Gay men and HIV/AIDS

In many countries, men who have sex with men have been heavily affected by HIV and AIDS. HIV prevalence among men who have sex with men has been found to be as high as 25% in Ghana, 30% in Jamaica, 43% in coastal Kenya and 25% in Thailand.12 In the USA, Canada, Australia, New Zealand and many parts of Western Europe, more people have become infected with HIV through male-male sex than through any other transmission route.13

On the basis of these figures gay men have been stigmatised for being promiscuous and taking unnecessary sexual risks. However, evidence suggests that on the contrary gay men have been very sensitive and responsive in regard to safer sex promotion, which has been shown to significantly increase condom use among men who have sex with men.14 15 The high rate of infection reflects a complex relationship between a lack of information, particularly in the early days of the epidemic, patterns of sexual activity, the risk of infection and prevalence of the virus among gay men.

In response to the global AIDS epidemic and increased awareness about the high HIV risks of anal sex, many gay men who previously had penetrative sex altered their behaviour.16 17 However, HIV infection rates among men who have sex with men in many Western countries have increased in recent years, which can be attributed partly to increases in high risk sexual behaviours such as anal sex.18 19 Maintaining safer sex practices requires the continued reinforcement of HIV prevention messages and services, which are failing to reach a great number of gay men around the world.20 It is also suggested that the availability and effectiveness of antiretroviral drugs has led many gay men to underestimate the consequences of HIV infection.21 The urgent need for HIV prevention among men who have sex with men is not just apparent in Western countries; sex between men is a primary HIV transmission route in Latin America, and there is growing evidence that male-male HIV transmission is a significant problem in Eastern Europe, Asia and Africa.