As we approach the observance of National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD) on September 27, it seems timely – indeed, imperative – to encourage all gay men, as well as those who work with, provide services to, and/or love them to take stock of the current toll of HIV/AIDS among gay men and take actions that improve health outcomes and ultimately end this epidemic.
Gay, bisexual, and other men who have sex with men (MSM) represent approximately 2% of the United States population, yet they account for over half of the 1.1 million people living with HIV in the United States (57%, or an estimated 657,800 people), and two-thirds of those with new HIV infections each year. By the end of 2010, an estimated 302,148 gay and bisexual men with an AIDS diagnosis had died in the United States since the beginning of the epidemic, representing nearly half of all deaths of persons with AIDS.
Given the persistent and disproportionate impact on MSM, the National HIV/AIDS Strategy (NHAS) calls for a significant reprioritization of resources and attention to this community. “Without better addressing HIV among gay and bisexual men we will fail to achieve the goals of the NHAS,” observed Dr. Ronald Vadiserri, Deputy Assistant Secretary for Health, Infectious Diseases.
Fortunately, since the release of the NHAS in 2010, federal and nonfederal stakeholders alike have taken steps to respond to this call. NGMHAAD provides an opportunity for all of us to re-commit ourselves to ongoing efforts to respond to this need. Three key areas of action are: promoting HIV status awareness among MSM, fostering linkage to and retention in HIV care, and promoting primary HIV prevention.
Promoting HIV Status Awareness among Gay Men
Even though the overall percentage of HIV-positive MSM who knew of their HIV infection increased from 56% in 2008 to 66% in 2011, there are still too many who do not know they are living with HIV. In fact, a 2011 study in 20 major U.S. cities found that 18% of gay or bisexual men had HIV. That’s about 1 in 6 men. But, of those men, 33% did not know they had HIV. Clearly, more needs to be done to promote HIV testing and status awareness among gay men.
A clear call to action for all gay and bisexual men is: Know your status! Learn the basics about HIV testing, including the types of tests available. People who don’t know they have HIV cannot get the medicines they need to stay healthy and may infect others without knowing it. CDC recommends that all gay and bisexual men get tested for HIV at least once a year. Sexually active gay and bisexual men may benefit from more frequent testing (e.g., every 3 to 6 months).
Fostering Linkage to and Retention in HIV Care
Medical advances have transformed and extended the lives of many people living with HIV. Yet, still too few people living with HIV are successfully navigating the HIV care continuum and receiving the full benefits of modern HIV treatment. According to the CDC’s National HIV Prevention Progress Report, only 41.7% of HIV-diagnosed MSM had achieved a suppressed viral load in 2010. This signals clear room for improvement and suggests that we must redouble our efforts to address gaps in the HIV care continuum, including examining those social and structural barriers to sustained care and anti-retroviral adherence.
Our recent webinar, “Improving Health Outcomes for Black MSM along the HIV Care Continuum” and HRSA’s new resource and TA center to improve HIV services for Black MSM, are two examples of federal activities currently underway to better facilitate and sustain engagement in HIV care and treatment for MSM. In addition, the new HIV Treatment Works campaign launched by CDC last week provides many useful resources and tools that community-based organizations, faith-based organizations, healthcare providers, and others can use to tackle misconceptions about HIV and its treatment, break down barriers to care, and reach persons who have been diagnosed, but have not been linked to care, and to re‐engage those who have dropped out of care. Take a look and see how you or your organization might be able to make use of these messages and tools.
Promoting Primary HIV Prevention
While promoting HIV testing and linkage to and retention in HIV care is essential, we must not forget about primary HIV prevention for MSM of all races/ethnicities and all ages. New HIV infections are occurring among MSM of all ages. As we were reminded by last week’s observance of HIV/AIDS and Aging Awareness Day, 44% of the estimated 2,500 new HIV infections in the U.S. among people aged 55 and older were among MSM. So, it is important for all stakeholders to continue to promote HIV prevention across the lifespan.
In addition, certain populations continue to merit enhanced focus. We know, for example, that in 2010, young gay and bisexual men (ages 13-24) accounted for 72% of new HIV infections among all persons aged 13 to 24, and 30% of new infections among all gay and bisexual men. Even more alarming, from 2008 to 2010 new infections increased 20% among young black/African American gay and bisexual men in that age range. So it’s imperative that we find new and better ways to reach these young men with effective HIV prevention messages and interventions.
Among the resources available to promote HIV prevention among MSM is the CDC’s new Start Talking. Stop HIV. campaign that encourages open discussion about a range of HIV prevention strategies and related sexual health issues between gay male sex partners. Effective partner communication about HIV can reduce HIV transmission by supporting HIV testing, HIV status disclosure, condom use, and the use of medicines to prevent and treat HIV.
It will take all of us to reduce the impact of HIV among MSM and achieve the goals of the NHAS. For some of us, this includes personal action such as getting tested or talking to our partners more openly about HIV. For others, this involves encouraging and supporting gay men in our lives who are at risk for or living with HIV. As we pause to reflect on National Gay Men’s HIV/AIDS Awareness Day, won’t you commit to one new action—however great or small—today to help us meet that goal?