CDC: MSMs Hardest Hit by HIV, Syphilis

A new analysis from the Centers of Disease Control and Prevention reaffirms previously studies that show that younger MSMs (men who have sex with men), which includes gay and bisexual men, are particularly hard-hit by STDs like HIV and syphilis.

MSMs in America are 44 times more likely than men in the general population to become infected with HIV, and 40 times more likely than women in general, the U. S. Department of Health and Human Services announced. Syphilis rates for MSMs were 46 times greater than for other men, and 71 times greater than the rate of infection among women in general.

Among the factors for the disparities, the CDC noted, were an already-existing higher rate of HIV and syphilis among MSMs as a group, making it more likely that new infections affecting sexual partners within that demographic would result, combined with a lack of access to services geared toward prevention. A lack of safer sex precautions, such as condom use, and the ongoing stigmatization of HIV and AIDS made MSMs less likely to learn about and use safer sex precautions, or to get tested. As a result, MSMs were also less likely to get treated. Moreover, younger MSMs are less likely to engage in safer sex practices; in addition, there is a lack of education around syphilis, in terms of recognizing symptoms of the disease.

The survey results were presented during the CDC's 2010 National STD Prevention Conference. A press release on the new results explained, "While CDC data have shown for several years that gay and bisexual men make up the majority of new HIV and new syphilis infections, CDC has estimated the rates of these diseases for the first time based on new estimates of the size of the U.S. population of MSM." The newly formulated estimates show that abut 2% of men in the United States have sex with other men, though the margin for error could mean that the figure is as low as about 1.5% or as high as nearly 3%.

"Because disease rates account for differences in the size of populations being compared, rates provide a reliable method for assessing health disparities between populations," the release said.

"While the heavy toll of HIV and syphilis among gay and bisexual men has been long recognized, this analysis shows just how stark the health disparities are between this and other populations," said the director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Kevin Fenton, M.D. "It is clear that we will not be able to stop the U.S. HIV epidemic until every affected community, along with health officials nationwide, prioritize the needs of gay and bisexual men with HIV prevention efforts."

Added Fenton, "There is no single or simple solution for reducing HIV and syphilis rates among gay and bisexual men. We need intensified prevention efforts that are as diverse as the gay community itself. Solutions for young gay and bisexual men are especially critical, so that HIV does not inadvertently become a rite of passage for each new generation of gay men."

Advocacy Groups Respond

Advocacy groups responded to the data at once. A statement released by the National Alliance of State and Territorial AIDS Directors (NASTAD) read, "NASTAD and NCSD call on policy makers across the U.S. to provide leadership to stop the unnecessary spread of HIV and STDs by ensuring all gay men have access to preventive services, know their status and, when positive, are linked to quality care and treatment."

Gay Men's Health Crisis (GMHC) called the new figures "shocking," and noted, "Men who have sex with men (MSM) comprised 57% of people newly infected with HIV in 2006, according to the CDC, even though MSM are only 2% of the adult population. However, research shows that most gay men practice safer sex, and gay male couples are twice as likely as heterosexual couples to practice safer sex."

"The CDC's newly released statistics highlight how HIV continues to disproportionately affect gay men more than any other group in the U.S.," GMHC's CEO, Marjorie Hill, said. "Greater prevention efforts targeted toward this population are clearly needed. We commend President Obama for proposing a new $28 million initiative in his Fiscal Year 2011 budget to expand innovative HIV prevention with gay and bisexual men. It is time the CDC match the trends of the epidemic."

The group also called for a host of other initiatives, including sex ed programs for middle schoolers that present fact-based material regarding STD transmission, including disease risks associated with same-sex intimacy, and anti-bullying efforts and Gay-Straight Alliances (GSAs) in schools. "Such interventions correlate with lower HIV risk behavior among gay and bisexual men, and better health and school performance outcomes," GMHC stated.

The group also called for community outreach designed to encourage family acceptance of gay children, which the group said "is correlated with lower rates of gay and bisexual men's engagement in high-risk sexual behavior," as well as outreach and education to combat stigma associated with gays and HIV/AIDS.

"Unfortunately, these disparate rates of HIV and syphilis infection are not surprising," read a release from The National Minority AIDS Council. "The AIDS community was unable to adequately educate the public about HIV/AIDS during the eight years of the Bush Administration, which emphasized abstinence-only approaches to health education. Research has demonstrated that these methods do not to work, and limited discussion of condom use in federally-funded forums. These situations, compounded with existing social and cultural stigmas around sexuality--and homosexuality in particular--helped fuel the increase in HIV and syphilis incidence in the MSM community."

Earlier research suggested that while GLBT youth are more susceptible to STD infection, with gay men and especially gay couples practicing safer sex at a higher rate than the general population, GLBT youth who are also racial minorities have an even higher incidence of HIV infection.

NMAC also called for higher funding levels that would be adequate to the task of educating the public, and more research into "whether age, race, sexual practices and regional variances are factors in HIV and syphilis transmission." NMAC also called for greater involvement of LGBTs by government agencies tasked with addressing disease prevention. Moreover, "Everyone committed to addressing HIV/AIDS needs to prioritize gay men," NMAC said. "This includes LGBT organizations, elected officials, social clubs, policymakers, businesses, social justice agencies, businesses and the general public. This is not just a problem impacting MSM; it is everyone's problem."

The CDC's media release noted that the CDC is heavily involved in prevention targeting MSMs, including gays and bisexuals. "CDC provides funding to health departments and community-based organizations throughout the nation to implement proven behavior-change programs for MSM and will soon expand a successful HIV testing initiative to reach more gay and bisexual men," the release stated. "Additionally, CDC is implementing an updated National Syphilis Elimination Plan in cities where MSM have been hardest hit by the disease, and will release an updated HIV prevention strategic plan within the next year to support the President's upcoming National HIV/AIDS Strategy. CDC officials note that the new analysis released today underscores the importance of the HIV and STD prevention efforts targeting gay and bisexual men recently announced as part of the President's fiscal year 2011 budget proposal."