than 25 years ago and more than half of all infections are attributed to male/male sexual contact—there continues to be a downplaying of that fact. Prevention resources are not proportionally allocated to reach this affected population.

The situation is even worse in most of the developing world, as was made clear at a conference on MSM and HIV in Mexico City, prior to the XVII International AIDS Conference.

“What we are seeing today in Asia, in every single major city that we have looked at, are epidemics of HIV of men who have sex with men that remind me of what we saw in the US, and Western Europe, and Australia in the 1980s,” said Peter Piot, executive director of UNAIDS. Modeling suggests that by 2020, half of all new infections in Asia will be among MSM.

But the response with targeted prevention “is not there at all.” Piot pointed to “homophobia in all its forms” as “one of the top five obstacles to really stopping this epidemic.”

David Wilson, who heads up the World Bank's HIV efforts, said within the last five years we have come to realize that “HIV epidemics are far more concentrated than we had believed. General population heterosexual transmission is only the major source in two regions, Africa and the Caribbean.”

“Everywhere else we are facing concentrated epidemics of sex workers, drug users, and men who have sex with men. They are the norm, not the exception. And our programs globally need to reflect this.”

In the countries of Latin America, MSM constitute anywhere from half to 90 percent of local infections. “It is massively higher than in sex workers,” said Wilson. “I don't think that is sufficiently understood.”

Read the rest on the Windy City Times.