HIV Epidemic Continues to Surge in Some Populations

HIV infection rate among gay and bisexual men remains a problem.

Despite a decrease in HIV infection rates among heterosexual men and women, the epidemic is still continuing to run rampant in gay men.

According to the US Centers for Disease Control and Preventiona 20-year-old gay black man has a 50% chance of contracting HIV in his lifetime. In a previous study, a team of researchers issued a call to action that laid out an ambitious plan to reduce the HIV epidemic in the gay male community.

Researchers set targets for funding, policy reform, and improvement in HIV prevention and treatment services. This included expanded access to the highly effective pre-exposure prophylaxis (PrEP).

In the current study published in The Lancet, the same team of researchers set out to determine what elements of their 2012 call to action have been achieved.

“While HIV rates have flattened overall in recent years, we’re really concerned that the HIV epidemic is continuing among gay men and we’re going in the wrong direction,” said lead study author Chris Beyrer, MD, MPH. “It’s a tragic situation and it’s painful that the history of AIDS is looking like its future, but that’s actually where we are. But the first step in taking on a problem is recognizing and articulating it and we’ve really don’t that here.”

In the study, researchers analyzed published medical research from January 2007 through October 2015. The results of the study revealed that a new $100 million investment fund from the US President’s Emergency Plan for AIDS Relief (PEPFAR) had been set up for key populations affected by the virus, including gay and bisexual men.

Researchers also found there were multiple nations who approved or initiated PrEP projects; however, the findings also indicate that the continued high rates of HIV amongst gay men is partly due to PrEP being unavailable to people who are in need of it most, as well as the backsliding of civil liberties for the gay community in Nigeria, Russia, and Uganda.

Although PrEP is available in the United States, authors noted that it is only accessible to people whose health insurance will cover it. Furthermore, there are racial and economic disparities among patients who end up actually receiving PrEP.

For example, in low-income, predominately minority communities, especially the South where many states don’t offer Medicaid expanded access, the epidemic is thriving. There is also an issue of discrimination against the gay community, with many nations that still have discriminatory policies in place making it potentially dangerous to get tested for HIV.

“Stigma and discrimination continue to play a very big role in these epidemics,” Beyrer said. “In many countries, these men are just not welcome in health clinics and the fear of discrimination stands in the way of not only treatment, but even just the testing that can go a long way toward stemming the spread of disease. The global epidemic of HIV in gay men is ongoing and efforts to address it remain insufficient. This must change if we are ever to truly achieve an AIDS-free generation.”